Foods, ingredients, or molecule intolerances appear to be on the rise and whilst some such as gluten or histamine are well known, others, such as salicylates, are more misunderstood. This article will delve into this lesser-known phenomenon exploring: 

• What are salicylates and what is salicylate intolerance? 
• Which symptoms are linked to salicylate intolerance? 
• What does the science say causes this condition? 
• How is salicylate intolerance diagnosed? 
• Suggestions on how to manage a suspected salicylate intolerance.

 
What are salicylates and what is a salicylate intolerance?  
 
Salicylates are natural chemicals found in many plants who use them to defend themselves against pests, bacteria, and environmental stressors. Salicylates are anti-inflammatory and as such have also been synthetically reproduced in laboratories for uses in medications, including aspirin and non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen. 
 
Salicylic acid has excellent anti-fungal and anti-bacterial properties, leading to its common use as an ingredient in processed foods, condiments, cosmetics, and beauty products. 
 
In terms of food, salicylates are found in many plant foods to a higher or lesser extent. Some of the foods that are common triggers are: 

• Berries (especially strawberries), grapes, oranges, and apples
• Tomatoes, peppers, and broccoli 
• Cinnamon, curry powder and chili powder
• Almonds and peanuts
• Tea, coffee, and some fruit juices

 
Salicylate intolerance is where a person’s system has difficulty metabolising and tolerating salicylates, leading to a range of symptoms.  The phenomenon was initially observed in medically diagnosed patients with either aspirin-exacerbated respiratory disease (AERD) or NSAIDs-exacerbated respiratory disease (NERD) (1,2).   In the cases of both AERD and NERD, high doses of chemical salicylates can trigger asthma, rhinosinusitis and urticaria.  
 
Clinical case studies have observed that for some, simply eating a diet high in salicylates can contribute to a variety of symptoms, although this can vary from person to person and may also depend on the quantity of salicylates eaten or exposed to over a short period of time. 
 
Which symptoms are linked to salicylate intolerance? 
 
Whilst respiratory and skin symptoms are the most recognised symptoms of salicylate intolerance, there are others including: 

• Digestive issues: stomach pain, bloating, wind, diarrhoea
• Headaches
• Behavioural changes including irritability, restlessness or difficulty concentrating.
• Joint pain and swelling, similar to arthritis symptoms. 
• Fatigue. Both chronic fatigue and low energy levels are often described.
• Anaphylaxis. Whilst extremely rare, severe allergic reaction has been reported. 

 
What does the science say causes this condition? 
As with so many conditions, the exact cause of salicylate intolerance is not well understood, however there are some areas which are being explored: 

• Inability to metabolise or detoxify salicylates properly. 
• Genetic SNPs. Some studies have identified modifications on genes (SNPs) including on CYP2C9, NAT2 and UGT1A6 which might indicate a susceptibility to salicylate intolerance. (3,4)
• Overexposure from food, medical or topical sources can lead to symptoms.
• Underlying health conditions. It is thought that some health conditions including irritable bowel syndrome (IBS), intestinal permeability (leaky gut) or Inflammatory Bowel Disease (IBD) may increase the risk of salicylate intolerance, however it may also be the salicylate intolerance which triggers the health conditions. Further studies are needed to explore this. (5,6)

 
How is salicylate intolerance medically diagnosed? 
Diagnosis of salicylate intolerance is tricky, mainly because of the number of overlapping symptoms with other conditions.  A medical or nutrition practitioner will undertake: 

• A review of your symptoms and medical history. Could your symptoms be linked to other conditions e.g., IBS, food allergies, auto-immune conditions?
• A dietary analysis. Keeping a food and symptom diary can help identify common food triggers. A nutrition professional can use that information to evaluate whether salicylates may be a cause.  
• Challenge testing. If your medical practitioner suspects AERD or NERD then challenge testing may be undertaken within a hospital setting. 

 
For many, a salicylate intolerance is linked to other conditions or genetics and is not, itself, the root cause.  Sufferers tend to go heavily down the elimination root, which whilst does initially provide relief, is not a sustainable or healthy long-term solution. Working with a practitioner to discover the main trigger of the sensitivity is key. 
 
