Salicylate intolerance as a result of taking COX2 inhibitors; with Menu guide/food list handouts for Low Salicylate diet & a combined Low Salicylate/Low Oxalate.

Phytonutrient excess can be causal in salicylate intolerance due to antioxidant inhibition of the COX2 enzyme. - Sulfation and glycine are also discussed.

Taking too many pain killers or phytonutrient antioxidants might make you intolerant to salicylates - accumulating instead of detoxing the natural pain relievers. This would turn into a positive feedback loop - accumulation of salicylates would be continuing to inhibit the COX1 and COX2 enzymes which would lead to ongoing difficulty excreting salicylates. Restricting dietary and other sources of salicylates is recommended and other COX inhibitors would also need to be limited. (Baenkler, 2008)

Phytonutrient antioxidants are a COX2 inhibitor and could add to the risk of salicylate excess leading to toxicity symptoms. (Baenkler, 2008) That means there is a fine line between a helpful amount for reducing inflammation and an excess amount where COX2 inhibition leads to salicylate intolerance and an escalating spiral of excess salicylate. This post is a follow-up to a recent post about my drinking too much Wormwood tea it seemed (but I loved it and didn’t want to stop - I am on day two no Wormwood tea.)

Slogan for the day - Too much of a good thing is a bad thing.

Anti-malarial herbs, Cox-2 inhibition leading to folate and methylation cycle inhibition - that's not good for healthy cells, but useful against cancer cells.

Being overly acidic would increase risk of accumulation also, as the urinary pH needs to be less acidic for salicylate to be excreted.

Quercetin, resveratrol, curcumin and other phytonutrient foods including my favorite pomegranate peel would all be antioxidant sources that could add to COX2 inhibition and that would be anti-inflammatory . . . until salicylate accumulation leads to inflammatory symptoms . . . confusingly for a person or practitioner. Salicylate excess symptoms are frequently misdiagnosed and treated as “asthma” or “irritable bowel,” “indigestion and bloating” or “lymphedema” - or all three of those seemingly separate diagnoses.

Figure: “Eicosanoids: formation, breakdown, effects (greatly simplified from [3, e1, e2, e3]).” Excerpt: “The focal point of the pathophysiology is the mechanism of arachidonic acid/eicosanoid metabolism, as clarified by the Nobel Prize winners Bergström (e1), Samuelson (e2), and Vane (e3). This is a system with complex elements (figure). Phospholipases break down phospholipids in cell membranes, giving arachidonic acid, the starting material for the eicosanoids. The main classes of eicosanoids – the leukotrienes (LT) and the prostanoids with the prostaglandins (PG) and thromboxanes (TX) – are predominantly formed by the lipoxygenases (LOX) and the cyclooxygenases (COX). They are important mediators of inflammation and hypersensitivity in almost all cells and organs.” (Baenkler, 2008)

Symptoms of Salicylate Excess can mimic allergy like symptoms, ADHD, and respiratory and digestive symptoms.

Acute poisoning may occur by taking too many aspirin or other painkillers or topical mint containing products covering a large area of the body. A smaller child may be at greater risk from accidental over-eating of aspirin or maybe real mint candy.

Salicylate Poisoning can cause ringing in the ears, tinnitus, an increased body temperature above 98.6’F, rapid breathing - hyperventilation, nausea and vomiting, dehydration and disorientation. An acute risk may occur with intake of 150 mg/kg or more of aspirin. Lower doses over a long time period may cause a range of symptoms. Death from metabolic acidosis and seizures may occur with a severe toxicity. (clinicalgate.com)

SALICYLATE EXCESS IS FREQUENTLY MISDIAGNOSED AS OTHER CONDITIONS. Treating the symptoms would never ‘cure’ the underlying problem. While severely restricting salicylate intake (diet, meds, and topical or toothpaste, or mint gum) can restore normal function - literally making the asthma or gassy bloating end. Restoring normal function is a much better solution than taking a bunch of medicines to treat a bunch of alleged diagnoses which really are just labels for symptoms. Medications often are also depleting mitochondrial support nutrients and that can lead to worsened mental and physical health risks.

