FOOD INTOLERANCE NETWORK FACTSHEET

Capsaicin for management of salicylate intolerance: an open trial

Science review
Report of pilot trial
How to participate in the open trial
Frequently asked questions
Reader stories
References
More information

Keywords: capsaicin, chilli, salicylate, trial, challenge

 

  Science review

Salicylates are compounds that occur naturally in plants and are used in pharmaceuticals. The average Australian diet includes 10 to 200 mg of salicylates a day from natural sources (1). Some salicylate sensitive people need to reduce their daily dietary salicylate intake to manage effects of salicylates including respiratory, skin, gastrointestinal, neurological and skeletal symptoms (2,3,4).

Capsaicin is an ingredient in chilli peppers that is responsible for their characteristic hot flavour, produced by activation of a nervous system receptor called TRPV1 that was discovered in 1997 (5). More recently, scientists have shown that salicylates activate the same receptor (6). Capsaicin and salicylates compete for access to this receptor (7).

If capsaicin is ingested a short time before salicylates, it can reduce the bioavailability of salicylates in the blood stream in both rats (8,9) and humans (10). Long term regular ingestion reduces salicylate levels further than a single ingestion (9).

A study using aspirin (a salicylate drug) with rats showed that a single low dose of 10 mg capsaicin/kg bodyweight nearly halved the bioavailability of aspirin, though aspirin blood levels remained unchanged. With a single high dose (30 mg/kg) or chronic administration once daily for 4 weeks of both low and high doses, aspirin blood levels were undetectable and salicylic acid bioavailability was reduced by up to 76% (9). However the doses of salicylates used far exceeded those obtained on a daily basis from foods so doses of capsaicin need to be reduced proportionately for a human trial based on likely intake from food.

Capsaicin was used to reduce adverse reactions to salicylates in a study in which salicylate-induced tinnitus in rats was significantly suppressed by a synthetic version of capsaicin (11). Nasal polyps, a well-documented salicylate-induced condition in humans, were significantly reduced by capsaicin (12). Capsaicin may also reduce gastric damage caused by salicylates – in Singapore, Indian and Malay people are several fold less likely to suffer peptic ulcers than Chinese people (13), which may be explained by the much higher amount of chilli in Indian and Malay traditional diets (10).

As a guide to dose, an average Indian or Malay person in Singapore consumes about 3 g of chilli daily (10), corresponding to about 12 mg capsaicin and there are several published articles in which 5-30 g/day of chilli has been advocated, leading to daily capsaicin intakes that might be as high as 100 mg. The human intake of capsaicinoids in India, Thailand and Mexico, where capsicum spices are heavily consumed, has been estimated to be 25 – 200 mg/day (14).

This review suggests that the capsaicin-salicylate competition mechanism could benefit individuals who experience adverse reactions to salicylates in foods.

  Report of pilot trial

Objective

To investigate whether regular ingestion of capsaicin could be used by salicylate-sensitive individuals to reduce adverse effects, thus allowing a higher daily intake of dietary salicylates, and to develop methodology for an open trial.

Method

Subjects: One male and one female who had had salicylate intolerance determined by a dietitian-supervised trial of the RPAH elimination diet (15). They had remained on the Failsafe eating program (16) for 15 years, eating additive-free mostly low salicylate foods with a few daily moderate items and occasional high items as tolerated or when prepared to suffer the consequences.

Dose of capsaicin: Cayenne pepper powder (Capsicum anuum, sometimes sold as Capsicum frutescens) with 60,000 Scoville Heat Units (SHU) was obtained in 550 mg neutral gelatin capsules. The Scoville scale is a measurement of the spicy heat of a chilli pepper where one part capsaicin per million corresponds to about 15 SHU. The dose of 500 mg dried chilli powder thus contained approximately 2 mg capsaicin. In bodyweight terms, this is a single dose of 0.03 mg capsaicin/kg bodyweight. A second cayenne pepper source with 67,500 SHU was used at 1.125 g (¼ teaspoon) per dose, giving approximately 5.6 mg capsaicin.

