FOOD INTOLERANCE NETWORK FACTSHEET
Sorbates (preservatives 200-203)
This factsheet is intended for people who are already following a diet that is free of additives and low in salicylates, amines and flavour enhancers (failsafe).
Until recently, sorbates didn't bother failsafers because they weren't in any foods we could eat. However, if you read labels regularly, you will have noticed that sorbate preservatives are creeping into all kinds of foods, mostly as sorbic acid (200) and potassium sorbate (202).
Sorbic acid and potassium sorbate are used in a number of foods describing themselves as ' natural'. Although sorbates occur naturally in some fruits, for commercial use they are manufactured synthetically, so it is misleading to describe them as 'natural'. They are one of the five groups of preservatives listed in the RPA Elimination Diet to be avoided, along with benzoates, sulphites, nitrates/nitrites and propionates.
Sorbates have been associated with asthma, eczema, contact dermatitis, eye irritation, nasal irritation and burning mouth syndrome (in medical journals, see below) and the full range of food intolerance reactions including irritable bowel symptoms and children's behaviour problems.
- Philadelphia Cream Cheese (in blocks or tubs both now free of sorbates)
- Plain cottage cheese (with sorbate preservative)
- Reduced fat spreads (read label carefully for other additives)
- Queen brand Writing Icing with natural colours and flavours (seemingly all natural)
- Woolworths fresh pikelets
- Golden Pikelet Bites, Pikelets and pancakes
- Mr Lee's Kitchen Fresh rice noodles
- Double Merino Brand Shanghai Wonton skins (wheat flour, water, salt, 202)
- Double Merino Brand Gow gee pastry (same ingredients as above)
- Bread (e.g. Tip Top Muffins, also contain vinegar)
- Flat breads and tortillas (e.g. Old El Paso, also contain other preservatives)
- Bakery products such as cakes, pikelets, pancakes, waffle
- Flour products such as fresh pasta and noodles
- Cheese, Cream cheese, cottage cheese, cheese slices, cheese sticks
- Reduced fat cheeses and spreads
- Drinks including fruit juices, cordial, brewed soft drinks, wine
- Fruit syrups, preserved figs, cherries
- Margarines, spreads and dips
Sorbates are also widely used in pharmaceuticals including tablets, syrups, eye, ear and nose drops, contact lens solutions; lotions and cosmetics; dermatitis or other local irritation caused by these products is well documented
 200: The Great Philly Incident (August 2007)
Over the course of a couple of weeks in September 2006, our daughter became progressively more lethargic, withdrawn and emotionally fragile (cried easily for no particular reason). She was getting upset quickly in a teary way and blowing things out of proportion. After the holidays her teacher commented she thought it was unusual for Lucy to be so lethargic, quiet, teary, keeping to herself and not playing, not interacting. As an example, the teacher had asked all the kids to pack away the books. Normally Lucy would do this fairly promptly but she just sat there mesmerised in her own little world and didn't appear to hear the teacher. The teacher came over to her after all the other kids had left the area of the classroom and said gently to her 'Lucy it's time to pack away now please.' Lucy just dissolved into tears and it took a while for her to regain composure. The teacher said it was very out of the ordinary for Lucy who was usually full of energy, vibrant, bubbly, friendly and always very, very happy.
That night, after ruling out illness, and with much careful consideration and dissection of her diet and environment, I discovered from Sue's website that Kraft had introduced preservatives (sorbic acid, 200) in the tubs of Philadelphia Cream Cheese tubs. Lucy eats this on a daily basis on her sandwiches and sometimes as a dip as she had done for years. I rang Kraft and they informed me that they had only just started putting this ingredient in a couple of months earlier. After checking old containers I figured that she had consumed at least two tubs. The change in her demeanour had been gradual but still clearly noticeable by us as well as her teachers as this was not the Lucy we knew. Once we switched to the preservative free Philly blocks, she became 'better' within a few days and had returned to her usual energetic, happy, amenable self within a week. I now check labels every time, even if it is something I have bought many times before. – by email
 202: Potassium sorbate makes my son clingy, crying (June 2009)
I have a 6 year old son who I already knew was intolerant to some foods. He has periods of eczema (which we have been able to control with his diet) and we have avoided these things for years. Luckily, because he was basically born with eczema, I had been very careful about introducing foods. I started giving him crumpets for breakfast when he was 2. He would be fine after eating them, however when he woke from his sleep he would be screaming and hitting me, very violent and uncontrollable. I initially thought it was hunger, as I found that when I gave him something to eat he would calm down. Anyway, to cut a long story short. I found out about preservative 282 and cut it out completely. He was normal again!!
