Salicylate sensitivity

Salicylate sensitivity is any adverse effect that occurs when a usual amount of salicylate is ingested. People with salicylate intolerance are unable to consume a normal amount of salicylate without adverse effects. Salicylate sensitivity differs from salicylism, which occurs when an individual takes an overdose of salicylates. Salicylate overdose can occur in people without salicylate sensitivity, and can be deadly if untreated. For more information, see aspirin poisoning. Salicylates are derivatives of salicylic acid that occur naturally in plants and serve as a natural immune hormone and preservative, protecting the plants against diseases, insects, fungi, and harmful bacteria. Salicylates can also be found in many medications, perfumes and preservatives. Both natural and synthetic salicylates can cause health problems in anyone when consumed in large doses. But for those who are salicylate intolerant, even small doses of salicylate can cause adverse reactions. The most common symptoms of salicylate sensitivity are: Stomach discomfort or diarrhea Itchy skin, hives or rashes Asthma and other breathing difficulties Rhinitis, sinusitis, nasal polyps Pseudoanaphylaxis Angioedema Headaches Bed wetting or urgency to urinate Changes in skin color/skin discoloration Fatigue Sore, itchy, puffy or burning eyes Hyperactivity Memory loss and poor concentration Depression Tinnitus ringing of the ears Swelling of hands, feet, eyelids, face and/or lips Asthma and nasal polyps are also symptoms of aspirin-exacerbated respiratory disease (AERD, Samter's Triad), which is not believed to be caused by dietary salicylates. There is no laboratory test for salicylate sensitivity. Typically testing is done by an "elimination challenge," to see if symptoms improve, or "provocative challenge," which intends to induce a controlled reaction as a means of confirming diagnosis. During provocative challenge, the person is given incrementally higher doses of salicylates, usually aspirin, under medical supervision, until either symptoms appear or the likelihood of symptoms appearing is ruled out.