Symptom measurement: Each subject listed in advance six of their individual symptoms caused by high salicylates and scored them on a daily basis from 0 (no symptoms) to 5 (severe symptoms) throughout the trial. Daily scores were summed to indicate severity of symptoms and averaged through the length of each phase. Typical symptoms scored were delay in getting to sleep previous night; poor sleep quality previous night; irritability generally; explosive outbursts of irritation; rumination and interior monologue; restlessness, inability to settle to task. A parallel food intake diary was also maintained.

Baseline: Before beginning the trial, subjects followed their usual low to moderate salicylate diet for one week strictly without transgressions to achieve a baseline of three symptom-free days in a row.

The pilot trial was in four phases:

Phase 1: one week of 500 mg dried chilli powder of known capsaicin content twice a day in capsules 30 minutes before low salicylate meals. This phase was to test whether salicylate-sensitive individuals could tolerate chilli powder since chilli contains salicylates. If they passed the chilli challenge, they could proceed to Phase 2.

Phase 2: one week of 1 g chilli twice a day 30 minutes before high salicylate meals. Chilli powder was mixed into yogurt or quark rather than swallowed in capsules, due to heartburn problems that emerged in Phase 1. This phase was to test whether salicylate-sensitive individuals were protected by capsaicin in the regime followed. The high salicylate food challenge consisted of six serves per day for one week of high salicylate foods or drinks such as apples, blueberries, tea, curry, melon and pumpkin.

Phase 3: one week of high salicylate meals as above but without chilli. This phase was to confirm that salicylate sensitivity still existed and that the effects, if any, of the capsaicin, were transient and did not carry over into the following period.

Phase 4: six months of long term regular ingestion of capsaicin twice a day before meals with increased intake of moderate and high salicylate foods without suffering from salicylate side effects. This 'real world' trial tested whether chilli could be easily incorporated into a daily routine, that no long term adverse effects developed, and that no tolerance to capsaicin developed.

Results

TABLE 1: Summary of food-based salicylate effects scored over periods shown

Baseline: Both subjects established a clear low salicylate intake baseline.

Phase 1 – capsaicin challenge: At the end of the week there had been no adverse reactions to chilli so subjects moved to the next phase.

Phase 2 – capsaicin + salicylate challenge: At the end of the week there had been no adverse reactions to the increased salicylate intake from chillies.

Phase 3 – salicylate challenge without capsaicin: Subject 1 (male) recorded a doubling of salicylate symptoms immediately to levels which would not ordinarily have been acceptable. Subject 2 recorded a quadrupling of symptoms and withdrew at the end of the second day due to symptoms that made work commitments too difficult.

Phase 4 –6 month observational trial: For six months, subjects kept a food diary while experimenting with various doses, forms and timing of capsaicin. Throughout this time, both subjects were able to tolerate moderate to high doses of food-based salicylates provided chilli powder was regularly taken beforehand. On occasions when subjects forgot to take chilli, salicylate symptoms reappeared. Rules for use of chilli were developed as reported in Frequently Asked Questions.

Discussion

Findings showed that regular ingestion of capsaicin immediately preceding salicylate intake enabled subjects to tolerate more high salicylate foods than they could otherwise. Various rules for the management of salicylate intolerance were developed and are reported in the Frequently Asked Questions below. Two important findings are that the protective effect of capsaicin appears to last only about two or three hours after ingestion and that the chilli needs to be eaten in the first few mouthfuls to get the best effect, presumably because the TRPV1 receptor has to be flooded by capsaicin before starting to eat the salicylates.

Both subjects reported overconfidence and an initial feeling that they could eat anything but found that chilli protected them only against salicylates, not additives, glutamates, amines or other natural food chemicals such as natural benzoates that tend to be in very high salicylate foods. After suffering reactions to a variety of foods that were not included in their usual diet, such as wine, mushrooms and tomatoes, subjects preferred to eat foods classified as moderate and high in salicylates rather than very high. Similarly, if at times they forgot to eat chilli, they were likely to suffer from salicylate reactions, so reported the need for a routine. Nevertheless, subjects felt that the use of chilli to manage salicylate intolerance had improved their quality of life.

