I often get asked questions like, “I’m allergic to sulfa drugs – do I need to avoid sulfur in supplements and/or food?” There is a lot of understandable confusion about the difference between sulfa drugs, sulfites, sulfates and sulfur. Many people are allergic to sulfa drugs and/or sulfites and thus assume that they have to avoid sulfates and sulfur, also. This article should help explain the difference between these four substances and clear some of the confusion.
Sulfa Drugs (Sulfonamides)
One of the more common drug allergies is that to sulfa drugs. Sulfa drugs are more appropriately labeled sulfonamides and are derivatives of para-amino benzoic acid. The sulfonamide drugs were the first antimicrobial drugs (antibiotics). The table below lists common medications that contain a sulfonamide component.
| Sulfonamide drug classes/individual drugs that may cause allergic reactions | ||||
|
Sulfonamide Antibiotics |
Thiazide Diuretics hydrochlorothiazide chlorthiazide metolazone chlorthalidone indapamide methyclothiazide |
Loop Diuretics furosemide |
Sulfonylureas chlorpropamide tolbutamide tolazamide glipizide glyburide |
Carbonic Anhydrase Inhibitors |
The sulfa drugs are usually not allergenic by themselves, but when a sulfonamide molecule is metabolized in the body, it is capable of attaching to proteins, thus forming a larger molecule that could serve as an allergen. Thus, the allergy is not to the original drug, but to a drug-protein complex. The sulfur atom is not the allergenic agent and being allergic to sulfa drugs does not imply having a propensity to allergy to other sulfur compounds. Rather, it is a unique property of this kind of compound, namely that it can form proteins that are allergenic in some individuals.
Sulfites (also Sulfur Dioxide)
Sulfites (or sulfiting agents) refer to a group of chemicals that include sulfur dioxide and sulfite salts. They are produced naturally in some foods, mainly those undergoing fermentation, and are thus found in red wine. Sulfites are metabolized to sulfur dioxide under certain conditions; sulfur dioxide is thought to cause reactions in cases of sulfite hypersensitivity.
Some sulfiting agents are FDA approved preservatives that are added to food and pharmaceuticals. The more common sulfiting agents are sodium sulfite, sodium bisulfate, and sodium metabisulfite. Examples of foods containing sulfites are listed in the next table; these foods may only contain sulfites under certain conditions. However, the FDA has banned adding sulfites to fresh fruits and vegetables offered in restaurants and other public venues due to allergy concerns. Fresh lemon and lime juice will not have sulfites, but bottled or dehydrated juice may contain sulfites.
| Foods that may contain sulfites | |||||
| Dried soup mixes Vegetable juices Baked goods Canned or dried fish Dried fruit Relishes Maraschino cherries |
Dehydrated vegetables Shredded coconut Sauerkraut Dried noodle meals Olives Pickles Shrimp, lobster, scallops |
Lemon and lime juice Jams and jellies Grape juice Wine Molasses Gravies Potatoes |
|||
A sulfite reaction is different from a sulfonamide allergy (a reaction to sulfa drugs) because sulfites and sulfonamides are entirely different chemicals and have unrelated mechanisms of reaction. A person sensitive to sulfites is no more likely to be allergic to sulfonamides (sulfa drugs) than any other individual and vice versa.
Sulfates
Sulfates are very important for everyone’s health and do not cause allergic or sensitivity reactions. Sulfates are used as escort molecules for a number of supplements including glucosamine sulfate and vanadyl sulfate. Sulfates are different from sulfites and sulfa drugs, and people who are sensitive to sulfites or sulfa drugs should not be sensitive to sulfates.
Sulfur
Sulfur is an essential element of life and is the eighth most prevalent element in the human body. No one is allergic to sulfur itself. When people say that they are allergic to sulfur they mean sulfites or sulfonamides, not sulfur or sulfates. Sulfur is mainly found in the body in amino-acids (such as methionine and cysteine) as well as connective tissues. It is also used in a variety of compounds in the body that help chelate and remove heavy metals from the body.
The benefits of sulfur compounds used in health products are well studied. Popular items include alpha-lipoic acid, methyl-sulfonyl-methane (MSM), allicin (the main active ingredient in garlic), glucosamine sulfate (and its natural polymer, chondroitin), SAMe (S-adenosylmethionine), and several important antioxidants, such as glutathione, N-acetylcysteine (NAC) and dimethyl-sulfoxide (DMSO).
Because sulfur is not the issue with allergic or sensitivity reactions, people that have a reaction to sulfites or sulfa drugs should not react to sulfur containing supplements. Although sulfur may not be a problem, supplement quality and processing can still impact allergenic potential.
Let’s use glucosamine sulfate as an example. Glucosamine sulfate is an amino acid polymer that is found throughout the connective tissues in the human body that is not known to cause allergy reactions. However, glucosamine sulfate is commonly derived from shellfish, such as crabs. If poorly manufactured, persons with shellfish allergy could have a reaction to it. However, purification of the glucosamine sulfate in high-quality certified manufacturing facilities used for many dietary supplements makes it safe for virtually everyone, even those with shellfish allergies.
The Bottom Line
Even though it is easy to do, when you hear that something contains sulfur, don’t equate that to sulfur-containing molecules, such as sulfites or sulfa drugs. They sound similar, but they have dramatically different properties and effects in the human body. Chemistry would be much more fun (and easier to understand!) if they did not give things similar sounding names…
That you for explaining this. I had a bad reaction to dried apricots, so afterwards, I would not eat any dried fruit – except black raisins, they seem to be ok for me. Although it smelled like sulfur. That would be called sulfites – right? But recently I wanted to buy some MSM, but I was confused on whether the ingredients might be harmful to me but says it is a naturally form of sulfur, so should be ok. Thanks for the clarifying information.
Hi Devi – dried apricots almost always have sulfites add/applied, while raisins may or may not – either way you are right, if you are having a reaction, it is likely to the sulfites. MSM would contains sulfur; you would have no more/less potential for reaction to MSM due to your reaction to sulfites. As a precaution, it would always be best to start with just 1 capsule/day and slowly increase your dosing under the guidance of a trained health care provider.