Salicylism will usually present as a mimic” The Internet Book of Critical Care, (emcrit.org) This graphic is incomplete regarding ‘all’ symptoms that might be seen with salicylate excess. It is focused on misdiagnosis which might be life threatening due to the wrong treatment being provided instead of reducing salicylate intake. Earlier symptoms include gassy bloating and asthma like congestion or cold/flu symptoms - it might even be called “Covid19”.

*Hyperthermia - body temperature elevated above normal.

Tachypnea - very rapid breathing rate compared to normal.

Tachycardia - *Ylang ylang essential oil really helps slow down the rapid heart rate for me, but laying down in a darkened area with elevated legs and trying to breath slower and calm oneself also helps. Ylang ylang does contain some plant salicylates but it doesn’t seem to worsen the problem for me like Mint family, Wintergreen or Birch essential oils. I used to eat a lot of mint lozenges and it turns out that that was a mistake. Live and learn the hard way - and that is why I share this information with others. Pain hurts and health is better.

(emcrit.org/ibcc/salicylates)

Salicylate excess symptoms

— from the perspective of a parent with a cranky child (Excerpt from the linked guide, sync):

Hyperactivity • Red cheeks and ears • Irritability • Defiant behavior • Aggression • Sleeping issues • Night or day wetting • Skin rashes • Diarrhea • Cries easily • Emotionally sensitive • Respiratory issues - Julie Matthews (sync)

Cravings for salicylate rich foods are likely

Other indications for using this diet include cravings for high salicylate foods, or reactions to these foods. - Julie Matthews (sync)

There seems to be an excitatory effect - yes, cravings for the things that make you feel gassy, bloated, congested, and later may make ADHD scattered thinking worse.

Gene differences in enzymes can make salicylate excess more of a risk, nutrient deficiencies can also and being overly acidic within the blood and body fluids can also increase risk of accumulating salicylates in excess.

Salicylate excess is a toxin problem rather than being an ‘allergy’ but the effect within the body mimics allergy-like symptoms as it can cause degranulation of mast cells and lead to histamine excess too. Histamine normally is a modulator within the brain, calming it, and excess can cause hyperexcitability which may present as severe anxiety and paranoia or mania and reckless behavior. Suicidal or violent urges may also result. ADHD like lack of concentration and difficulty with decisions is also seen with salicylate or histamine excess.

Add poor processing of gluten/casein and soy and opiate-like chemicals would add to mental stimulation and out of control behavior.

Before a crash in mood, the mania or morphine-like effects can be ‘fun’ and a person or child is likely to crave the very foods that lead to mood crash later on.

Diet guides with food lists, a menu plan example and a few recipes

Both of the following guides have some recipes designed for special need diets commonly used to help children or adults on the autism spectrum or who have other behavioral conditions like ADHD. This approach may also be helpful with Alzheimer’s and other neurological conditions.

1. Low Salicylate Meal Plan / Food List, a Bioindividual Nutrition guide by Julie Matthews (sync) *I am in training as a Bioindividual Nutrition practitioner. These food guides, and the training, are subsidized in part by my paying subscribers, thank you for your financial support!

2. Low Oxalate Diet (LOD)/Low Salicylate, Amine, Glutamate Diet (SAG) “This diet reduces oxalates and phenols from food sources to decrease, and often eliminate symptoms that could not be resolved by either the LOD or SAG diets alone. This meal plan is also gluten-free, casein-free and soy-free.” a Bioindividual Nutrition guide by Julie Matthews (sync.2)

   • Amine is referring to histamine and tyramine sources and this guide is not super excellent for histamine intolerance but is a start. Avoiding phenols is helpful for ADHD type conditions and a common problem ingredient is red and yellow food dyes or ‘purple’ foods - polyphenol rich berries or produce.