This pilot trial established the possible efficacy of capsaicin in managing aspects of salicylate intolerance and provided a framework for further research, initially in the form of the open trial described below.

  How to participate in the open trial

If you would like to participate in the open trial and have already done the RPAH elimination diet with a salicylate challenge, please register by emailing This email address is being protected from spambots. You need JavaScript enabled to view it.. This ensures that both positive and negative results are reported. Note that you are required to accept the following indemnity if you participate:

Legal Release and Indemnity:

• I participate in this trial at my sole risk and responsibility.
• I release, indemnify and hold harmless Sue Dengate, the Food Intolerance Network and their servants and agents from and against all actions or claims which may be made by me or on my behalf by other parties for or in respect of arising out of any injury, loss, damage or death caused to me whether by negligence, breach of contract or in any other way whatsoever.
• I also agree that in the event that I am injured, I will bring no claim, legal or otherwise, against Sue Dengate, the Food Intolerance Network or their servants and agents in respect of that injury.

1. Where to get chilli in Australia

550mg capsules - you can get cayenne pepper chilli powder with 60,000 Scoville Heat Units from http://www.herbosophy.com.au/search.php?search_query=cayenne&x=0&y=0  for $17.50/100 capsules plus postage.

Or these: BIOVEA cayenne pepper capsules
https://www.biovea.net/AU/product/detail/3655/cayenne-pepper-450mg-40000-heat-units-180-vegetarian-capsules/?TI=GGLAU&C=N&gclid=Cj0KCQiA3-yQBhD3ARIsAHuHT65p3RgnO6Klv6Rvr4GXDw89Ud948BcW0MMrf6mxjoGig7Wm3BtCjVQaAtSAEALw_wcB

2. How to keep a food and symptom diary

Like any other challenge on the RPAH Elimination Diet, you need to keep a food and symptom diary.

• Make a list of your own salicylate symptoms (you should have already identified your own symptoms during your salicylate challenge) – but only list salicylate symptoms, for example, I had to delete headache which is caused by amines, and runny nose which is caused by dairy.
• Every day, rate each symptom on a scale of 0-5 where 0 is none and 5 is the worst. As usual, you are aiming for 3 symptom-free days in a row before starting any challenge. It took me 7 days to achieve my 3 symptom-free days because we had eaten out the day before I started recording symptoms.

Subject two - Baseline week (ate out the day before starting)

•  After three symptom-free days in a row, you can start taking chilli (read the FAQs first). If at the end of a week of taking chilli your scores are the same or better, you can decide to continue to Phase 2 etc. Keep reading the FAQs to make sure you are not making mistakes.

3. How to report to us

We are interested to hear your stories and also to see your actual results. Because we have limited resources to analyse your results, please send them to This email address is being protected from spambots. You need JavaScript enabled to view it. in the same format as the table below if you can, like this:

My name:

If you can't determine averages and standard deviations, just send your raw results.

This factsheet will be regularly updated with results from Network members, and a new category will be established in the Failsafe forum to share experiences and ideas.

  Frequently asked questions

Are there any disadvantages of using chilli to manage salicylate intolerance?
Is there any danger from taking chilli as suggested?
Does this mean I can eat anything I want?

Can I eat spaghetti with tomato-based topping?
Can I drink wine?
Does this mean I can eat lots of high salicylate fruit and vegetables?
Can I eat berries?
Which foods do you eat now?

Chillies contain salicylates , so wouldn't that cause a problem?
Can I eat fresh chillies instead of chilli powder?
Can I use commercial chilli sauce?
How many times a day do you have to eat chilli?
How do you eat chilli powder?
I really hate the hot taste of chilli. Is there any alternative?
What about chilli powder and heartburn?

Wouldn't it be better just to eat spicy meals and curries all the time?
Why can I eat hot curries in Thailand and Nepal that would affect me at home in NZ?
How do Indians manage salicylate intolerance?

What should I do if I forget to take the chilli before a meal?
What if I am eating out and the meal includes additives?