I’m glad you found the article helpful!
Sincerely,
Dr. Chad
A friend gave me a Sulfathiazol powder for a small wound. Is this safe to take since I have a sulfa drug allergy.
Hi Patricia – thanks for the comment; I would direct you to your physician and/or pharmacist to help you make that call –
Dr Chad
I’m allergic to a sulfur medication that was for a bladder infection I’m trying to take it’s called cardio chelate which has sulfur in is that safe for me to take
Hi Marilyn,
Unfortunately, I am not familiar with this product nor do I have enough information about your case/reaction to make a recommendation, so you will need to check with your health care provider in this regards.
In general, if you’ve had a reaction to sulfa drugs, you are no more or less likely to have a reaction to sulfur than someone that is not sensitive to sulfa drugs; that said, this does not mean you can take any product (irrespective of whether or not it contains sulfur) with 100% certainly that you will not react to it. Hence the need to contact your health care provider.
Good luck!
Sincerely,
Dr. Chad
Ok, so I’ve always been allergic to sulfa, but in the last 10 years I started having allergic reactions to sulfites, especially in alcoholic drinks. In the last 2 years I’ve developed an allergy to sulfates as well, so any soaps, shampoos, or anything that comes in contact with my skin, especially Epsom salts, caused inflammation, pain, swelling and redness, and severe irritation. Is this really uncommon? I have dyshidrosis on my hands and feet and a nickel allergy and finding things I can soak my feet in is difficult.
Hi Jodi,
Whenever a person has immune reactions to multiple items, it is usually more of a sign of immune dysfunction than a reaction to a specific item or items. For instance, it is very likely that in addition to the items you’ve listed above, you also have sensitivities to multiple other foods/substances. The fact that you’ve identified multiple items that contain sulfur does not necessarily mean that they are related; in fact, the research that is out there would indicate that they are not.
I would suggest that you complete a Lymphocyte response assay from Elisa/Act Biotechnologies to determine other non-IgE immune reactions and work with a provider well versed in reversing immune dysfunction to correct them.
Good luck!
Sincerely,
Dr Chad
Hi Dr. Oler,
I am very allergic to Bactrim and Trimpex. I stop breathing. I am looking at an OsteoStim supplement that contains L-taurine which says it is/has sulfonic acid. Is this safe for me? I asked Dr. Keith McCormick, who sells Osteostim as part of his line of Osteonaturals for bone health what he thought and he said he did not have an answer for me. Thank you. Claire Eady
HI Claire – thanks for reaching out; unfortunately, without knowing substantially more about your health history, I cannot provide the guidance you are requesting. I can tell you that taurine is a unique ‘amino acid’ as it contains a sulfonyl group (which is likely what is being referred to on the label); if that is the case, a person sensitive to sulfa medications would be at no higher risk of reaction to these compounds than someone that was not allergic to sulfa medications. Consulting your allergist would be advisable.
Sincerely,
Dr Chad
For many years I have been taking Clopidogrel Bisulfate (generic for Plavix). The most recent two bottles have a very strong sulphur odor. I’m now suffering with “allergy induced asthma.” I have Never had allergies or asthma in all my 60 years. I am wondering if there is a connection. Is the drug odor from a sulfate, or a sulphur??
Much appreciated!!
Hi Stella – thanks for comment/question – sulfates/sulfur can have a very strong odor; I would suggest you contact your pharmacist and prescribing doctor to find out if there was a formulation change as an immediate next step. There can certainly be other causes of allergy induced asthma, but this would be a good place to start investigating.
Good luck!
Sincerely,
Dr. Chad
With the sulfur emmited from the geysers in Yellowstone Park,is it unsafe to breathe this air as I am allergic to sulfa drugs and sulfites
Hi Marge,
While I don’t know the exact composition of the things emitted from the geysers in question, I can tell you that those that are allergic to sulfa drugs and/or sulfites are no more or less likely to react to sulfates and/or sulfur other compounds that contain sulfur than those that are not allergic to sulfa drugs and/or sulfites. However, almost nobody will like the smell:)
Hope that helps –
Dr. Chad
Hi, I still don’t understand because i am allergic to any medication that contain sulfur, For all 17 years of my life its been hared for some doctors to give me medication for my rash that comes here and there. I can’t use most face produce’s and its hard to be a teenager.
i also wanted too know Whats the difference between sulfate and sulfur?
Hi Nelyanna,
Thanks for your inquiry – without knowing a great deal more about your case history it will be difficult to comment with any conclusiveness, however, it sounds as though you may have a sensitivity to one or more sulfur-containing compounds. I would recommend you complete an Lymphocyte Response Assay (LRA) through Elisa/Act Biotechnologies: http://www.elisaact.com; choose a panel that includes the Additives/Preservatives as well as any medications, foods and/or therapeutic herbs in question. This should provide you more information about the source of your reaction as well as give you/your health care provider some guidance as to how to correct any underlying imbalances. Also have your 25-hydroxy vitamin D levels checked (they are likely low).
Good luck!
Dr. Chad
Hi, I have had Stevens-Johnson syndrome from Sulfur based medicine an with Toxic Epidermal Necrolysis. I want to know if I can take glucosamine chondrotion and Sulfate and MSM. I can not take aspirin because it is sulfur based. The Stevens Johnson was from Sulfur Based medicines ……..please give me information as I won’t live through that horrible experience again. thank you
Hi Cecilia,
Thanks for the comment/question; unfortunately, I am not familiar with Stevens-Johnson Syndrome and cannot provide the direction you are seeking. I would suggest speaking with your health care provider to find some guidance/resources.
Sincerely,
Dr. Chad
My son gets a hive-like reaction every time he’s in salt water (both Pacific and Atlantic). Someone mentioned that it might be a reaction to sulfites in sea water. Where could I get more info about this?
Hi Samantha – thanks for the inquiry; I have not heard of this, but I would suggest Google Scholar as a resource. In addition, I would be interested if he has a reaction in other saline environments, like an Epsom salts bath and/or water with salt added.