Suggestions for managing a suspected salicylate intolerance.

1. Review your diet by using a food and symptom diary. (you can download one FREE below). Note, that if you are reacting to everything then you need to work with a professional to find the route cause rather than starting to eliminate foods as the foods aren’t the actual issue.
2. Complete this quiz to see whether salicylates rather than histamines might be a trigger for you. 
3. Consider adopting a low salicylate diet. If you plan on changing your diet, you should consult with a healthcare or nutrition practitioner.  A low salicylate diet shouldn’t be followed for more than 3 weeks as it could lead to nutrient deficiencies. 
4. Pay attention to the ingredients of the foods you eat. Check the food labels. Many processed foods, condiments and sauces contain salicylates. 
5. What gene SNPs may you have that could contribute to a salicylate intolerance? How efficient are your detoxification pathways?  
6. Many over the counter medications are based on salicylic acid, so check with your pharmacist.
7. Skin and personal care products often contain salicylates. Try to choose those that are salicylate free. If in any doubt, contact the manufacturer. 
8. Lifestyle and emotions can influence how well a person can tolerate things. Get regular exercise and manage stress and relaxation. 

 
If on medication, please speak to your GP/consultant before making any changes to your diet. 

 
Sign up for my news to receive the published articles straight to your inbox. 
 
Read more by clicking below to see my previously published articles: 
 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• Autumnal Allergies – Yes, it is a thing
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now?
  
  

Who Am I? 
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 
 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
References: 

1. Skypala IJ, Williams M, Reeves L, Meyer R, Venter C. Sensitivity to food additives, vaso-active amines and salicylates: A review of the evidence. Clin Transl Allergy. 2015;5(1):1–11. 
2. Kęszycka PK, Lange E, Gajewska D. Effectiveness of personalized low salicylate diet in the management of salicylates hypersensitive patients: Interventional study. Nutrients. 2021;13(3):1–14. 
3. Park SM, Park JS, Park HS, Park CS. Unraveling the genetic basis of aspirin hypersensitivity in asthma beyond arachidonate pathways. Allergy, Asthma Immunol Res. 2013;5(5):258–76. 
4. Palikhe NS, Kim SH, Nam YH, Ye YM, Park HS. Polymorphisms of Aspirin-Metabolizing enzymes CYP2C9, NAT2 and UGT1A6 in Aspirin-Intolerant urticaria. Allergy, Asthma Immunol Res. 2011;3(4):273–6. 
5. Raithel M, Baenkler HW, Naegel A, Buchwald F, Schultis HW, Backhaus B, et al. Significance of salicylate intolerance in diseases of the lower gastrointestinal tract. J Physiol Pharmacol [Internet]. 2005;56 Suppl 5:89–102. Available from: http://europepmc.org/abstract/MED/1624719
6. Tuck CJ, Malakar S, Barrett JS, Muir JG, Gibson PR. Naturally-occurring dietary salicylates in the genesis of functional gastrointestinal symptoms in patients with irritable bowel syndrome: Pilot study. JGH Open. 2021;5(8):871–8. 

 ​

The trees begin to lose their leaves, and you sigh a great sigh of relief thinking that the hay fever and seasonal allergies season is finally over. Then you realise that you are still getting symptoms – itchy eyes, runny nose, a dermatitis flare. It is very possible and even probable that you are suffering from Autumnal allergies. 
 
TV adverts and magazine articles would have you think that hay fever and seasonal allergies only happen in the spring and summer, but that isn’t the case.  Autumn brings its own set of allergens ready to trigger a runny nose, atopic dermatitis, and itchy eyes. If it isn’t plant pollen, what are the autumnal triggers that can cause so many issues? 
 
Weed pollen, mould spores and house mites are the most common triggers for Autumnal allergies, read on to find out more details and to get my 5 tips to lessen the autumnal allergy symptoms.
 
Weed Pollen 
 
Not all pollen producing plants flower in spring.  A whole category of weeds flower in the autumn and produce the highly allergenic weed pollen. These plants usually flower from late August until the first frost (usually around the end of November but growing later with climate change). This category of plants includes common weeds found in the UK such as nettles and sorrel but also varieties that are much newer to the UK and Europe such as the American Ragweed. Not only is ragweed a recent invader, but it also produces one of the highest amounts of pollen, causing uncomfortable hay fever and dermatitis symptoms in many sufferers.  
 