Does eating chilli help with weight loss?
Does eating chilli help with inhaled salicylates?
Can I use this with children?


  Q. Are there any disadvantages in using chilli to manage salicylate intolerance?

A. Yes: overconfidence! This system is NOT a magical cure. It will NOT work if you:

• forget to take chilli
• don't take enough chilli
• take chilli at the wrong times, or
• eat foods high in other food chemicals that can cause symptoms.

We often forgot to take chilli at first because we became used to eating so many previously forbidden foods. Then our salicylate symptoms would come back (see also success stories). Once you learn to use the system, it does take the pain out of being salicylate sensitive.

  Q. Is there any danger from taking chilli as suggested?

A. Please seek medical advice if you have any concerns. The most likely foreseeable risk from participation in this trial is that, based on experience in the Food Intolerance Network, resuming a moderate to high salicylate diet will cause food intolerance symptoms to recur, with the possibility of minor illness such as a cold due to a lowered immune system. Sometimes you will forget to take the chilli and that can be unpleasant when salicylate symptoms return and withdrawal is required.

We suggest that you should be able to answer 'yes' to each of the following:

• I do not suffer from ulcers or heartburn as a chronic illness, either before or after my diagnosis as salicylate intolerant.
• I am not allergic to latex, bananas, kiwi, carob, chestnuts or avocado.
• I am not pregnant or breastfeeding.
• I do not suffer from asthma.
• I am not using any medications for other illness.
• I have been eating a reduced salicylate diet for at least 12 months.
• I am avoiding the 50 additives known to cause problems in food intolerant people and also any other substances to which I have been proven intolerant.

The EU Scientific Committee on Food concluded that the available data did not allow it to establish a safe exposure level for capsaicinoids in food, while noting traditional use at 25-200 mg capsaicin per day (14). The high consumption of chillies in Mexico and India was reported to be associated with cancer of the upper digestive tract. In contrast, the maximum daily intake from mild chillies and paprika in Europe was roughly estimated to be 1.5 mg/day. In the one study conducted in Europe, no increase in the incidence of gastric cancer was found in association with occasional and lower intakes of chillies. The open trial is suggesting a dose of about 6 mg capsaicin at a maximum of five times per day, meaning a daily dose at the low end of traditional human intake in capsiacin-eating societies.

  Q. Does this mean I can eat anything I want?

A. No! Chilli won't protect you against additives, glutamates, amines and some other natural food chemicals such as natural benzoates that tend to be in very high salicylate foods.

  Q. Can I eat spaghetti with tomato-based topping?

A. Unfortunately, no. Tomatoes are listed as very high in salicylates, amines and glutamates especially when processed into sauce, paste and toppings. Chilli will not counteract the effect of amines and glutamates and doesn't appear to counteract very high salicylates, at least in our experience. Fresh, peeled, sliced tomato is listed as high rather than very high in salicylates. If you can tolerate amines and glutamates, chilli may help you to tolerate fresh tomato slices but beware of overdoing it if you are sensitive to amines or glutamates. I myself eat fresh sliced tomato only occasionally despite our garden running wild with them.

  Q. Can I drink wine?

A. Hmm, we tried wine. Despite using SO2GO to get rid of sulphites, chilli definitely did NOT protect us against whatever is in red wine. Very high salicylate foods and drinks are likely to contain other food chemicals - such as natural benzoates, oxalates, tannins, amines and/or glutamates – and some of those can also affect salicylate sensitive people too. Moderate and high salicylate foods and drinks are safer. According to the RPAH Elimination Diet Handbook, most people with salicylate sensitivity can manage half a glass of white wine at dinner. Chilli may help you to increase that if you don't react to amines and glutamates.