Good luck in your search –
Dr. Chad
I have g6pd, Doctor says to avoid sulfur and sulfur drugs. The definitions are confusing.
Hi Dorothy – thanks for the comment; I am assuming you are speaking about a deficiency of the enzyme glucose-6-phosphate dehydrogenase. In this instance, sulfa drugs would be contraindicated, but I do not know of any studies that would suggest you avoid foods and/or supplements that contain sulfur or sulfates. If you know of any, I’d love to see them –
Sincerely,
Dr. Chad
I have an allergy to Sulfa drugs. I was in a new hair salon to get my hair colored and highlights which I do every 6 weeks. But this time was different. At the new salon, as I was leaving, I noticed a rash starting on my thighs. It was not itchy but in the morning, the rash was ALL over my body and still not itchy. I went to my Dr. and he said it looks like a drug allergy. He knows Im allergic to Sulfa and I was not taking anything drug wise. I called the salon to see what was in the products they used and the word that stayed on my mind was Sulfates. Could this have caused the rash. My Dr put me on a steroid to get rid of the rash.
Hi Julie – thanks for the question. According to research, you would be no more likely to react to sulfates than a person that is not reactive to sulfa medications. However, that doesn’t mean this (or some other chemical/environmental insult) did not cause it. Unfortunately, it is often very difficult to determine the exact cause(s) in cases like this, however, you may want to consider running a hypersensitivity test such as the Lymphocyte Response Assay from Elisa/Act Biotechnologies: http://www.elisaacti.com.
Good luck!
Dr. Chad
i just found iut im allergic to sulfa drugs would this mean im allergic to well water since it has sulfer in it ??
Hi Debi – based on the research, the answer to your question is no – being allergic to sulfa drugs does not increase the likelihood that you will have a reaction to sulfur in foods/water.
Dr Chad
I had a severe reaction to a Homeopathic-sulphur remedy. My throat started to close and ended up in Emergency and received Benadryl IV. I am confused now as to what I can take or what I can eat (ie would garlic supplements be ok?)
Hi JC,
Thanks for the comment; I can certainly understand why you would be confused. Having a reaction to a homeopathic remedy does not indicate that you are any more or less susceptible to a reaction to sulfur containing foods or supplements. Assuming the homeopathic remedy was formulated properly, there would be no actual sulfur in it to react to. Unfortunately, because of this fact, it doesn’t give you any information about the possibility of reaction to other sulfur-containing substances. The next most logical reason for the reaction would be a filler in the product, so be sure and investigate your reaction/non-reaction to other substances in the product.
Good luck –
Dr Chad
This happens to me whenever there are sulfites, bisulfites, Metabisulphite s, Sodium dioxide , Sodium Benzoate, silicon dioxide, and even some others. I have an anaphylactic response. I am finding it more and more difficult to take any kinds of meds because these chemicals are used as fillers in just about everything. Can someone please tell me what a person with such allergies can do? I’ve been postponing needed surgery because they don’t know what anesthesia to even give me. Do you know they even put Sulfite in the Epi Pen?? And now Sodium Benzoate in some forms of Benadryl and other antihistamines. What is a person like me supposed to do in an emergency when the very thing I’m allergic to is in the remedy for the reaction???
Hi Helen,
Thanks for the question; you certainly sound like you are in a tight spot. I would recommend you find a provider skilled in using the Lymphocyte Response Assay from Elisa/Act Biotechnologies (www.elisaact.com) and test for all of these substances. They should then be able to help you determine your best next steps.
Good luck!
Sincerely,
Dr Chad
Dear JC, I had exactly the same reaction while on homeopathic Sulphur… in my case they used cortizone to open the throat. Any info. on homeopathic Sulph? m
After swimming in a natural pool of water that smelled heavily of sulpher, eyes open playing tag, my eyes were so cloudy I was essentially blind. I was put to bed and in the morning, the cloudiness started to dissipate. None of the rest of the group of 15 or so we’re affected. I assumed that I was allergic to sulpher. Since then I attempted to stay away from known sources. I am currently taking a diuretic that I just found out contains sulfa and think this is the reason why I have been diagnosed with severe dry eyes. My eyes are constantly dry and scratchy. After reading the differences between the sulfa and sulpher I am confused about exactly what I am allergic? to.
Hi Patricia,
Thanks for the comment; I would not jump to the assumption that you are allergic to sulfur based on your experience. You may certainly be having and immune reaction to something, but there are too many other possible/probable antigens based on your experience. Before you begin to eliminate foods/items from you diet/world, I would suggest getting some more testing done, like a Lymphocyte Repsonse Assay from http://www.elisaact.com – make sure and get the items tested that you are interested in and go from there.
Good luck!
Dr Chad
I am currently trying to rid myself of bacterial cystitis naturally. I have a big bag of organic sulphur and wonder if this would help as the drugs commonly prescribed are the sulfa medications. Many thanks in advance for your reply.
Hi Vicki – thanks for the comment; organic sulfur will not work the same as sulfa-based antibiotics; I do not know of any data that would support their use to address bacterial cystitis. In this case, it would be more common to use berberine or uva-ursi along with probiotics designed to target healthy urogenital health.
Good luck!
Dr. Chad
Hi Doc,
Thank you for writing this explanation. I understand that sulfa allergy and sulfite sensitivity are not correlated, but I have both. I spent a lot of time in college prepping lettuce for a salad bar using sulfites, just before they were banned for that use. I also had to be treated for asthma at that time. My reaction to sulfa drugs is standard: rash on chest and thighs.
I love a hot spring soak, so it is great to know I don’t need to avoid those.
I have been reading about sulfite sensitivity because it has been a problem for me recently. I found information from Dr. Google that says that having a lot of sulfates can make it harder for the body to metabolize sulfites in people who are sensitive to those. My current sulfite problems have corresponded with me ingesting more sulfates (N-Acetyl Cysteine and lots of San Pellegrino water, which I remembered my love of and started drinking a lot a couple weeks ago). It had something to do with sulfates blocking the production of sulfite oxidase.