On and off over the years I discovered other things that affected him, so I added those to my list of things to avoid. A few months ago we went over to Europe. When we came back he went back to school and started getting very clingy, crying and not being able to read or write properly and was not able to concentrate. I have had trouble with these symptoms on and off over the 1½ years. I mentioned this to my friend, she gave me your book and I started an additive free diet. After about 1 week everything had improved dramatically. I waited about 4 weeks before I introduced additives, one a time … He reacted to 202 (potassium sorbate) in a drink of juice by crying and becoming clingy. He had it at dinner time, then had trouble getting to sleep. The next day he was very sensitive and cried a lot and hid in his room when our visitors arrived and would not come out until they had been there for several hours. He got better after he had his lunch (which he ate by himself in his room). He then came out, but didn't talk much and sat right next to me. He only had it the once, as I did not want to make the situation worse. He can drink fresh juice with no problem. - Michelle by email
 200, 160b, 320: these "no-no's" cause cramping and diarrhea (June 2009)
I am a 43 mother and have done the RPA elim diet. I have Colitis that was triggered by a single episode of food poisoning ten years ago. It took a long time to get a diagnosis of microscopic colitis. For a long time I was told that it was irritable bowel. Finally a colonoscopy and biopsy showed it - a very under-diagnosed condition. My big 3 "no-no's" are: annatto 160b, synthetic antioxidants such as BHA 320, and sorbates.All of those cause cramping and diarrhoea. – Kate, by email
When my son had a nasty chest infection/bronchitis I gave him crushed up Panamax paracetamol 4-hourly for a couple of days, as well as the inners of amoxil capsules.
A couple of days later, his behaviour was absolutely shocking and it culminated in him having a night terror one evening, the most severe one he has had since being failsafe since last September.
I knew something was going on, and I decided to check up about Panamax – and discovered it has potassium sorbate (202) in it. We have not yet done any challenges on additives as we already avoid dairy and salicylates, so decided to pretty much stay additive-free. However, we do seem to be okay with moderate amounts of pure MSG and amines.
I strongly suspect that his behaviour and night terror were induced by the preservative 202. What angers me more is that I was completely unaware of the existence of the preservative in this product, due to the lack of these medicine companies having to label their products. Our kids are already sick when we need to give these drugs to them, and they need to get better, but how can they when their body is also trying to fight against an artificial preservative?
Even when I asked at the chemist for a preservative-free paracetamol, they were not able to tell me what was in the products they sold. If only we could have good information about what is in these medical items, ie. through labelling. I don't accept the excuse that there isn't enough room on the packaging – if a box of soap can list its numerous chemical ingredients, so should a box of pain relief or any other medicine.