Mould Spores
 
Mould is around us all the time, but at this time of year levels peak with the falling leaves gently composting on the ground releasing large amounts of allergenic spores.  These are the main types of mould which have been highlighted as being triggers for allergy symptoms: 
 
Cladosporium Herbarum – this is a black mould that you can sometimes be found on bathroom walls or in a fridge, but it is also found on rotting vegetation. This is the considered the most allergenic of the moulds as it is easily airborne and so can spread quickly. 
 
 
Penicillium Notatum – found in decomposing leaves and soil. This mould is also the type you find on food that is going off eg. bread and fruit. 
 
Alternaraia Alternata – mainly found in rotting wood and therefore, forests, but can also be present on food and textiles. 
 
Dust Mites
Many sufferers of asthma, eczema or hay fever also have a dust mite allergy and whilst dust mites exist all year, reactions tend to peak in autumn as the weather becomes damp but remains relatively warm and we retreat inside and close our doors and windows, but we haven’t yet put our heating on. 
 
5 Tips to Lesson the Autumnal Allergy Symptoms

• Avoid stomping through fallen leaves as the movement will shake up any pollen or mould spores.
• Mould spores like the damp, so ensure your home is well ventilated and consider furnishings that can be easily wiped or washed.
• Check your property for any signs of damp or mould and consider purchasing some dehumidifiers for some of the less well-ventilated areas of your home and/or the bedrooms
• Avoid drying your washing on radiators as this drastically increases the amount of humidity in the air. 
• Remember to clean your fridge regularly as mould often builds in the more hard-to-reach shelves

 
If you were interested in this article, you may be interested in these other blogs I’ve previously published: 
 
Sign up for my news to receive the published articles straight to your inbox. 
 
Read more by clicking below to see my previously published articles: 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now? 
  
  

Who Am I? 
I’m Jessica Fonteneau, the Eczema and Digestive Health Nutrition Expert. I’ve worked with hundreds of clients to help them change their diets, better manage their flares, and find relief.
 
My vocation is to help those with eczema and digestive issues, because I have suffered with these interlinked conditions since I was 6 months old, and I truly know what it is like to experience these debilitating conditions. 
 
Every client I have ever worked with has their own triggers and ideal nutrition. There is no such thing as ‘one-size-fits-all’. Whether you work with me one-to-one or use my guided tools, my objective is to help you uncover what works best for you, so that you take back control and experience relief. 
 
My guided programmes are only suitable for adults as children have very specific nutrition requirements. I do, however, work with many child clients as part of my clinic. 
 
I also offer two free communities for adults caring for children with eczema and digestive symptoms, feel free to come and join us and get some well-deserved support. 

• Free community for adults with skin and/or digestive issues
• Free community for carers of children with skin and/or digestive issues

 
To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
 

Every so often a new health buzz word emerges. The new “thing” that, once resolved, will, theoretically, solve everything.  
 
From the questions I get within my community forums or from clients, histamine seems to be the current molecule of interest, particularly in relation to skin, gut and autoimmune issues, but does it deserve this notoriety?  
 
There is a lot to unpick regarding histamine, so I have divided the topic into 5 separate articles. The first is published below and the next four will follow over the next month, so keep watching this space or sign-up for my emails to receive the articles direct to your inbox: 

1. What is the histamine and eczema/dermatitis link?
2. What is the histamine and gut health link? 
3. What is the histamine and auto-immune conditions link? 
4. Histamine and oestrogen – why histamine may trigger skin and gut issues at the menopause.
5. Histamine Intolerance is it really a thing? 

 
What is the histamine and eczema/dermatitis link? 
Today’s article covers: 

• What is histamine? 
• Histamine and the immune system, how does it work? 
• Histamine and eczema, what’s the link? 
• Which eczema types are most linked to histamine.
• My top tips for managing histamine as an eczema/dermatitis trigger.

 
What is histamine? 
 