Is that correlation spurious? Is it coincidental that I am having sulfite reactions more than usual at the same time as I am ingesting more sulfates? I’ve stopped both the N-Acetyl Cysteine and the San Pellegrino and have had some improvement, but not completely. The problems have been coming and going for some time, so it is hard to tell exactly what is related to what. Would sulfates seem like a worthwhile contributing factor to pay attention to?
Thank you again for your generosity with time and knowledge,
Andrea
Hi Andrea,
Thanks for the comment/question; It is unlikely that the intake of sulfates is contributing to or triggering your sulphite sensitivity. The enzyme sulphite oxidase oxidizes sulphite to sulphate, and it has been suggested that inadequate activity of this enzyme may result in excessive accumulation of sulphite; however, sulfate intake should have no influence over the activity of this enzyme, as there isn’t a feedback loop regulating the conversion of sulphite to sulphate. Here is an article that may be of interest: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017440/.
Hope this helps!
Sincerely,
Dr. Chad
Thank you. I had started with that article, but maybe I misread the part about sulfates. Sulfites seem to cause pain in my hands and feet especially.
My nutritionist has narrowed that down to inflammation that impinges on nerves in my neck. I am trying to find what things cause that inflammation and why it has been worse lately. At least I can go back to drinking San Pellegrino now!
Enjoy!!
Dr Chad
I am allergic to both sulfa drugs and red wine. I have been having stomach issues for years and was recently put on a digestive enzyme by a dietician. It is helping with my digestive issues but I’m having a reaction similar to what happens when I take sulfa drugs, but much milder. Is it a coincidence that these symptoms started when I started taking the enzyme or is there something in it that could be causing the problem?
Hi Laura – thanks for the comment/question. It is unlikely that you are reacting to a digestive enzyme; however, I would look at the other ingredients in the product you are taking to see if there is something that may be causing you an issue. I would also recommend a high potency, strain-identified probiotic, like Ortho Biotic (https://naturalsolutionsforahealthyyou.com/products/ortho-biotic-60-capsules/) to help with improving your gut health and immune function.
Good luck!
Sincerely,
Dr Chad
Thank you for your informative article! Since I happen to be one of those people who is allergic to both sulfites and the sulfa drug, I had wondered if the allergies might be related. That question is what brought me to this page. Thanks for your clarification and clear explanations about the terms!
You are very welcome K.K. – I’m glad you found the article useful –
Sincerely,
Dr. Chad
Hello,
I’m allergic to Sulfatrim. I want to have a spa treatment, but there is a warning which says to please refrain if you have allergies to sulfur. Am i in danger if i proceed with the treatment?
Hi Jessica,
Thanks for the comment; I really can’t say with the information presented. This would be an instance where you’d have to confer with the medical director at the spa to find out what the potential issues are. I would be very surprised if they couldn’t find a work-around solution for you.
I hope you enjoy your spa treatment!
Dr Chad
I keep reading that there is no way a person could be allergic to sulfate containing drugs and retail products.
I beg to differ. I had to have 3 hip replacement surgerys within 3 years, the last a revision. I was given the Morphine pump as primary pain control. A rash developed that doubled in severity each time. The 3rd surgery resulted in a dark purple rash that burned and itched which eventually peeled. No one believed I was allergic to the sulfate component. Because using shampoo products with lauyryl sulfate caused moderate scalp itch, I started using a sulfate free shampoo and the itching completely stopped.
I have been poo reactive Plavix which has a bisulfate component. Will I have a reaction?
Thank you 🙂
Hi Elizabeth – thanks for the comment; I’m sorry for the confusion, I’m sure this has all been a very frustrating (and eye-opening) process for you. From your comment, it certainly seems clear that you are having an immune reaction to something in each of those products and it is possible that the sulfur-containing ingredients are the culprit. Just because there is not a known (or probable) mechanism doesn’t mean it’s not happening, it just makes it more unique.
However, if that is the case, then there is no president for you to determine whether or not you will have a reaction to something without being exposed to it first. Because of this, your only real recourse is to (a) speak with your doctor and pharmacist about your past reactions and concerns and (b) try any given medication to see if you have an adverse reaction. I would be surprised if your prescribing doc didn’t modify the recommendation and/or dosage to accommodate your concerns.
Good luck –
Dr. Chad
What probiotics target urinary health. I often have e-coli in my urine. Was treated with sulfur drugs recently and developed leg cramps so bad it injuried my thigh area where I had had a hip replacement. Had to be hospitalized the pain was soo bad.
Hi Glinda,
Thanks for contacting us; we use a product called UltraFlora Women’s from Metagenics to work very well; it is a 50:50 blend of L. rhamnosus GR-1 and L. reuteri RC-14 (1 billion live organisms each) taken 1 or 2x/day.
Good luck!
Dr Chad
Hello
I can´t find the LRA test on http://www.elisaact.com/
Here you go: https://www.elisaact.com/test-categories/ –
Dr. Chad
I have a question:
Why sulphur is good for you but it is advised that one should stay away from shampoos that have sulphur in it. Am I missing something here?
Hi Odetta,
Thanks for the comment; this is a common point of confusion. Sulfur is a basic building block of life as we know it and is essential for human health. The difference with compounds used in personal care products (and many foods) is that sulfur is part of a larger compound and that compound either directly or indirectly (i.e., via products of metabolism) cause a negative response in some people (allergic or otherwise). So, it isn’t the sulfur per se that is the culprit; it is the compound that the sulfur is contained in and/or how that compound is metabolized in the body.
Hope that helps!
Dr Chad
I have been prescribed, for a colonoscopy in a week, SUPREP BOWEL PREP KIT, which is an oral solution containing sodium sulfate, potassium sulfate, and magnesium sulfate. I understand I am allergic to sulfa drugs, because I once broke out in a rash all over my body following an antibiotic injection for some sickness. Will I be allergic to those three sulfates in the oral prep kit for my colonoscopy?
Hi Jon,
Great question! Based on the available research, you are no more likely to have an immune reaction to the compounds listed above than someone that does not have an allergy to sulfa drugs. However, you will need to discuss this with your physician to keep them updated.
