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Blocked/runny nose, rhinosinusitis, nasal polyps – new research

It is common for our members to report symptoms like blocked/runny nose, rhinosinusitis, and/or nasal polyps. As always with food intolerance, they can be related to any of the usual suspects: salicylates, amines, glutamates, additives, dairy and/or gluten.

blognasal

However, some nasal polyps are strongly related to salicylates. People with salicylate intolerance often say their doctors don’t know about low-salicylate diets, and Professor Hanns-Wolf Baenkler agrees (1):

“If a natural substance causes symptoms which do not involve the immune system, this is not an allergy or a side effect, but is known as intolerance. One example is the bronchial asthma and rhinitis which develops in some patients after administration of salicylates. Although salicylate intolerance has been known for more than 100 years, it is not adequately recognized in the relevant areas of medicine.”

So it is good to see three Canadian low-salicylate diet studies published in medical journals over the last 6 years (2,3,4).

These showed that that a low-salicylate diet can reduce symptoms of:

AERS (aspirin-exacerbated respiratory disease)

  • asthma
  • nasal polyps
  • salicylate intolerance

… with symptoms such as *blocked/runny nose *postnasal drip *reduced sense of smell/taste *facial pain or headache *pain in upper teeth *pressure over forehead and face *snoring * frequent nosebleeds 

In doctor-speak

*Otolaryngology = ENT (ear, nose & throat)
*Aspirin exacerbated respiratory disease (AERD) formerly called Samter’s Triad consists of bronchial asthma, chronic rhinosinusitis with nasal polyposis and hypersensitivity to acetylsalicylic acid
*low salicylate diet led to improved rhinologic, ear/facial & sleep dysfunction symptoms


Our readers agree

"I have been on the RPAH low salicylate diet for many years with tremendous success in controlling very severe asthma…  My doctor… has been very interested and supportive of all the food intolerance information. He is quite a convert! As well as asthma, I also had very bad nasal polyps. Had two lots of very painful surgery to remove them. When I stopped using the nasal spray the specialist prescribed they went away and never came back. My GP was totally convinced!!! - Krys aged 78 from story [1606]

Q. “Does anyone else here have nasal polyps? I have had an operation twice to remove them, but I am extremely good at growing them …! Just wondering if there was any relationship to food..."
A.“Yes I have. Definitely caused by foods for me. Low salicylate diet has helped a lot. Can breathe thru my nose now “ - Jann from facebook group, story [1329]

“nasal polyps … have bothered me since my 20s… when I said I used to have asthma the ENT specialist  told me  that people who have asthma and nasal polyps are usually salicylate sensitive … I got your book Fed Up out of the library … we cut salicylates out of my diet and one week later I was able to breathe through my nose …” -  Geoff from story [995]

“I have Samter’s Syndrome … For the last 29 years I have been taking medications and trying to stay alive. When I found the Australian salicylate lists I was so excited, I could finally understand what was happening. I was inadvertently eating salicylates every day – from a US reader, story [994]  

NOTE The Canadian low salicylate list contains some items that have since been updated by RPAH in the latest version of Friendly Food eg tamarillos (now very high), golden delicious apples, Nashi pears (the last two are mod sals but only if ripe and peeled) - and there are more …

Not only salicylates…

The Canadian diet involved only low salicylates – but failsafers have reported  polyps or sinus symptoms triggered by other food chemicals – and the benefits of the full diet:

“(In my late 20s) I had the nasal antrums of both sides of my head scraped out in an effort to cure a chronic sinus problem caused by polyps … (on the  RPAH elimination diet, in my late 50s) I am now getting the nutrition I need from much simpler foods. The improvement in my sense of taste and smell more than compensates for not eating rich tasting foods” - Bernard from story [601]
    
“For me neither of my surgeries made the difference that stopping dairy has…I had constant sinus infections. I'm simply nowhere near as mucusy …. finally went off dairy and taaa daaa its much better. Infections stopped!! - Rachel from story [1329]

“(According to) my specialist … a majority of his sinus sufferers find that soy affects them - Theresa from story [1329]

“My symptoms are generally: extreme irritability; extreme sinusitis-like symptoms, including ear aches and imbalance, near-permanent blocked or runny nose, and general flu-like symptoms (body ache, chills etc; extreme tiredness; and skin problems)...I underwent the diet with a dietician about two years ago - I'm now 38 ... severe intolerance to amines, salicylates, glutamates, colours and preservatives – Diego from story [1276] 