  Q. Does this mean I can eat lots of high salicylate fruit and vegetables?

A. Perhaps. Foods listed as moderate are probably safer, but you may be able to manage some high salicylate foods.

• First, if you are amine or glutamate responder, check whether your favourite high salicylate fruits and vegetables contain amines, as many now do - e.g. mangoes, custard apples and figs are listed in the high salicylate category as also containing amines, and corn is listed as high salicylate also containing glutamates. Ask for our Salicylate & Amines Mistakes Information sheets if you are confused: This email address is being protected from spambots. You need JavaScript enabled to view it.. In the very high category, all items including most berries, cherries, dates, grapes, kiwifruit, plums, tomatoes and pineapple contain at both salicylates and amines and sometimes glutamates as well. In our experience, chilli DOES NOT WORK FOR THE VERY HIGH category, presumably because they contain other natural food chemicals such as natural benzoates as well.
• Second, you need to know which fruit and vegetables are listed as moderate or high e.g. carrots, pumpkin, sweet potatoes, apples, lychees, peaches, etc. If unsure, ask for our Salicylate & Amines Mistakes Information sheets: This email address is being protected from spambots. You need JavaScript enabled to view it.
• Third, check how long it is since you had your last dose of chilli – we think it should be WITHIN TWO TO THREE HOURS but are not sure.
• Fourth: the amount of salicylates you can tolerate may depend on your dose of chilli. We don't know – but we welcome feedback (This email address is being protected from spambots. You need JavaScript enabled to view it.)

Salicylate content of some fruits and vegetables

*Source: Swain A et al, 1985

** RPAH Elimination Diet Handbook, 2009 (available from www.allergy.net.au)

  Q. Can I eat berries?

A. Strawberries and all other berries except blueberries and mulberries were upgraded from high in salicylates to very high in salicylates in the 2009 RPAH Elimination Diet Handbook (available from www.allergy.net.au), and are now listed as containing amines as well as salicylates. We have found we can manage 10 blueberries at a sitting, along with other moderate and high salicylate foods but blueberries are probably the highest salicylate item we eat and if we double the amount of blueberries combined with other salicylate-containing foods, we can notice that we have had too much. Foods listed as moderate are probably safer.

  Q. Which foods do you eat now?

A. We found that – except in India – we didn't like taking chilli before breakfast, so breakfast is failsafe (e.g. oat porridge, milk, pear). Taking chilli before snacks was also a problem because it was too easy to forget sometimes. So we independently settled on a routine where we take chilli twice a day – before lunch and dinner – and otherwise stick to a low salicylate diet, unless wanting to eat a higher salicylate fruit or there is a special occasion. This means for our two biggest meals of the day we can routinely eat from a much wider selection of moderate to high salicylate vegetables and fruit than were previously possible for us, for example, asparagus, beetroot, carrots, cucumber, corn, non-iceberg lettuce, sweet potatoes red and white, butternut pumpkin with smaller and limited amounts of mango, rockmelon, pomegranate, rhubarb, lychees, blueberries and the odd slice of fresh tomato, see photos.



I also enjoy fresh lemon juice with fish and oysters again, but I have to be careful due to amines in lemon juice. Interestingly, we found people in Indian and Nepal ate fruit as part of a main meal that would involve chillies. Or the street vendors would sell, for example, a pineapple or cucumber sprinkled with chilli powder.

Q. Chillies contain salicylates so wouldn't that cause a problem?

A. All spices including chilli are listed as very high in salicylates in the RPAH Elimination Diet Handbook, page 48. However, in an analysis of salicylate contents of foods, chilli powder is low compared to other spices such as cumin and paprika (see table). Note that spice merchants consider cayenne, which is also relatively low, to be a particular variety of chilli. Considering the small dose of chilli used, 1 gram of chilli powder per day even if using cayenne would be a low to moderate dose of salicylates (0.013 mg to 0.176 mg). This problem concerned us too, which is why the trial was preceded by a week of eating our usual low to moderate salicylate diet, while taking chilli capsules and keeping a diet/symptom diary to see if they would affect us, but there was no reaction.

Salicylate content of chilli compared to some other spices

Source: Swain A et al, 1985

  Q. Can I eat fresh chillies instead of chilli powder?

A. I tried eating fresh green supermarket chillies because I preferred eating them like that, but I found they were so variable in their heat that sometimes they worked and sometimes they were so mild as to be completely ineffective – which meant I had to go through the whole reaction to salicylates again, so I gave up after a few days. Perhaps I should have persevered using only the ones that tasted hot. But there is another possibility – fresh chillies were found to have the same salicylate content as chilli powder (see table above) so if you eat a whole fresh chilli you are ingesting a very high salicylate dose compared to a tiny dose of chilli powder. Could it be that the salicylates in the milder chillies reached the TRPV1 receptor first?