Sincerely,
Dr. Chad
My daughter had a severe rash outbreak recently and after using prescribed ‘bactroban’ it seemed to get worse and her PA said she was thought to be allergic to ‘sulfa drugs’, but the pharmacist and ER physicians said ‘bactroban’ isn’t a sulfa drug.
She finally saw a dermatologist who did a biopsy and concluded that she has psoriasis.
I was wondering if liposomal glutathione could be helpful for her whether or not she is allergic to sulfa drugs.
Hi Sophie – Bactroban cream does not contain any sulfa drugs; however, allergic reaction is listed as one of the possible side effects (see: https://www.rxlist.com/bactroban-cream-drug.htm#warnings_precautions for more information). I can’t speak to the liposomal glutathione, but having a reaction to bactroban does not in-and-of-itself indicate an allergy to sulfa drugs.
Hope that helps –
Dr Chad
Hi, I’m allergic to Sulphur and Bactrim. Have to be very careful with that drugs I can take when sick. I was just wondering if I’d be unable to visit an active volcano or not due to all the sulphur that would be present?
Hi Gwen – thanks for the question; you’ll have to double check if you are allergic to sulfur or sulfa medications (the latter is likely). If you are allergic to sulfa medications, going to a volcano should not cause an issue. Of course, you should check with your physician prior to going on your adventure.
Have fun –
Sincerely,
Dr Chad
Hi Dr. Oler,
Thanks for your article. I have a bit of a confusing health situation, being treated by several doctors and I’ve done as much research as I can. I have had years of extreme, life altering digestive distress-that recently has been diagnosed as SIBO, likely Hydrogen Sulfide dominant. This is basically the best guess and seems to have anecdotal support from the medical
Community as far as my test results, but there isn’t a test to specifically diagnose the Sulfide component, but my doctor wants to move forward with treatment as she sees this in a large percentage of her patients presenting with clear SIBO symptoms. I also am allergic to sulfa drugs (rash when a kid), sulfites (at least in red wine, just more mild histamine reaction, and possible digestive issues if consumed more regularly), and I think I react also to Sulfur foods-and recently have had a doctor mention that I may need to go on a low sulfur, low FODMAPs diet, and seems to have extreme gas and bloating when consuming them. It seems from reading that these aren’t necessarily correlated in most people–but is it possible to have a very high sensitivity for some people, and it be related? Also, would you know anything about sulfa/sulfite/sulfur allergies and intolerance and metal toxicity? I should mention, I think I have consumed a high amount of sulphites and sulphur heavy foods in my life, so this could be an intolerance that compounded over time. (I’m an otherwise healthy mid 30s female). Very random questions, thanks for your time!
Hi Rachel – thanks for sharing your situation; without knowing more about your history, it would be impossible for me to make recommendations. However, I would recommend that you read and follow the dietary recommendations in The Plant Paradox by Steven Gundry, MD, as it sounds like this may be of great benefit to you.
Please keep me updated – good luck!!
Sincerely,
Dr. Chad
ok I’m going to sound stupid but i really want to start eating chia seeds but they have sulphur in it I can’t takes meds that have sulfa in it will this be ok to eat? thanks Melanie
Hi Melnaie – thanks for the question; you are no more likely to have a reaction to foods that contain sulfur than someone that does not have a reaction to sulfa medications. Enjoy your chia seeds:)
Sincerely,
Dr. Chad
Hi I’m allergic to sulfa drugs is it ok to take sambucol which has sulphur in it just curious as to if I can or can’t take it
Hi Jody,
Thanks for the question; unfortunately, I am not familiar with this product, so I can’t provide any guidance. I suggest you bring it to your physician and/or pharmacist in order to get the answer you are looking for.
Good luck!
Sincerely,
Dr. Chad
I was recently prescribed Prevacid and Carafate to treat gastritis. I am allergic to Sulfa. I know Carafate contains sulfate, am I safe? An ingredient in Prevacid has me confused,sulfinyl benzimidazole. Does it contains sulfa?
Hi Marilia,
Thanks for the comment; neither of these medications is in the classification of a sulfa drug, so that should not be an issue for you. Of course, you should consult with your prescribing doctor and pharmacist to be sure these are are the correct medications for you.
Good luck –
Dr Chad
Dr. Oyler,
Your explanations are congenial, professional and concise. You are a fabulous resource for us all. Bravo and thank you.
Sorry, autocorrect misspelled your name.
No worries:)
Dr. Chad
Thanks for the feedback Terri – I am glad you found the information useful –
Sincerely,
Dr Chad
So informative, helpful, and hopeful. Thank you for your forum.
Thanks for the feedback Susan – I’m glad you found the article useful –
Dr. Chad
I am allergic to drugs containing sulfa ie: Bactrum. I have to have a barium swallow which they use barium sulfate. Should I be concerned. Is sulfa and sulfate (barium) the same?
Hi Pat – thanks for the comment. You are no more likely to react to the barium sulfate than someone that does not have a sulfa drug allergy. They are not the same –
Hope that helps-
Dr. Chad
Just like many others, I am allergic to sulfur drugs. Some months following a severe reaction to a sulfamethoxazole antibiotic, I experienced terrible histamine symptoms while having a shower, everyday, every shower. I started reading the labels on all the products used at shower time and the common link seemed to be sulfates. Research shows that there is no link to sulfates and sulfa drugs, but once I changed to sulfate free shampoo and soaps I have never again experienced the histamine symptoms and finally enjoy having a shower! I truly believe there has to be some sort of link? I want to start taking Glucosamine but am reluctant…
Hi Marg,
Thanks for sharing your experience. It is certainly possible you are reacting to something in your person care products, and that something may very well be sulfur-based. However, this does not mean that you are sensitive to these compounds because you have a sulfa-drug allergy. That said, if your immune function is compromised (assuming this is an immune reaction), determining the root cause(s) and correcting them should lessen or eliminate your response to those products; this is very unlikely to change your reaction to sulfa-medications. If your reaction to these products is not immune related, then it is most likely toxicity/detoxification related; again, a viable course of action would be to work a functional medicine provider to determine the root cause(s) of the imbalance and work to correct it so your reaction is lessened/eliminated.