Histamine is a neurotransmitter, produced by mast cells, found throughout the body, but specifically in the skin, respiratory system, and the gastrointestinal tract, but also by basophils, a type of white blood cell which is involved in an immune reaction. 
 
Histamine is mostly known for its involvement in the immune response cascade (one reaction, causing the next and so on).  This neurotransmitter is directly responsible for itching, redness and swelling (inflammation) but is also involved in numerous other processes including stomach acid, contraction of smooth muscle (muscles involved with respiration and digestion amongst others), and the dilation of blood vessels. 
 
Whilst histamine, the neurotransmitter, is the main driver, there are four different types of histamine receptors (H Receptors) which determine the type or location of a histamine response. (2,3)

• H1 receptors are linked to anaphylactic shock and shortness of breath, the most dangerous of all allergic reactions. However, on the flipside, H1 receptors also involve histamine in sleep-wake cycles, body temperature regulation, emotions, especially anger (think of that momentary hot flush), memory, and learning.  Most histamine related skin reactions are linked to this first category of H receptors.

• H2 receptors are mainly found in the digestive tract and heart and can be linked to stomach acid, low blood pressure, rapid heart rate and headaches.
• H3 receptors manage histamine release from mast cells and neurons within the brain and can be linked to mood via dopamine, serotonin, noradrenaline, and acetylcholine. 
• H4 receptors are found in bone marrow and are linked to the production of red blood cells, but also inflammatory disorders and autoimmune conditions. 

 
Histamine and the immune system, how does it work? 
 
When the body encounters an allergen, be it environmental (pollen or dust mites, for example) or food (e.g., gluten, dairy etc.) the immune system responds by producing immunoglobulin E (IgE) antibodies which bind to mast cells and basophils which then trigger the release of histamine. 
 
Histamine release makes blood vessels dilate resulting in blood rushing to the area and leading to the common signs of inflammation: redness, itching and swelling. 
 
Histamine is also involved in the inflammatory response when tissue (or skin) is damaged or infected, causing the blood vessels dilate, drawing blood flow and delivering white blood cells to the damaged area which then help to fight off possible infection.
 
Histamine and eczema/dermatitis – what is the link? 
 
Atopic Eczema alone affects an estimated 20% of children and 10% of adults in the Western world (1), which is an absolutely massive number of people.  If you suffer from any type of eczema/dermatitis you already know that it is a chronic inflammatory skin condition that can be dry, itchy, and inflamed, all symptoms linked to a histamine response. 
 
Most researchers agree that there is a link between histamine and eczema/dermatitis. Histamine triggers inflammation, causing itchiness, redness, swelling and testing has identified that individuals suffering from an eczema/dermatitis flare, have high levels of histamine. What is less clear is what the specific connection is. In other words, just as no two eczema/dermatitis sufferers appear to have the same triggers, the histamine connection may be different for everyone.  
 
In terms of current and recent research, the following three links have been specifically examined: 

1. Whether it triggers eczema/dermatitis in the first place.

1. Whether it only plays a role in exacerbating and maintaining a flare which has already been triggered.
2. Both.

 
Research suggests that histamine’s role in eczema/dermatitis may go beyond its inflammatory role.  Evidence has been found that it may contribute to the breakdown of the skin barrier, resulting in ‘Leaky Skin’, making skin less able to retain moisture and act as a protection against irritants.  This means that potential allergens and irritants cross into the body more easily, triggering an immune response. 
 
Exploring the eczema types most linked to histamine.
 
As we already know, not all eczema/dermatitis is alike, which means that not all types will necessarily have a histamine link, but those that are include:  

• Atopic eczema/dermatitis. This, the most common type of eczema, is associated to allergies and asthma and so it makessense that histamine is linked to this type. However, whilst histamine plays a role in exacerbating symptoms, it isn’t the only driver, other possible causes are low vitamin D status, a SNP on the Filaggrin gene, a poor gut microbiome, amongst others. To learn more about Atopic Eczema/Dermatitis specifically, you can read the linked article.