Please use our experience in your endeavours to fight for better information labelling on medicines – it's our kid's future. – Joanne, Vic
I too had a reaction to Panadol branded paracetamol, which occurred after taking it for multiple days. I know that I react to sorbates so made the presumption that this was what I was reacting to in the Panadol. - Ruth (June 2016)
 202: Night terrors and sleep disturbance in a senior related to potassium sorbate preservative? (August 2013)
I came across your web site when I was trying to find out if potassium sorbate could cause sleep disturbances. My sister aged 61 was awake for about three hours and kept repeating the words "I'm terrified" and I believe it was from the potassium sorbate that was in the sweet cider we were using to make her fruit smoothies. She had no headaches for several days, then had one on Saturday. I asked the Aide if she did anything different and she mentioned the cider. I checked the label and saw the preservative. Then that same night my sister was awake with the night terrors. I had also noticed a slight rash on her face and found that the preservative can cause rashes also. I poured all that cider away and bought some that has no preservatives and she slept good for me the last two nights. - Leanda, US, by email
 200: Severe contact dermatitis reaction to sorbates (200-203) (November 2009)
My son is now almost 4. He has always eaten happily from a wide range of food groups. We generally try to avoid feeding him (much) processed food, but since we travel a lot, it is inevitable that we also eat on the run. He was just under 12 months when he had his first reaction - to eating cream cheese. The effect was instantaneous and obvious: raised, red rashes on mouth, face, fingers, belly - anywhere that the food made contact. Other common allergens (like dairy, wheat, soy, nuts) clearly were no problem, so it only took another couple of incidents for us to figure out preservative 202 was the culprit. Since then we have mostly been able to avoid it, but it does crop up when we're not expecting it: like in some yoghurts (in NZ), margarines and so-called some 100% orange juices (the 100% claim is on the front of the bottle, but preservative 202 is listed in the ingredients). Again, the reaction is obvious - and although it causes some discomfort, the reaction doesn't seem to pose any obvious health risk.
As an aside, after spending some time this evening trying to research 202 allergies on the internet, I am surprised how very little information is available on it. Your website was one of the few to contain any information. Thanks for the tips about sorbates being also present in pharmaceutical products, since I had no idea about this. – Kate, by email (It is illegal to say 100% juice if there is a listed preservative! The ACCC has prosecuted several companies over that, see https://www.accc.gov.au/media-release/accc-receives-undertakings-from-orange-juice-producer. If you'd like me to act on it, let me know the name of the company. It is only through consumer complaints that change will occur.- S)
References and further reading
Swain A and others, The Simplified Elimination Diet, Royal Prince Alfred Hospital, Camperdown, 1995, p.33.
Genton C, Frei PC, Pécoud A. Value of oral provocation tests to aspirin and food additives in the routine investigation of asthma and chronic urticaria. J Allergy Clin Immunol. 1985 Jul;76(1):40-5.
Cho JH and others, Laryngoscope. Long-term use of preservatives on rat nasal respiratory mucosa: effects of benzalkonium chloride and potassium sorbate, 2000;110(2 Pt 1):312-7. These researchers tested preservatives that are often used in nasal drops, eyedrops and cosmetics on rats and concluded that even a low-concentration solution of preservatives can lead to nasal lesions.
Josephson JE, Caffery B. Sorbic acid revisited. J Am Optom Assoc. 1986 ;57(3):188-9. In this study, fifteen percent of 135 contact lens wearing patients reacted with an adverse ocular response to sorbic acid in their contact lens solution.
Le Coz CJ, Abensour M. Occupational contact dermatitis from potassium sorbate in milk transformation plant. Contact Dermatitis. 2005;53(3):176-7.
Clemmensen O, Hjorth N. Contact Dermatitis. Perioral contact urticaria from sorbic acid and benzoic acid in a salad dressing. 1982;8(1):1-6. Contact urticaria was observed in a kindergarten in 18 of 20 children following the intake and accidental perioral application of a mayonnaise salad cream.
Göransson K, Lidén S. Contact allergy to sorbic acid and Unguentum Merck. Contact Dermatitis. 1981;7(5):277.
Fisher AA. Cutaneous reactions to sorbic acid and potassium sorbate. Cutis. 1980;25(4):350, 352, 423.
Haustein UF. Burning mouth syndrome due to nicotinic acid esters and sorbic acid. Contact Dermatitis. 1988;19(3):225-6.
Thanks to Kathleen Daalmeyer for the supermarket research.
The information given is not intended as medical advice. Always consult with your doctor for underlying illness. Before beginning dietary investigation, consult a dietician with an interest in food intolerance. You can see our list of experienced and supportive dietitians http://fedup.com.au/information/support/dietitians
© Sue Dengate update November 2015