The upshot of this is that I would encourage you to put more time/energy into the “figuring out the cause(s) and correcting them” avenue than trying to find a connection between sulfa-drugs and sulfate/sulfite reactions.
I hope this helps – good luck!!
Sincerely,
Dr. Chad
I am currently taking Eloquis blood thinners and i am having a similar reaction to when i found out I had a sulfa allergy. Does Eloquis have any sulfa-like components? Please and thank you
Hi Alyson – not to my knowledge, but you should address this question to your pharmacist and prescribing physician to be sure and to discuss possible alternatives.
Good luck!
Sincerely,
Dr. Chad
Hello. My name is Sherri. Nice to meet you. I have been looking for real answers to my all of a sudden certain foods create severe air hungry responses everywhere! This by far is the best blog I have seen yet, (or whatever you call these steams of conversations, I am so old school). I now have a severe allergy to cranberries,fish of all kinds, sulfa meds, and sulfate products in general make me lose my air! I have been using the same shampoo for a decade and eating cranberries/drinking cranberry juice all my life! These Dr’s call it “asthma, non specific bronchospasms,” etc. Then they send me home with sulfa antibiotics (which I am allergic to) to treat my non existent UTI’s, landing me back to near anaphalax shock again. So frustrating. I am eating so healthy, (thinking it was a sulfite allergy, then candida, etc) and now if I eat squash I can’t breathe! I’m reduced to an Epi pen, no answers. The allergist told me that food doesn’t create breathing issues, only skin disorders. I guess I showed him when my face blew up and he had to throw the nebulizer on me! This is terrible. There’s something wrong but I don’t know what. I can’t think straight, (I’m a paralegal, need to be able to think), I’m exhausted all the time, or dying for air. I have asthma, but this type of airway constriction is different. I think it is some type of allergy to amino acid rich foods? I also have a hitial hernia, and acid reflux. I can’t eat apples but mango is fine. If I don’t eat at all, I’m okay too:( ugh. Not sure where this all came from. Thanks for listening.
Hi Sherri – thanks for sharing your story, although it sounds like you have been through more than your fair share of frustration (and frightening experiences!).
I would highly suggest you find a naturopathic doctor and/or functional medicine provider in your area that can look at your case from a different perspective; they should be able to find out what is happening with you and get you some much needed answers.
Good luck – and please keep me updated!
Sincerely,
Dr Chad
Hello Dr. Oler,
My wife is allergic to sulfur in drugs. Should she avoid sulfitting agents as well as sulphur drugs?
Thank you,
Ron
Hi Ron – great question. Being allergic to sulfa drugs does not put her at a greater risk of being sensitive to sulfites or sulphur; however, it is no guarantee that she is not sensitive to them either. The only real option is to eliminate them for a period of time (generally 1-3 months) and then try a minor exposure to them to see if/how she reacts. Doing so under the supervision of your health provider is certainly recommended.
Good luck!
Dr Chad
Thanks for your information. I am going in for a prostrate biopsy tomorrow and the doctor wants me to take a antibiotic before the procedure. He first wanted me to take levofloxacin but we know of two personal friends that had their tenons affected by this drug. It may be rare but I already have a few issues with my legs and feet so I didn’t want to take the chance on this drug. He then prescribed an injection of Gentamicin. From what I read here this is NOT the same as sulfa, of which I am allergic, but from the sulfate family. Is this correct or should I avoid this antibiotic also? Thank you Todd
Hi Todd,
Thanks for the comment/question; gentamicin is not a sulfa drug; it is an aminoglycoside antibiotic, that is not chemically related to sulfa drugs.The manufacturers make the gentamicin as a sulfate salt to increase its solubility. Sulfur does not equal “sulfa”.
Best of luck with the procedure –
Sincerely,
Dr. Chad
When you are allergic to sulphur can you take morphine sulphate?
Hi Unathi – thanks for the comment/question. It is a common misconception to equate an allergy to sulfa medications with an allergy to sulfur; luckily, they are not the same. If a person has a reaction to sulfa drugs, they are no more likely to react to sulfur containing medications than someone that does not react to sulfa medications. However, you should always check with your physician before taking any medication.
Hope that helps!
Sincerely,
Dr Chad
I have an issue with sulfur specifically, which you are saying no one is allergic to. I have tried taking MSM on several occasions. Each time I have taken it, I have been bedridden for up to 2 days feeling like I have been poisoned. If I eat raw onions, I also feel like I have been poisoned. Raw onions are not as bad as MSM, but I still can’t eat them. Does this mean I can’t take SAMe either? I am trying to understand what to avoid since supplements are expensive. I was told by a doctor that I was born with an intolerance to sulfur, which makes sense because I’ve always had that reaction to raw onions and garlic.
Hi Karin,
Thanks for the question/comment. It would be impossible to have an immune reaction to sulfur and live (which is what I was referring to in this post); you could certainly have a non-immune reaction (i.e., intolerance) to specific sulfur containing compounds. Unfortunately, the safest bet would be to avoid all sulfur containing supplements, as you will only be able to determine your tolerability through trial and error (as it sounds you have been doing). Sorry I couldn’t provide more guidance –
Dr Chad
thank you Dr Chad.
You are very welcome Karin:)
Dr. Chad
Dear Doctors, I just had a cataract procedure & received Versed & Propofol which I found out contains Sulphite. When I came out of the surgery my face looked totally different, meaning it was like all my collagen had been sucked out of my tissues. I had bags under my eyes, lumps under the bags & severe wrinkles on my fore head and under my eyes. My son looked shocked when he saw me & when I got home I saw why! The surgery center said that I was moving around so they had to give me more medication to keep me still. My question is “If I am allergic to Sulfa drugs could this be a reaction to it?”