• Contact dermatitis. Contact dermatitis occurs when the skin comes into direct contact with an allergen or irritant, which can cause an inflammatory response involving histamine. Some of the main triggers for this type of eczema include metals eg. nickel, fragrances, cosmetics, latex, and some plants. 
• Urticaria (hives). Urticaria or hives are raised, itchy welts that appear on the skin and histamine is the main causes of this type of skin reaction. Hives can resolve quickly (which is generally considered less than six weeks) or can persist chronically, for a significant period.
• Prurigo Nodularis. This is a chronic (long-lasting) skin condition which comes up as extremely itchy lumps. Whilst the cause of Prurigo Nodularis is still unknown, histamine has been identified as being linked to the extreme itching individuals suffer.   

 
In summary, here are my 7 top tips for managing histamine as a trigger for eczema/dermatitis: 

1. Identify and avoid triggers. Use a food/environment and symptom diary to log reactions and help identify your own patterns and triggers. You can either use a form or your own diary/journal. Keeping track is essential. 
2. Adopt a low-histamine diet by avoiding some foods that are particularly high in histamine. Some of these foods include aged cheeses, fermented foods, processed meats, alcohol, tomatoes, spinach, and some types of fish.  Complete the histamine quiz here to see if you can identify whether high histamine foods may be an issue for you.
3. Avoid histamine-releasing foods. Whilst some foods aren’t high in histamine, they can trigger a histamine release from the body. These include citrus fruits, strawberries, chocolate, and nuts. Be wary about eliminating too much from your diet as you can make things worse, consider consulting with a nutrition professional. 
4. Support gut health. Histamine is metabolised and broken down in the gut, so the healthier your gut the less likely you are to be affected by histamine.  Consider adding probiotics and prebiotics to your diet. However, careful! Many foods considered good for the gut e.g., kefir and sauerkraut, can trigger histamine flares, so start small and increase rather than going all in immediately.
5. Enzyme supplements. DAO (diamine oxidase) is the enzyme responsible for breaking down histamine in the gut. Taking this supplement before a histamine rich meal may help people with naturally low levels of this enzyme, digest histamine foods better. As before, it is always better to consult with a nutrition practitioner before starting any supplementation.
6. Stress management. Did you know that stress and anxiety can trigger histamine? Include daily stress management techniques to keep yourself calm such as meditation, low impact exercise or hobbies that make your heart sing. 
7. Find out how your genetics may impact your relationship with histamine. The Lifecode Gx Histamine Intolerance test analyses the genes and nutrients needed to breakdown and remove histamine, showing where disruptions occur and how to support optimal function.  

Speak to your medical practitioner, Registered Nutritional Therapist or pharmacist adviser for further guidance. If on medication, please speak to your GP/consultant before making any changes to your diet. 


Histamine Masterclass - 1pm, Thursday 14th September. 

I will be holding an online Masterclass on histamine on Thursday 14th September 2023 at 1pm - claim your early bird ticket at £10.  Don't worry if you can't attend live, you can send your questions in advance and the Masterclass will be emailed to all attendees post the event.
 
Read more: 

• Motivated to change but struggling to stay on track? Tips for long term transformation.

• Symptoms but no idea what’s triggering them? Here are some tips to unravel the mystery.  
• Top Tips for Eating for the Planet without Compromising Your Nutrition 
• I want to eat more plant-based but pulses give me terrible digestive issues
• What is the atopic march?
• Why is eczema/atopic dermatitis itchier at night?
• You’ve been diagnosed with an atopic condition, but what does that mean? 
• Atopic dermatitis/eczema – a chronic condition that effects all ages 
• The skin microbiome, the key to good skin health  
• Autumnal Allergies – Yes, it is a thing
• If one-size-fits all diets worked, don’t you think we would have the magic formula by now? 
  
  

To easily keep up with my articles, masterclasses, ebooks and online programmes and receive exclusive access to early bird offers, sign-up to my newsletter.  
 
Interested in what I do and who I am? Go to my website: www.jessicafonteneaunutrition.com
 
1.           Nutten S. Atopic dermatitis: Global epidemiology and risk factors. Ann Nutr Metab. 2015;66:8–16. 
2.           Buddenkotte J, Maurer M, Steinhoff M. Histamine and antihistamines in atopic dermatitis. Adv Exp Med Biol. 2010;709:73–80. 
3.           Patel RH; Mohiuddin SS. Biochemistry , Histamine. 2023;32491722.