“I got asthma for the first time four years ago…  Finally I got the diagnosis of asthma and chronic allergic rhinosinusitis … I have not been sick since I started the elimination diet … I have found that I react to all the food you say sensitive people might react to: MSG, nitrates, salicylates, amines, colours, preservatives and dairy foods, although MSG is the worst – Tracy from story [361]

And many more

References

1. Baenkler H, Salicylate Intolerance: Pathophysiology, Clinical Spectrum, Diagnosis and Treatment, Dtsch Arztebl Int. 2008 Feb; 105(8): 137–142. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696737/

2. Doron D Sommer  et al, Treatment of aspirin exacerbated respiratory disease with a low salicylate diet: a pilot crossover study Otolaryngol Head Neck Surg. 2015 Jan;152(1):42-7. https://pubmed.ncbi.nlm.nih.gov/25344589/

3. Doron D Sommer  et al, A novel treatment adjunct for aspirin exacerbated respiratory disease: the low-salicylate diet: a multicenter randomized control crossover trial, Int Forum Allergy Rhinol, 2016 Apr;6(4):385-91. 30 patients; 6 weeks on regular or low-salicylate diet then crossed over for another 6 weeks; significant improvements for the upper and lower respiratory tracts. https://pubmed.ncbi.nlm.nih.gov/26751262/

4. Sowerby LJ et al, Effect of low salicylate diet on clinical and inflammatory markers in patients with aspirin exacerbated respiratory disease - a randomized crossover trial, J Otolaryngol Head Neck Surg, 2021 Apr 23;50(1):27. 7 patients; 1 week on high or low-salicylate diet then crossover; improved rhinologic, ear/facial and sleep dysfunction symptoms. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063291

More info

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Food intolerance

Some of the many symptoms of food intolerance that can be helped by diet:

Airways: Asthma, Stuffy blocked or runny nose/ nasal polyps, Frequent nose bleeds, Catarrh, chronic throat-clearing, Sinusitis, Frequent ear infections, Frequent tonsillitis, Frequent colds and flu, symptoms of Samter's Triad, hayfever, allergic rhinitis Skin: Eczema, Urticaria (hives), Cradlecap, Other skin rashes, Angioedema (swollen lips, eyes, tongue), Geographic tongue, Pruritis (itching), Rosaceae, Allergic shiners (dark circles under eyes), Pallor (pale skin), Flushing, Excessive sweating, Body odour, Sore vagina in children, Alopecia (patchy baldness) Digestive system: Irritable bowel symptoms (IBS), Dysphagia (difficulty swallowing), Recurrent mouth ulcers, Indigestion, Nausea, Bad breath, Vomiting, Diarrhea, Stomach ache, Bloating, Reflux in babies, adults, Constipation, Colic in babies, adults, Sluggish bowel syndrome (feeling of "more to come"), Encopresis, Soiling (sneaky poos), Dairy intolerance, Gluten and wheat intolerance, Eating disorders (ed), anorexia nervosa, bulimia nervosa, binge eating disorder (BED)  Bladder: Bedwetting, Daytime incontinence, Urinary urgency, Recurrent inflammation (cystitis) Skeletal: Growing pains, Gout, Arthritis, joint pain, arthralgia Eyes: Nystagmus (involuntary movement), Blurred vision Muscles: Low muscle tone, Myalgia (muscle pain), Tics (involuntary movement), Tremor, Leg 'jiggling', Heart: Rapid heart beat, Heart palpitations, Cardiac arrhythmias, Pseudo heart attack (feeling of impending doom, chest pressure, pain down arm), Tachycardia (fast heart beat), Angina-type pain, HHT Central nervous system: Headaches or migraines, unexplained tiredness, Chronic fatigue, Feeling 'hung-over', Confusion, Dizziness, Agitation, Tinnitus (noises in ear), HyperacusisAuditory sensory processing disorder (ASPD), Paraesthesia (pins and needles), Dysaesthesia (numbness), Hypoglycemia, Salicylate-induced hypoglycemia, Epileptic seizures, Fits, Sensory symptoms of multiple sclerosis, Scents and perfume sensitivity, Symptoms of lupus Anxiety: Panic attacks, Depression, Obsessive ruminations (repetitively focusing on bad feelings and experiences from the past), Self harm, Suicidal thoughts, actions, teeth grinding (bruxism) Impaired memory: Vague or forgetful, Unable to concentrate, Won't persevere, Unmotivated, Disorganised, Easily distracted, Difficulty reading and writing Speech: Loud voice (no volume control), Speech hard to understand, Speech delay, Selective mutism, Stuttering, Repetitive noises, Talks too much (empty chatter) Coordination: Poor handwriting, Poor coordination, Frequent accidents, Vertigo Sleep: Difficulty falling asleep, Restless legs syndrome (RLS), Persistent night waking, Insomnia, Nightmares/night terrors/sleepwalking, Sleepless babies, Sleep apnoea Mood: Brain snaps, Mood swings, Premenstrual tension, Grizzly or unhappy, Cries easily or often, Irritable, Uncooperative Oppositional defiance: ODD, Loses temper, Argumentative, Refuses requests, Defies rules, Deliberately annoys others, Blames others for own mistakes, Touchy, easily annoyed, Angry, resentful Other behaviour: ADHD, ADD, Autism, Aspergers, Inattentive, easily bored, unmotivated, 'Unable to entertain himself', Restless, fidgety or overactive, Head banging, Hyperactivity, Fights with siblings, Difficulty making friends, Destructive, aggressive, Unreasonable, Tantrums, Demanding, never satisfied, Disruptive, Discipline is ineffective, Pervasive Development Disorder