I have been really weak, tired and have a hard time keeping my eyes open ever since. I just want to get back to normal but don’t know where to turn. I understand that some people have gotten HEP C & even HIV after use for outpatient surgery because they used a larger container of Propofol. I am waiting for blood test results now & am scared this won’t be good. I have been tested before for both during a hospital stay for anemia from the Dapsone drug which I found out was eating my red corpuscles. I feel like I’m in a science fiction movie!
God Bless you for all your help!
Cynthia
Hi Cynthia – thanks for contacting us, although I am sorry to hear you are having to go through all this. Being allergic to sulfa medications does not put you at any higher risk of reacting to sulphites than someone that is not allergic to sulfa drugs. However, that doesn’t mean you aren’t reacting to the sulfphites (or something else) in one or more of the medications. I actually had a similar experience many years ago after an MRI and found that I was allergic to something in the MRI contrast (which is exceptionally rare). I would suggest seeking out a functional medicine provider and/or naturopath in your area to have some additional testing done to try and determine what is occurring so you can properly address it (and not have to go through this again!).
I wish you the best of luck –
Sincerely,
Dr Chad
I’m extremely confused. I have been told by my doctor years ago, after having a severe reaction to prescription eye drops for a cut on my eye, that I am allergic to sulfur… NOT sulfa sulfates, or sufites, etc., but specifically sulfUR, which would explain why I become deathly ill for days upon eating eggs, garlic and broccoli, some other things as well, and why I had a horrible reaction to any topical meds containing sulfUR as an ingredient. Would that not mean that i cannot also use sulfa, sulfates, sulfites, etc., as they all CONTAIN or are forms of sulfur? I have googled this to death! All i read is it’s impossible to be allergic to sulfur. Huh? Lately just trying to figure out if that’s what’s in my water softener that’s giving me a problem? Wondering if it’s in water softening salts.
Hi Anna – thanks for the comment; this is a very confusing topic and you are certainly not alone. I just answered a similar question, so I will reprint the response here:
While it is theoretically impossible to be allergic to sulfur (many of proteins/amino acids in your body contain sulfur) you can certainly “react” to various forms of sulfur. The issue may be semantics; you are probably not having an immune reaction (i.e., allergic reaction) to at least some of these compounds; it is more likely some kinds of non-immune reaction (i.e., intolerance) due to some deficit in how your body breaks down these compounds. Either way, consuming these compounds causes you distress.
The good news is that intolerances can often be overcome IF you can determine where in the digestive/metabolic processes the deficit(s) are; finding them can be a trick, but I would suggest you start with a functional medicine provider and start by looking at an organic acids test along with genomic testing to see if that doesn’t supply some answers.
Good luck!
Sincerely,
Dr. Chad
Dr. Oler,
I have had this discussion many times with MDs. In 1973 at age 21 I was passing blood clots in my urine. An urgent care Dr on a Saturday prescribed a sulfa drug at the time. By Monday my arms and legs were all itchy with spots. My employer sent me to urologist that day who started treating me with a non-sulfa drug.
In the mid-1980s here in FL my mom, kids and I would go to a buffet restaurant. But every time we ate there we would have to race home before the diarrhea would hit. This happened with a few other restaurants that had salad bars. Once the State of FL outlawed sulfate use in restaurants these reactions also stopped.
I have never been able to take ferrous sulfate as it causes vomiting and diarrhea. I can take ferrous gluconate or ferrous fumerate so I know it is not the ferrous.
Two days ago I had to prep for a colonoscopy. I was given SUPREP which is sodium sulfate. Half way through I vomited it up and had to finish with polypropylene glycol. Again I had this discussion with my MD… He says I must be allergy tested because it is not possible to be allergic to all 3 forms of sulfa. Can you help me understand?
Thank you.
Hi Arlene – thanks for the article. While it is theoretically impossible to be allergic to sulfur (many of proteins/amino acids in your body contain sulfur) you can certainly “react” to various forms of sulfur. The issue may be semantics; you are probably not having an immune reaction (i.e., allergic reaction) to at least some of these compounds; it is more likely some kinds of non-immune reaction (i.e., intolerance) due to some deficit in how your body breaks down these compounds. Either way, consuming these compounds causes you distress.
The good news is that intolerances can often be overcome IF you can determine where in the digestive/metabolic processes the deficit(s) are; finding them can be a trick, but I would suggest you start with a functional medicine provider and start by looking at an organic acids test along with genomic testing to see if that doesn’t supply some answers.
Good luck!
Sincerely,
Dr. Chad
I think anyone that is drawn to reading this article should be aware of the connection of sulfur intolerance to the CBS and MTHFR gene mutations. These mutations directly affect the liver’s ability to metabolize any sulfur-based amino acid.
Down-regulation, or diminished CBS activity, results in poor sulfur metabolism, the pooling of sulfur groups, and potentially high homocysteine.
Moreover, the transsulfuration pathway is the only pathway capable of removing sulfur-containing amino acids under conditions of excess.
The older I get the slightest amount of sulfur-based amino acids cause toxic overload that is evident with brain fog, bloating, gas and breakouts. Many foods I could eat 20 or 10 years ago have been completely banned from my diet. Reading the lables to discover inclusion of garlic, onions, yeast, soy or dairy (not to mention sulfites) is a necessity. I was told at age 18 I was “allergic” to sulfa-based drugs, as well.
I hope this helps!
Dear Dr. I’m allergic to sulfa drugs,i also noticed my scalp as breaking out with little bumps I switched to sulfa free shampoo,now my face is breaking out with small pimples I take good care of my skin could this also be a sulfa drug reaction
Hi Sharon,
It is possible you are reacting to something in a product that you are using topically on your head/scalp/face and it could be a sulfur-based compound. It is really hard to know without further testing, like an LRA test: http://www.elisaact.com.
Dr Chad
Hi Dr Oler, I am Celiac and have done all possible to avoid gluten. Lately, I have been unwell and have had times of nausea, vomiting, chronic headaches, dizziness, bloating and difficulty breathing. Been trying to put the pieces of the puzzle together and think I have an intolerance to Sulfites. Is there any correlation that you know of, between Celiac Disease and intolerance to Sulfites, which makes people with Celiac Disease more prone to being intolerant to Sulfites ? Look forward to you response. Many thanks.