  Q. Can I use commercial chilli sauce?

A. Chilli sauce is the most palatable way to eat chillies. However, it is difficult to find a commercial chilli sauce that contains a high enough level of capsaicin; is free of nasty additives; and preferably free of ingredients with salicylates, amines and glutamates such as tomatoes or lime juice. The best one we have found is http://www.byronbaychilli.com/products/product/5-red-cayenne-chilli-sauce-with-lime.html red cayenne chilli sauce but it's not suitable for amine responders because it contains lime juice. The equivalent of our ¼ tsp chilli powder is two tablespoons of additive-free chilli sauce. However, we have found that we have to eat most of the chilli sauce in the first few mouthfuls to get the best effect, because the TRPV1 receptor has to be flooded by capsaicin before you start eat the salicylates. Conclusion: obviously you don't want to eat a chilli sauce that contains nasty additives such as sorbates (200 and others), synthetic antioxidants (320 and others, could be unlisted in vegetable oil) or benzoates (211 and others). Even if you are not sensitive to amines and glutamates, it may be counterproductive to use a chilli sauce based on very high salicylate ingredients.

  Q. How many times a day do you have to eat chilli?

A. During our trial we ate chilli twice a day – preceding lunch and dinner – and those were the only meals when we ate higher salicylate foods. However, it may be more effective to eat chilli in divided doses every 2 or 3 hours throughout the day. For example, we recently spent a month in southern India, eating traditional additive-free Indian food for nearly every meal including breakfast. There were large amounts of chilli in every meal and that worked very well. The anti-salicylate effect depends on flooding the TRPV1 receptor with capsaicin so it is not available for salicylates. Presumably the more you eat regularly, the better.

  Q. How do you eat chilli powder?

A. In Phase 1, we took chilli in capsules 30 minutes before the meal, and both on occasion suffered from heartburn which is a known side effect of chilli. For Phase 2 we mixed the same amount of chilli powder with a liquid. The best way to counteract the heat of chilli is to mix it with milk, yoghurt, cream cheese, quark or something oily such as a few teaspoons of home-made hummus, kidney bean paste, pear chutney, home-made gravy (for non-amine responders), chicken stew, vegetable soup or similar, to be consumed before the meal or in the first few mouthfuls of the meal. Yoghurt is the very best way to take chilli but Australian yoghurt is now considered to be moderate in amines – and I agree, it is not as fresh and mild as it used to be. So I now make my own quark (yoghurt cheese) for mixing with chilli by straining yoghurt overnight (see http://fedup.com.au/recipes/other-recipes-and-hints/quark-how-to-make ) and failsafe hummus is my next preference.

The most convenient way to get measured doses is to use capsules and empty them into at least 2 tsp of a liquid or paste when needed but this is also expensive – another way to do it is to measure one quarter teaspoon (1.1 ml) of chilli powder each time you need it.

     

  Q. I really hate the hot taste of chilli. Is there any alternative?

A. Maybe. Scientists have identified a non-burning version of capsaicin called capsiate in CH-19 Sweet peppers. Capsiate activates TRPV1 receptors in the gut but not in the mouth which is why consumers don't feel the heat. Capsiate is currently sold as a weight loss supplement because, like capsaicin, it can speed up metabolism and cause the body to burn fat. Capsiate is sold only by MSG and aspartame manufacturing giant Ajinomoto, whose executives patented both the capsiate and the CH-19 peppers but failed to create a commercial product when the weight loss effect of capsiate turned out to be only 'modest'. A controlled 4 week UCLA study of capsiate vs placebo found capsiate boosted metabolism but did not result in weight loss (17). It's available only through health professionals and only in the New York tri-state area  www.capsiatenatura.com. We are not sure yet whether it will have the same anti-salicylate effect as capsaicin because Ajinomoto have tied it up so thoroughly. It would be ironic if they are really sitting on a natural alternative to Ritalin.

