Tuesday, September 22, 2009

Hidden Sulfites

Biotin (Vitamin B7) - is an incredibly strong sulfite

Corn Syrup: 1/2 cup is about 1,5000 micrograms


Sulfur Dioxide (which breaks down and produces sulfites) occurs in:
  • Taurine (in Red Bull)
  • Carmel Color
  • 6 out of the 7 FD&C colors
  • Aspartame - artificial sweetener
My husband's allergic reaction to sulfites ranges from a mild allergic reaction (swollen lips, pale face, bright red splotches) to a severe GI response (heart burn, throat constriction, inability to speak). If he takes a drink of Red Bull or even chews a piece of gum that contains aspartame he will have immediate heartburn. This is his body's warning sign - it is telling him "I cannot handle this if you continue to consume it I will shut down".

In early 1985 the Food & Drug Administration created the Adverse Reaction Monitoring System (ARMS) to better monitor the effects of additives and deal with consumer complaints. ARMS has received nearly 6,000 complaints since its inception. Aspartame and sulfite preservatives top the list, accounting for almost 95 percent of all complaints (SOURCE).

To report an allergic reaction to the FDA contact: (313) 393-8189 (SOURCE).

Monday, September 21, 2009

Medications & Sulfites

Yes it is discerning to learn that even medications have sulfites (either as a by product, naturally occurring, or as preservative). Here is a list of medications that contain sulfites (SOURCE).

Bronchodilator solutions for asthma
  • Adrenalin chloride 1:1000 concentration
  • Alupent
  • Bronkosol
  • Isuprel hydrochloride solution
  • Micronefrin
  • Vaponefrin

Topical eye drops

  • Pred-Mild
  • Pred-Forte
  • Sulfacetamide
  • Prednisol
  • dexamethasone)

Injectable medications

  • Amikacin - an antibiotic
  • Aramine - an antishock agent
  • Betamethasone phosphate (Celestone) - a corticosteroid
  • Chloropromazine (Thorazine)
  • Dexamethasone phosphate (Decadron) - a corticosteriod and ophthalmic drops
  • Dopamine
  • Epinephrine (Adrenaline, Ana-Kit, Epi-Pen)
  • Garamycin - an antibiotic
  • Gentamycin
  • Intropin - an antishock agent
  • Isoetharine HCl
  • Isoproterenol
  • Hydrocortisone
  • Hydrocortone - a corticosteriod
  • Lidocaine with epinephrine (Xylocaine) - a local anesthetic
  • Meperidine (Demerol) - an analgesic
  • Metarminol
  • Nebcin - an antibiotic
  • Norepinephrine (Levophed) - an antishock agent
  • Pred Mild - ophthalmic drops
  • Pred Forte - opthalmic drops
  • Prednisolone - opthalmic drops
  • Procaine (Novocaine) - a local anesthetic
  • Prochloroperazine (Compazine)
  • Promethazine (Phenergan)
  • Pronestyle - an antiarrhythmic
  • Solutions for total parenteral nutrition and dialysis
  • Sulfacetamide - ophthalmic drops
  • Tobramycin
  • Xylocain - preserved with epinephrine
  • Trimovate
  • Timodine
It is advisable if you have a strong allergic reaction to sulfites that you discuss the use of an Epi-pen in the event of an emergency with your doctor. Each 0.3 mL in EpiPen contains 0.5 mg sodium metabisulfite (SOURCE). You may be told to request individual vials of epinephrine to avoid the sulfite preservative, but in July 2009 we were informed by Dr. Steven Wise (whom we found through the American Academy of Allergy Asthma & Immunology) that even individual doses are preserved with sulfites. Dr. Wise went on to say that and Epi-pen is what would be administered at the hospital and he [my husband] should only use it if he cannot breathe and is already on his way to the emergency.

So do we have an Epi-pen? Yes. Have we ever had to use it? Thankfully, no.

In Fall 2009 my husband had a procedure where the Doctor applied Xylocain (even after repeated warnings that my husband was allergic) to his skin. The Doctor even joked "see nothing happened". Well it took about seven hours before my husbands throat began to feel tight and luckily it did not progress any further than that. He could still speak and swallow so he took a benedryl. The good news is now we know what kind of a reaction he will have to epinephrine applied to the skin. The bad news is that we know it will be a more severe and quick reaction if he must actually inject the Epi-pen.

In August 2010 my husband went to a new doctor because our insurance change and she

Wednesday, September 16, 2009

Sulfite Testing

I feel it is only appropriate to start this blog off with the 400 pound elephant in the room - is it possible to test for a sulfite allergy? The answer is yes, but you may have difficulty finding a doctor knowledgeable enough about sulfites to perform the test at confidence level where you feel safe. If you are lucky enough to live near La Jolla, California you should contact Dr. Ronald Simmon of the Scripps Research Foundation who is one of the only experts in sulfite sensitivity. Sulfite testing should only be performed by a doctor, under close observation and in an appropriate setting. You will need to provide written informed consent prior to testing and should construct a Living Will in the event of an emergency.

Sulfite Skin Testing
Two skin pricks (at 1 and 10 mg/ml) are administered. You will be observed to see if there is a consistent spectrum of reaction. If you have a positive reaction they may proceed with an oral challenge.

Dose Challenge
Double-blind oral challenge with (usually) sodium metabisulfite. You will be observed to see if there s a consistent spectrum of reaction.

A Note of Caution - Delayed Hypersensitivity Reactions
Some people have reported a delayed allergic reaction that occurs 8 - 12 hours after ingestion. If you participate in any sulfite testing you should be under observation for the next 24 hours in the event of a delayed reaction.

The prevailing stance is that the usual adverse reaction to sulfites is almost always asthmatic - but there are exceptions to that rule. If you know that you had allergic reaction symptoms (heart burn/upset stomach/tight throat) after eating something that contains sulfites listen to your body. If you don't think your doctor is taking your concerns seriously - find another one!