It's pretty common when your skin won't stop flaring to be told that you might have salicylate sensitivity.
It's become an (unfortunately) popular test for people with eczema.
I get asked a lot about it and whether I think that people should follow it. Being that I'm not a fan of restrictive elimination diets for chronic skin rash issues, I wanted to share my two cents.
The truth is — salicylate-rich foods are VERY healthy.
They're not bad for you… and reacting to them often means something entirely different than “You should avoid them.”
In fact, outright avoiding salicylate-rich foods if you don't have a salicylate allergy is not a smart move. (And I mean a legit allergy… not a sensitivity.)
It puts you at great risk for nutrient deficiencies and can make you unnecessarily miserable in the process.
In today's episode, I'm sharing what a “Salicylate sensitivity” means to me AND what I do about it.
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In this episode:
- What are salicylates and where are they found?
- Using a low salicylate diet for reducing skin rash flares
- What does being sensitive to salicylate-rich foods mean?
- Salicylate connection to your liver
- What nutrients + foods help your liver process salicylates
Quotes:
Salicylates are (for the most part) naturally-occurring in plants (fruits & veggies) with one exception- Aspirin (and any drugs that contain it) contain salicylic acid as the main ingredient.
Being sensitive to salicylates means that you don't have a gut problem… you have a liver detoxification problem.
097: Are Your Rashes Triggered By A Salicylate Sensitivity? [FULL TRANSCRIPT]
Welcome back to episode #97 of the Healthy Skin Show!
In today's episode, I wanted to talk to you about phytochemicals called salicylates.
If you've been dealing with skin rashes for some time, you may have heard of the low Salicylate diet and some people may have suggested that you give it a try.
The question is, is it worth it to give the diet a try and what does reacting to salicylates really mean?
If you can't tolerate salicylates, you're probably going to be surprised because it's not what most people think.
What Are Salicylates?
Before we get ahead of ourselves, let's talk about what salicylates are!
Salicylates are naturally-occurring phytochemicals that exist in plants. Some plant foods have a higher quantity of Salicylates in them.
The amount of salicylates present is food is not the result of cooking a certain type of food for a period of time.
Nor is it something that is sprayed on the plant while it's being cultivated by a farmer like fertilizer or some sort of herbicides. It is naturally-occurring inside of the plant itself.
Take white potatoes as an example — they are considered to be high in salicylates! One exception many people don't know is that the salicylates are concentrated in the skin. Removing the skin actually drops the salicylate content of the potato flesh to a low level.
When you look online, some websites will claim that salicylates are really bad for you or even toxic! In some instances, I've seen websites claim that salicylates will kill you… and that is not the case.
Salicylates are (for the most part) naturally-occurring in plants (fruits & veggies) with one exception. Aspirin (and any drugs that contain aspirin) contain salicylic acid as its main ingredient.
Aspirin is the pharmaceutical version of the botanical agent called Willow bark. Willow bark, when digested in your gut, produces salicylic acid.
Are Salicylates In Food Bad For You (And Your Rashes)?
So if salicylic acid or salicylates are naturally occurring, then can they be bad for you?
Well, it is possible to have a salicylate allergy potentially ending up with anaphylaxis. But that's a very small number of people.
When we discuss salicylates in terms of skin rashes and dietary changes, we're talking about salicylate sensitivity or salicylate intolerance.
And this is where things get a bit murky because being sensitive to salicylates means that you don't have a gut problem.
You have a liver detoxification problem.
We're used to thinking of intolerances and sensitivities as a food-digestive-gut problem, but in this particular case, that's not accurate.
Salicylates are not proteins that would normally be the culprit behind a sensitivity or intolerance. They're not processed in the digestive system in the same way that proteins typically are.
Because they're a phytochemical., they go to the liver which will end up processing them.
So if you react to salicylates, it's a clue that your liver needs support… not that you have a gut problem.
This also does not mean that your liver needs to be detoxed. There are natural detoxification pathways in your liver ready and able to do the task at hand.
If you're not clear on your liver's Phase II Detox pathways, check out episode #47 where I dive pretty deep into the whole process of liver detoxification.
Your Liver Deals With Salicylates — Not Your Gut
What is most imperative for you to know is that any salicylates you eat head straight to your liver. Your liver sends them down Phase II detox pathways in order to be processed.