  Q. What about chilli powder and heartburn?

A. According to many articles on the internet, chilli is one of the top heartburn causing foods, and we certainly found that to be true when taking chilli powder in capsules. However, we have never once suffered from heartburn when taking chilli powder mixed with yoghurt, dips such as failsafe hummus, or sauces.

  Q. Wouldn't it be better just to eat spicy meals and curries all the time?

A. Yes, probably it would. During this trial we spent one month in Nepal and one month in southern India, eating mostly fresh, local additive-free fresh foods that contained chillies. I loved eating fresh, additive-free local masala dosa, idli and curries three times a day in India but it is different at home in Australia. We are not as good at Indian cooking; packet mixes or curry pastes may contain nasty additives (such as 320 in oil, artificial colours in anything coloured red, yellow or even in yoghurt-based dishes). We had a massive reaction to a curry paste from the UK with ingredients that looked safe. You certainly can't expect Indian restaurants in Australia to be additive-free although, having said that, you may sometimes now find us eating a masala dosa at the Malabar in Kings Cross which is also recommended by the Coeliac Society http://www.menulog.com.au/malabar_south_indian_cuisine. The idea is to flood the capsaicin receptor before salicylates can get in – either by eating chilli constantly, or before you eat salicylates. In one hotel in India, when we ate mostly chilli-free western style food with only one curry meal per day for a few days, we noticed that the protective effect against salicylates stopped. Presumably it is better to eat chillies with every mouthful, Indian style.

  Q. I have noticed when travelling that I can eat hot curries in Thailand and Nepal without reacting but I always react to food like that at home in NZ. Why?

A. I had wondered the same thing myself for years as I noticed that I could tolerate so many more salicylate containing foods when in India and Nepal. Obviously the chillies are protective in India and other countries where traditional food is still largely additive-free. My guess is that that Indian and Thai food in NZ and Australia often contains some nasty additives such as 320 (virtually ubiquitous in NZ), artificial colours and preservatives. Another contributing factor could be that regular ingestion of chilli protects much more against salicylates than a single ingestion. By the way, doctors in Singapore have noticed that people whose ethnic food (Indian and Malay) contains lots of chilli are much less likely to suffer from stomach ulcers e.g. salicylate-induced, than those whose traditional food is lower in chilli (Chinese). An average Indian or Malay person consumes about 3 g chilli per day, about three times what we used in our pilot trial (13).

  Q. How do Indians manage salicylate intolerance?

A. Much better when living in India than living in Australia! See story [1061] http://fedup.com.au/stories/2011/1061-salicylates-migraines-due-to-salicylates-july-2011

Q. What do I do if I forget to take the chilli before a meal?

A. The same as you would normally do when you make a mistake with your diet - you can take an antidote such as ENO regular flavour - not lemon flavoured http://www.chemistdirect.com.au/eno-regular-200g/

  Q. What if I am eating out and the meal includes additives?

A. Chilli won't help. You can take your usual food intolerance antidote such as ENO regular not lemon flavoured  http://www.chemistdirect.com.au/eno-regular-200g/

A. Does eating chilli help with weight loss?

A. Eating chilli can help with weight loss by decreasing the appetite, boosting metabolism and increasing fat burning, especially at high doses, but scientists warn that the effects are 'modest' (17). You still have to follow a weight loss diet. Heidi Allison, author of The Chili Pepper Diet, conducted a study in which 14 subjects ate 5-6 small low fat meals a day with and without chillies. During two months of eating chillies, participants lost an average of 9.4 pounds. In the no-chilli phase of the study, subjects reported strong cravings for fatty and sweet foods, cheated on their diets and on average lost ten times less (0.9 pounds). One woman regained all the weight she had lost (twelve pounds) within four weeks. When chillies were reintroduced, weight loss resumed. Allison reported that chillies controlled cravings for 2-4 hours, and that the people who did best ate chillies at 3-4 hourly intervals, adding chillies to breakfast, lunch, mid-afternoon snack and dinner (18). More weight loss information http://fedup.com.au/factsheets/support-factsheets/failsafe-weight-loss .