HI Michele,
Thanks for the comment/question; I do not know of any data linking gluten intolerance to an immune reaction to sulfites. However, it is known that people that have gluten intolerance are at a higher risk of developing/having both immune (i.e., allergy/hypersensitivity) and non-immune (intolerance) reactions to other foods/substances. A good option would be to run an LRA test and include sulfites in whatever panel you decide to run: http://www.elisaact.com.
Good luck!
Sincerely,
Dr. Chad
I am allergic to sulfa, Bactrim specifically, and would like to get a tattoo. Some of the inks have mercury sulfide. Is this something I should worry about? Neither my doctor nor my pharmacist can give me an answer.
Hi Deb,
Great question; your allergy to sulfa medications does not put you at any higher risk of reacting to sulfide compounds than someone that is not allergic to sulfa drugs, but that doesn’t rule out the possibility of adverse reaction. The honest answer is that each person is there own experiment so neither your doctor nor pharmacist can give you a conclusive answer.
Hope that helps –
Dr Chad
Hi, Doctor. Thanks for the interesting article. I’m still left wondering about my own sensitivities, though. I had a reaction to Bactrim, but it wasn’t dermatological in nature. I had chest pain and shortness of breath. I was recently started on 325 mg of ferrous sulfate because of anemia in pregnancy. I went to the ER yesterday with similar chest pain and shortness of breath. Your article says that sulfonamides are different than sulfates in supplements…is it still possible to have the same reaction to both?
Hi Mary,
It is certainly possible to have a similar reaction to different substances; I would suggest having more extensive testing completed with your functional medicine provider to see if you can identify the offending agents. If possible, an LRA from Elisa/Act Biotechnologies is a good place to start: http://www.elisaact.com.
Good luck –
Dr Chad
I disagree with this article! I have a sulfa drug allergy and also am highly sensitive to sulphites in food and supplements(man- made and naturally occurring.) I find it difficult to believe that I am unusual in my sensitivities.
Hi Darbie – thanks for your comment. I no way does this data mean that you don’t suffer from these sensitivities and that others may as well. However, based on the data available, the research shows that you are no more likely to suffer from sensitivities to sulfites because you have a sulfa allergy. Case in point, since you have multiple sensitivities (i.e., immune challenges – as indicated by your comment) it is very likely that you have multiple other sensitivities to non-sulfite substances. These do not occur because of the sulfa allergy either, but rather to an imbalance in your immune function causing a heightened response. Others may well have other hyper-sensitivity reactions to other substances, but correlation in no way indicates causation. This is important because we always want to get to the cause(s) of imbalance so they can be corrected. In your case, the cause is likely to be immune insult/damage, so your efforts should be focused on identifying and addressing these.
Good luck!
Sincerely,
Dr Chad
Hi Dr.Oler,
I am allergic to the sulfa drug Bactrim and get severe vomiting from it. I hope I understand this article correctly, that it should be ok to apply sulfur topically to my hormonal acne? The Kate Somerville dermatology brand has an acne spot treatment that contains 10% sulfur, zinc oxide, BHAs, salicylic acid, isopropyl alcohol, etc. Topical Cleocin hasn’t worked at all so I want to give this sulfur treatment a try.
Hi Katie,
Thanks for the comment. The article is pointing out that research indicates that you are no more likely to react to sulfates than a person that is not allergic to sulfa drugs. However, there is no way to know if you will react to any substance (sulfur-based or not) without testing and/or use, so be sure and speak to your doctor/allergist about it first.
Sincerely,
Dr Chad
I’m allergic to sulfa medication…. if I understand correctly it’s not the same as the sulphur found in MSM. I’m wanting to start taking MSM… just want to be safe…
Hi La’Kisha –
You are correct: sulfa medications and the sulphur compound found in MSM are distinctly different. Based on the available research, being allergic to sulfa medications does not put you at increased risk of having a reaction to MSM. However, to be clear, it does not decrease your risk either, meaning you could have a reaction to MSM, but it would not be related to your sulfa allergy.
Hope that helps!
Dr Chad
I’m completely confused by your article.
1. I was in chemistry class we were burning sulfur to see the chemical reaction. Teacher been doing it for years I was the 1st student My nasal passage and throat lining was burned away (doctor said it look like a drank acid) found out I’m allergic to Sulfur!
2. Had a bladder infection and was prescribed sulfa since it not sulfur broke out in rash from head to toe.
3. I was persribed Naratriptan for migraine & I stop breathing because Naratriptan has Sulfite type in it again different from sulfa & sulfur Doctor thought I’d be fine I’m lucky to be alive.
You says all 3 Are different doesn’t mean if your allergic to one you will be to the other. Is it possible to be allergic to all 3? Because I tell all my dr I’m allergic to sulfa/sulfur/sulfite do they think I’m crazy for saying that?
Hi Michelle,
I’m very sorry for the confusion. The point of the article was the (a) sulfa medications, sulfur and sulfites are distinct compounds and (b) having a reaction to one does not mean you are necessarily reactive to the others. You can certainly have reactions to both sulfa and sulfites as well as any number of other substances. It is extremely unlikely that you react to sulfur (the element), as this is one of the building blocks of life.
I hope that helps!
Dr Chad
I have very bad reactions to wine (severe vertigo and nausea) snd to a lesser degree to some of the sulfite containing foods that you mention. But I also have had a similarly horrible reaction to Epsom salts bath. The first time it happened I thought I might have been a bit dehydrated, but the second time it was so bad, I became violently ill with horrendous vertigo lasting several hours. I thought it was sulfites, but I’m understanding that they’re different compounds? Is it possible to have a reaction to both?
Hi Anne,
It is certainly possible to have a reaction to both (as well as almost any other compound)! This post just points out that those that are allergic or sensitive to sulfa drugs (for instance) are no more likely to react to sulfites as those that are not allergic/sensitive to sulfa drugs, and vice versa.
That makes it important to listen to your body and get testing done if at all possible so you don’t have to find out solely through trial and error.
Sincerely,
Dr Chad