3. And an older resource of mine: Alkalizing Foods, (sync.3).

   1. Being overly acidic within the body can make salicylate and oxalate excess more likely, so it is helpful to follow an alkalizing diet too - less rich dairy and meats and presoak nuts, seeds, beans and grains as unsoaked seeds have phytic acid which is more acidifying of the body and promotes elevated phosphorus in ratio to calcium and magnesium.

4. For more information see Julie Matthews book Nourishing Hope for Autism - Nutrition and Diet Guide for Healing Children - ADHD, Autism, Learning and Development Delays, (Matthews, 2008). It is an older book at this point, yet the field of autism care has advanced so slowly that it is still largely cutting edge. It needs an update for the changes in rate of autism and for updates. The information in the book about magnesium is inaccurate and ‘folic acid’ is used too much or indiscriminately in place of ‘folate’. Mostly this is a helpful book though with a lot of information that is not readily available from standard health care sources.

**My main caution with the book: The ‘Specific Carbohydrate Diet’ is quite a bit older and depends on a lot of fructose, which had been thought beneficial, but it isn’t. The diet has helped people and is still used but I would not endorse it. I would recommend using a modified version with less fructose and only using it for a limited time to help reboot the microbiome. The gist is to have such restricted carbohydrate intake that the gut bacteria are starved. That gets rid of negative species and then hopefully good species can be restored with an improvement in diet and probiotic food or supplement use. Long term however, starving the gut microbiome would make digestive function worse as gut microbes are what stimulate more enterocyte nerve cells which then signal for more peristalsis contractions of the intestinal muscles.

Salicylate overview for review or background info

Salicylates are pain relieving chemicals found in many plants besides the willow or myrtle tree bark in which it was initially discovered. Willow bark extracts became commonly used as aspirin. Excessive doses of aspirin are harmful and may have been an underlying causal factor in the historical Spanish Flu that caused many deaths in the US. Was it the Flu? or the high dose aspirin that caused deaths? (and was the ‘Flu’ really an adverse vaccine reaction?)

Excessive doses of aspirin or salicylates is still a risk that kills a few tens of thousands of people each year. Misdiagnosis and lack of recognition of salicylate as the cause of a patient’s negative symptoms is part of the reason for salicylate related deaths.

• A useful food list that combines low oxalate and low salicylate food lists and has printable condensed sheet to be able to take along for grocery shopping: (eatbeautiful.net).

• This is also a useful salicylate list with entries for foods high in amines or natural glutamates (MSG-like): (alessandraedwards.com/)Sulfation pathway function is needed for salicylate processing

Methylation cycle dysfunction can increase risk as it can lead to or include dysfunction in the sulfation/trans-sulfation cycle which is interconnected with the folate and other methylation cycles.

It is common for people with a compromised biochemical pathway called sulfation to have salicylates sensitivities. Conditions often associated with poor sulfation include ADHD, autism, dysbiosis (imbalanced gut flora) or autoimmune disorders such as lupus. […]

Salicylates are rich in nutrients, so it’s important to not overly restrict these foods for the long term. Epsom salt baths can aid sulfation. Addressing methylation and specific digestive enzymes can be helpful. Amines and glutamates, may need to be reduced as they are processed similarly. Some people react to salicylates in particular; whereas others react to additional compounds. - Julie Matthews (sync)

Any problems with methylation cycles can lead to sulfation cycle difficulties as the cycles are interlinked. Sulfation enzymes tend to be rate limited for anyone anyway, so moderate intake can help prevent excess = tiny amounts of garlic, or turnips or cruciferous vegetables but not lots, or maybe none depending on how sensitive. Epsom salt baths are also a source of sulfate in a usable form.

Having sulfation problems means you may have both too little of beneficial forms and too much of harmful forms. A 20-minute Epsom salt bath can give the beneficial form without giving too much, but don’t stay in the bath longer. An excess of magnesium and sulfate can be absorbed through the skin.