Most of the salicylate load is processed through the glycine pathway, which requires glycine and vitamin B6.
A smaller portion is processed through the glucuronidation pathway.
It's not that your gut can't handle the salicylates in the foods which is what most people think.
Instead, if you seem to have a skin rash flare-up after consuming high salicylate foods, it's a clear sign that your liver needs support.
It doesn't mean that you necessarily need to remove high Salicylate foods. The low salicylate diet is in and of itself is a bandaid.
It's not addressing the root cause of the problem which is your liver doesn't have the nutrients available to it to process the salicylates in the first place.
See, these pathways in the liver are nutrient-dependent. If you don't have enough of these specific nutrients available for the liver to work with, detox pathways slow down to a snail's pace.
Another problem with the low salicylate diet is that it's very restrictive.
It's pretty common for my chronic skin rash clients to be nutrient-depleted.
By unnecessarily cutting out so many foods, you reduce diversity and nutrient-density. And as a result, you can find yourself in a bit of a jam.
Unsurprisingly, many clients of mine have tried a low salicylate diet and seen next to no improvement at all.
If that's been your experience, then salicylates probably aren't your problem and I would recommend beginning to add them back into your diet.
[Nervous about reintroducing foods that you cut out WITHOUT triggering a skin rash flare? READ MORE HERE]
Though it's not common, there can be instances where someone may have some genetic SNPs that impact the functioning of these liver enzymes.
If you believe that you might have some sort of SNP impacting the Phase II Detox pathways, it may be worthwhile to sit down with a doctor who understands genetic information.
How To Support Your Liver If You Have Salicylate Sensitivity
My recommendation if you believe that you have salicylate sensitivity is to focus on supporting your phase II liver detoxification pathways.
The particular pathways in question include the glycine pathway and glucuronidation.
First, glycine and vitamin B6 are necessary to support the Glycine pathway.
As for vitamin B6, the active form is preferable typically called P5P.
Before supplementing with higher doses of Vitamin B6, consult with a practitioner. You can over-supplement B6 and cause some very unpleasant symptoms.
Second, certain foods may be helpful to support proper glucuronidation. Cruciferous vegetables and citrus are great options to add to your diet daily.
I realize that citrus can be a trigger for people with skin rashes as some find it can trigger a flare.
And you can also try adding in a daily cup of rooibos tea (which is naturally caffeine-free).
Unfortunately, there isn't a lot of research out there that exactly pinpoints the best food to support glucuronidation. I feel like it's safe to say that more research is needed!
In some instances, there's conflicting information about what supports glucuronidation and what slows it down. Studies done in test tubes and human beings haven't always matched up.
I have had good luck supporting clients who are sensitive to salicylates with supplementation. I recognize that some people prefer to deal with health issues through diet. You can try adding in some of these foods and see if this makes an improvement.
If not, you may need more than what your diet provides from a nutritional perspective.
And if you're not properly absorbing the nutrients, supplementation may be warranted. THIS is one of the Phase II detox support supplement that I use in my clinical practice.
Got any questions or comments? Leave them below so we can keep the conversation going!
If someone you know has been thinking that they've got to eliminate all these foods and they are freaking out…
Or they're really miserable on a low salicylate diet (especially that they haven't seen any results on it), share this episode with them.
This could be really helpful for them to realize that a low salicylate diet is not necessary to help them support their skin.
Thank you so much for tuning in and I look forward to seeing you in the next episode!
REFERENCES
https://www.hindawi.com/journals/jnme/2015/760689/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4414920/
I found this very interesting. My cousin’s son has eczema that she believes to be from salicylates.He is on a low salicylate diet and his eczema has cleared up. Would the things you recommend in this episode still apply to him?
absolutely! Removing the foods are only band-aiding the problem since it’s the liver that processes this phytochemical. As for dosing, you’d need to speak with someone who works with children (depending on his age) like http://www.jennifercarynbrand.com. The amounts typically needed for kids and adults are much different.
I was wondering if this is true with amines as well? If my daughter reacts to amines is this also a liver problem?
No, this is a totally different issue unfortunately. From my understanding, aminos are typically broken down by the MAO enzyme that is located in the gut. Amines are breakdown products of proteins… salicylates are phytochemicals. So they’re very different things.
