Hippocrates used salicylates, the chemical basis of aspirin, to treat pain and fever in the fifth century B.C. He used willow tree bark medicinally, as did Native Americans and other cultures around the globe, though it would be many centuries before anyone understood how aspirin worked. We now know it reduces swelling, fever and other forms of inflammation by decreasing the production of hormone-like prostaglandins. People can develop intolerance to aspirin, unfortunately – and to other salicylates, including those occurring naturally in wholesome foods.
Aspirin Intolerance
Physical reactions to aspirin are common, according to James T.C. Li, an asthma and allergy specialist with the Mayo Clinic. True allergic or immune-system reactions, resulting in life-threatening anaphylactic shock, are rare but do occur. In most cases people develop symptoms of sensitivity or intolerance to aspirin. Physical reactions can range from fairly mild to severe. The most common immediate responses are asthmatic and involve the respiratory system, and include wheezing and shortness of breath. Longer term, chronic sinusitis, chronic hives and nasal polyps requiring surgery may develop. Hay fever symptoms from runny nose to itchy eyes may accompany milder reactions.
Salicylate Sensitivity
Because salicylates are chemically very similar to aspirin, they can trigger an allergic reaction and anaphylaxis in people with aspirin allergy. High-salicylate fruits and other foods and substances that contain salicylates can trigger intolerance too – and symptoms that range from mild to severe -- especially in but not necessarily only in people who are sensitive to aspirin. What can make salicylate baffling is that people with aspirin or salicylate sensitivity may react to some foods or products high in salicylates but not others. The only way to know which might be a problem is to try them.
High-Salicylate Foods
Biologists think salicylatyes occur in many plants – and especially in plants’ fruits, which carry seed to produce the next generation – to help repel insect attacks and protect against bacteria and fungi. Many berries are very high in salicylates, including blackberry, black currant, blueberry, boysenberry, loganberry and youngberry. Red high-salicylate fruits include cherry, cranberry, currant, raspberry, red currant and strawberry. Other possible trigger fruits for aspirin and salicylate sensitivity include apricots, dates, grapes and raisins, guava, pineapple and plums and prunes, plus some orange citrus: oranges, tangelos and tangerines. Tomatoes and tomato-based foods, peppers and even olives and radishes may cause problems. The Auckland Allergy Clinic, locates in the Resources section of this article, lists many other high-salicylate substances to avoid.
Treatment
For people with a true aspirin allergy, which is a life-threatening condition, complete avoidance of aspirin, all non-steroidal anti-inflammatory drugs (NSAIDS), all other drugs or substances that contain aspirin and all salicylate products is the only possible treatment. Carry a self-injecting dose of epinephrine at all times, because you never know when inadvertent exposure might occur. Avoidance is also the best course of action for those who suffer from aspirin sensitivity – especially if symptoms include severe asthma – but corticosteroid drugs, including inhalers, are effective in a pinch. Increased biological exposure to aspirin and related substances, under a doctor’s care can help inactivate aspirin and salicylate sensitivities – and shrink nasal polyps, to avoid surgery.
References
- Mayo Clinic; I Think I May Have an Aspirin Allergy. What Are the Symptoms?; James T.C. Li; November 2010
- U.S. National Library of Medicine; Deutscher Arzte-Verlag GmbH -- Salicylate Intolerance; Hanns-Wolf Baenkler; October 2007
- American Academy of Allergy, Asthma & Immunology; Medications and Drug Allergic Reactions -- Tips to Remember
- Auckland Allergy Clinic; Salicylate Sensitivity; September 2001