• An obvious symptom of excess sulfate/sulfur is a racing heart rate - tachycardia and the essential oil Ylang Ylang can help slow that down. It is scary and feels like a panic attack or heart attack, or you just don’t know what.

• A symptom of excess magnesium is a slowing heart rate and relaxed smooth muscles. The sphincter of the anus might be felt to relax. Getting drowsy may occur - get out of the tub! 40-60 minutes in an Epsom salt bath might lead to the magnesium excess symptoms for anyone and watery stools then follow for about 24 hours - that is dehydrating of fluid and electrolytes. Drink extra water and have some extra salt and potassium. The literature online tends to say you can’t overdose from Epsom salt soaks, and it probably would be hard from a foot soak but I have gotten the watery stool effect from staying in the bath for 40 minutes or more. I set a timer now for 20 minutes.

Glycine, an amino acid, is also needed for excretion of salicylates

Glyphosate may be reducing our glycine supplies or competing. Supplementing with 3 grams per day or a couple times per day may be helpful. (Chris Masterjohn, PhD recommends glycine supplements at ~ that dosage. Linked below.) Glycine also supports methylation cycles and glutathione production.

“Glycine is also the main ingredient for the Phase II detoxification pathway which is needed to clear phenols, salicylates, benzoates, and excess organic acids.” (p161, Matthews, 2008)

Milk thistle could be helpful and other support nutrients for detoxification pathways include vitamins A, C, E, and B vitamins folate, methyl or hydroxy B12, choline, betaine, B1, 2, 3, and B6, the amino acids methionine, cysteine and taurine, and the minerals zinc, selenium, iodine and magnesium. (p 161, Matthews, 2008)

While too little glycine increases risk of salicylate excess due to reduced excretion, too much glycine can be a risk factor for oxalate excess. (p 200 Nourishing Hope) People with dysfunctional DPP-IV enzyme might accumulate too much glycine and other industrial toxins or phenol-based medications which it would help digest in normal function. Gelatin and bone broths are a natural source of glycine but would also be rich in other amines - histamine and tyramine and might cause migraines or other symptoms. Houston Enzymes, Kirkman, and Klaire Labs are companies with an enzyme supplement product that contains DPP-IV. The enzyme helps protect against the opiate like side effect of poorly digested gluten, casein and soy protein. (p145, Matthews, 2008)

• Enzymedica is also a company with a DPP-IV containing supplement. See: DPP-IV: What it is and how it Works, January 4, 2018, (enzymedica.com) *I am unaffiliated.

Chris Masterjohn’s post about glycine is focused on our startle reflex. (Substack)

Startled?! Try Glycine!

Glycine is calming and may also help if insomnia with difficulty falling asleep initially is a problem. Glycine helps cool the body and brain down which precedes sleep, so taking a half teaspoon (about 3 grams) in a glass of water prior to bed may help the body prepare to sleep. A cold compress on the forehead and setting the thermostat at 65’F for sleep may also help. See my older post: Sleep and Health (Substack)

See this page for more details about salicylate sensitivity and other food lists. (Substack)

Salicylate Risks & Benefits, Fibromyalgia & POTS

Disclaimer: This information is being provided for educational purposes within the guidelines of Fair Use and is not intended to provide individual health care guidance.

Reference List

(Baenkler, 2008) Baenkler HW. Salicylate intolerance: pathophysiology, clinical spectrum, diagnosis and treatment. Dtsch Arztebl Int. 2008 Feb;105(8):137-42. doi: 10.3238/arztebl.2008.0137. Epub 2008 Feb 22. PMID: 19633779; PMCID: PMC2696737. *Translated from the original German by Rodney A. Yeates, M.A., Ph.D.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696737/

(Matthews, 2008) Matthews, Julie, Nourishing Hope for Autism, Nutrition and Diet Guide for Healing Children - ADHD, Autism, Learning and Development Delays. 3rd Ed. Sept. 2008, Healthful Living Media, https://www.amazon.com/Nourishing-Hope-Autism-Nutrition-Paperback/dp/0981655807