Thank you! I had broke out in a rash 2 years ago and no one could figure it out, it lasted 6mths. I have the slow Phase II you speak of. Back then I had a Acupunturiest tell me I was sensitive to salicylates but dismissed it as I thought it was a “fad” thing.
I ended up treating it as candida and did some Diatmoacous Earth and antifungals and it cleared. But recently menopause has brought on conspipation so I started prunes. They are very tasty, but a small itchy rash on my arm is developing. ??Salicylates??
Since most things I was told to try for the pathway detox I was too sensitive to, the ND and DO said I just have to manage with food. I don’t even know how to do that.
Any suggestions for how to get the salycylates detoxed sooner, or how to help that pathway. I had heard K2 (butter) I tried P5P and that was one I had sensitivities to.
I enjoyed reading your excellent and very informative article on salicylates.
Sadly, I have been battling eczema my whole life. I have noticed throughout my life,
whenever I have lost weight on a more restrictive diet, my eczema improves dramatically.
I now put this down to cutting out a large variety of high salicylate foods.
Your liver connection is correct, because whenever I have tried to detox my liver in the past, my eczema goes off the charts and I have to stop.
Lately, I have been experimenting with eating a low salicylate diet and my skin has improved and my horrible, horrible tinnitus has dropped. I am drinking weak Rooibush tea to survive the lack of something stable to drink. Decaf coffee seems to be OK. I have read a lot about oxalates and have removed a lot of these foods too. I have researched to see if Rooibush tea is OK but information varies from good to bad.
It is a restrictive diet, but, the relief is worth it one hundred fold. I am going to research more on this subject concerning the role of the liver and supplements, but, with caution because of my reaction to liver detoxing.
Thank you so much Jennifer.
Greetings from Australia.
Hi Rhonda, it’s pretty common for the Phase 2 pathways of liver detox to be overwhelmed in clients I work with in my private practice. It’s not that the liver needs detoxing… because the liver already does that itself. Instead, it needs the nutrients (that your body doesn’t make) to make sure that Phase 2 liver detox can run properly. Without enough of these specific nutrients, the pathways slow. So that’s why salicylates can be an issue because they are processed through Phase 2 detox. By better supporting Phase 2, it allows salicylates to be processed more effectively so that you don’t need to avoid salicylate-rich foods. Hope that helps!
I’ve been suffering for about 5 months with skin itching over the entire body. Unlike the eczema you most often read about on the internet, my skin is not noticeably dry or scaly. The skin itching problem is often worst at night and in bed. Since blood tests indicate dust mite allergy I have been looking at that as a suspected cause. However some foods seem to make the problem worse and they are usually either high oxalate foods or high salicylate foods. Sometimes my skin itches without visible rashes. Sometimes it turns noticeably red when itching.
I routinely take glycine as a supplement as well as B vitamins but that hasn’t fixed the problem whatever it is. I’m well aware that our produce is often badly contaminated with glyphosate which interferes with glycine metabolism.
Hi Kelly, I can understand your frustration and where I think you’re getting stuck here is in thinking that glycine and B6 alone will solve this problem. However if there is a constant overload to the glycine pathway (which can come from just more than salicylate foods) and skin itching is a predominant complaint, those 2 nutrients alone won’t solve your problem. I’d recommend you looking deeper and consider that you could have hidden infections or gut dysbiosis issues that are driving this (and in turn overloading your glycine pathway at the same time).
Also, do your point about glyphosate and glycine… that’s a very controversial idea at this point even amongst functional doctors who are leaders in the field. While there is speculation that glyphosate could interfere with liver detox — it would be specifically impacting Phase 1 (also known as the P450 Cytochrome system) of liver detox which may be upregulated (or sped up). However, I couldn’t find any mention of its impact on Phase 2 liver detox which includes the glycine pathways. This is an important distinction because Phase 1 and Phase 2 are very different pathways and should not be lumped into one category.
If you want to read more about glyphosate and glycine, I’d recommend this article from Dr. Carnahan which provides a balanced response and criticism to the glyphosate/glycine idea — https://www.jillcarnahan.com/2019/07/22/glyphosate-is-being-inserted-into-your-proteins-by-mistake/
Hi Jennifer, I have eczema since one year now and I suspect having a salicylate sensitivity/intolerance because when I leave out salicylate-rich foods, I see a fast improvement of my skin. Unfortunately, as you say, the low salicylate diet is very restrictive (especially because I am reacting sensitive to histamine too) and I can’t keep up this diet. I am wondering if Vitamine B6 (which I have a lack of) and glycine can heal my skin and if so, how long does the process take that the liver functions properly again.