Some causes of food intolerance:

Food additives: Artificial colours: (food dyes, artificial colors) tartrazine 102 (E102, FD&C Yellow No.5), quinoline yellow 104 (E104), sunset yellow 110 (E110, FD&C Yellow No.6), azorubine, carmoisine 122 (E122), amaranth 123 (E123), ponceau, brilliant scarlet 124 (E124), erythrosine 127 (E127, FD&C Red No.3), allura red 129 (E129, FD&C Red No.40), indigotine, indigo carmine 132 (E132, FD&C Blue No.2), brilliant blue 133 (E133, FD&C Blue No.1), green S, food green, acid brilliant green 142 (E142), fast green FCF 143 (E143, FD&C Green No.3), brilliant black 151 (E151), brown, chocolate brown 155 (E155)  Natural colours: (colors) Annatto (annatto extracts, bixin, norbixin, 160b, E160b) Preservatives: Sorbates: (sorbic acid 200, E200, sodium sorbate 201, E201, potassium sorbate 202, E202, calcium sorbate 203, E203) Benzoates, hydroxybenzoates, parabens: (including benzoic acid 210, E210, sodium benzoate 211, E211, potassium benzoate 212, E212, calcium benzoate 213, E213, ethyl para-hydroxybenzoate 214, E214, sodium ethyl para-hydroxybenzoate 215, E215, propylparaben 216, E216, propyl 4 hydroxybenzoate 217, E217, methylparaben 218, E218) Sulfites, bisulfites, metabisulfites: (200-228, sulphites, sulphur dioxide, sulfur dioxide 220, E220, sodium sulphite 221, E221, sodium bisulphite 222, E222, sodium metabisulphite 223, E223, potassium metabisulphite 224, E224, potassium sulphite 225, E225, calcium sulphite 226, E226, calcium bisulfite 227, E227, potassium bisulphite 228, E228) Nitrates & nitrites: (249-252, potassium nitrite 249, E249, sodium nitrite 250, E250, sodium nitrate 251, E251, potassium nitrate 252, E252 Propionates: (bread preservative, mould inhibitor 280-283: propionic acid 280, E280, sodium propionate 281, E281, calcium propionate 282, E282, potassium propionate 283, E283, 'natural' preservatives in bread, cultured or fermented wheat, dextrose, sugar, flour, whey or anything) Synthetic antioxidants: Gallates 310, 311, 312 (E310, E311, E312), tBHQ 319, E319, BHA 320, E320, BHT 321, E321 Flavour enhancers: (flavor enhancers) glutamic acid and all glutamates, MSG monosodium glutamate 620-625, yeast extract, hydrolysed vegetable protein HVP, disodium guanylate 627 (E627, DSG, GMP), disodium inosinate 631 (E631, DSI, IMP), ribonucleotides 635 (E635, I&G, nucleotides)  Flavours: (flavors)  Natural food chemicals: Salicylates: salicylic acid, sodium salicylate, acetylsalicylic acid Biogenic amines: vasoactive amines (tyramine, phenylethylamine, histamine and others) Glutamates:  Natural foods: Dairy: milk, yoghurt, cheese, butter, lactose-free milks Wheat or Gluten: (wheat, rye, barley, oats) Soy: Sugar free sweeteners:Sugar free sweeteners: polyols, sorbitol, mannitol

On this website, failsafe refers to foods that are Free of Additives and Low in Salicylates, Amines and Flavour Enhancers. Note that copyright applies to the commercial use of the term "failsafe" in the food and health context so as to control inappropriate use by the food and health industries.