Is there another thing I can do to support the liver and speed up the healing?
I would really looking forward to get an answer.
Thank you in advance!
Kindly regards
Anne
Hi Anne, I’d speak with your practitioner to help you sort out a dosage of B6 since too much can cause issues. It generally depends on a variety of factors… the salicylates aren’t usually the only thing slowing down this liver detox pathway. Until you fully deal with everything that’s overloading it, you will likely have to continue supporting this pathway.
Hello Jennifer,
I am going to supplement with glycine for my Sal intol, but I need advice on dosage. The link to your recommended supplement is broken (at least at my end it is) I’m taking a b6 p5p supp, I would also like to know what dosage you’d recommend for that too please? Thank you.
Hi Jessica, you can try taking 3-5g of glycine 1-2x/day. As for the P5P, 5-10 mg/day is probably a safe amount (though I preface that statement with — I’m not your practitioner and don’t know your case so I have no idea if that’s appropriate for you). I cannot recommend a higher dose without more detailed testing since there can be negative consequences from taking too much for your body. You’d need to work with someone to have dosages refined for you. But hopefully that will give you a starting point.
Hello jennifer,your article is very interesting and informative,I got alot out of it thank you …I have had problems with salicylates for years now..I develop itchy rashes and hives on my neck and face from eating any foods that are not ” low” salicylate “….yet I also develop a burning red face and itching from consuming gluten/wheat and potassium sorbate..I have tested negative for celiac disease….could this be more than just a liver detoxifying problem for me…
Hi Katie, so the salicylate issue is a phase 2 liver detox issue of not having enough nutrients like Glycine and B6 to process salicylates.
The issue with gluten/wheat and potassium sorbate are totally different issues. I generally recommend clients avoid gluten to begin with because it increases gut permeability. It’s possible that you could be sensitive to both of these things… but it’s not a liver detox issue.
Hi! i’m not sure of this page is still active but i have been told i might have a salicylate intolerance / allergy bc of symptoms i have and have recently been trying to sort my skin as it’s making me very low confidence (really red near the nose / acne / dark circles) i’m wondering if salicylate can cause this? i’m just really confused on what next step to take. thank you for your website it’s really helpful 🙂
If you believe you have a salicylate issue, you can either try supplementing with B6 and Glycine as I’ve mentioned in the article. Or test out a low salicylate diet for 2-3 weeks.
I stop stop breathing because of salicylates , and im not alone. If you actually have this problem you know it is not just rashes . Please be careful about your advice because for people who actually have is allergy know alot different to what you are saying . The low sal diet you say is restrictive is a lifesaver litterly.It can takes months on a low sal diet and cutting out shampoo conditioner soap toothpaste anything you put on your skin . There are sals everywhere … popping pills if you are still putting sals on you skin won’t do anything. Please ….This allergy can be life threatening dont mess with something you really dont understand and only just read about.
Hi Melynda, I appreciate your desire to emphasize that an allergy to salicylates can be life-threatening, but I did actually mention that in the article. This article is geared towards someone with a sensitivity or intolerance (unfortunately both terms are thrown around to indicate a reaction to salicylates that is NOT an allergy). An allergy is an IgE response (and actually is NOT a sensitivity nor an intolerance) that absolutely can be life-threatening. Most people in this community do not have this allergy which is why the article is focused on someone with a “sensitivity” and what that actually means in terms of diet and biochemistry. But yes, for someone with an actual IgE allergy, strict avoidance of salicylates will be very crucial!
Would you be able to provide the percentage of RDA of B6 to take. I see some supplements contain nearly 6000% of the RDA, and others much less. I understand the advice to ask a physician, but for a short-term test I may just purchase some and take a wait and see approach. Thank you!
Hi David, unfortunately the RDA is not a useful recommendation to go by in terms of supplementation. It’s frankly a very meaningless number to go by for pretty much any nutrient. It often causes people to be afraid to take certain things because it is perceived as being too much.
That’s why my general suggestion is typically 10-15mg/day of B6 if you’re doing this on your own. Most of my clients are taking more, but their doses are based on their labs.