  Q. Does eating chilli help with inhaled salicylates?

A. It seems to. As someone who is sensitive to strong fragrances, I generally hate a crowded gym class with a mix of fragranced body oils, deodorants, hair products and face creams. On the days I eat a chilli snack before the class, I don't seem to be bothered by fragrances, so that is what I choose to do now. From the scientific viewpoint, of course there is the possibility that the 30+ other people in the gym class have all chosen not to wear fragranced products on the days I take chilli.

  Q. Can I use this with children?

A. Children can start eating chilli by the age of two, according to Susan Moores, a registered dietitian in St. Paul, Minnesota, and a spokeswoman for the American Dietetic Association. "There's no hard-and-fast rule about this, but 24 months is a good benchmark," she says, because by the second birthday, your child will be accustomed to eating a wide variety of foods, and her intestinal system will be more developed and better equipped to digest spicy meals. http://www.babycenter.com/408_when-can-my-baby-eat-spicy-foods_1368539.bc. However, according to Heidi Allison, author of The Chili Pepper Diet (18), children in Mexico and South America are introduced to chillies between 4-6 years old, through chilli salsa with gradually increasing amounts of chilli to develop the child's taste for chilli. Breastfeeding mothers may be urged to avoid chillies altogether because capsaicin can pass into breastmilk. We would be interested to hear whether people from Indian, Thailand, Mexico or South America have anything to add to this information.

Children in Mexico start eating chilli around the age of 18 months with sweets (lollies) with chilli in them - lots of sweets have chilli added! Or maybe occasionally our 20 month old daughter will have a bit of sweet sauce (salsa) if we are having it- thanks to Diego

  Reader stories

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[1105] "can manage more salicylates" (February 2012)

Thanks for your research! I have found I can manage more salicylates e.g. pumpkin, sweet potato, rockmelons - but I had a rough night last week when I took some leftover sweet potatoes from the fridge for a snack at work & didn't eat chilli first. That night I was right back to the salicylate reactions - difficulty falling asleep, insomnia, and bad dreams that have plagued me for years – and I forgot about ENO (that's another one, forgetfulness). – Lydia, Qld

  References

1. Swain AR, Dutton SP, Truswell AS. Salicylates in foods. Am Diet Assoc. 1985;85(8):950-60. http://www.ncbi.nlm.nih.gov/pubmed/4019987

Abstract To determine salicylate content, 333 food items were analyzed. Foods were homogenized with 25% sodium hydroxide, allowed to stand overnight, acidified with concentrated hydrochloric acid, and then extracted with warm diethylether over 5 hours. The extract was dried and taken up in dilute sodium bicarbonate solution for analysis. Salicylic acid was separated by high performance liquid chromatography and quantified by reading at 235 nm. Salicylic acid standards were used throughout to standardize extractions and analyses. This is the most comprehensive set of data on food salicylates yet published; extraction appears to have been more complete for some foods, giving higher values than those previously published. Most fruits, especially berry fruits and dried fruits, contain salicylate. Vegetables show a wide range from 0 to 6 mg salicylate per 100 gm food (for gherkins). Some herbs and spices were found to contain very high amounts per 100 gm, e.g., curry powder, paprika, thyme, garam masala, and rosemary. Among beverages, tea provides substantial amounts of salicylate. Licorice and peppermint candies and some honeys contain salicylates. Cereals, meat, fish, and dairy products contain none or negligible amounts.

2. R. H. Loblay, A. R. Swain, "Food Intolerance,". In Recent Advances in Clinical Nutrition, vol. 2, Libbey, London. Ed: M.L. Wahlqvist & A.S. Truswell pp. 169‐177, 1986.

3. Feingold BF. Dietary management of nystagmus. J Neural Transm. 1979;45(2):107-15. http://www.ncbi.nlm.nih.gov/pubmed/469522

Abstract Two case reports illustrate the therapeutic response of congenital nystagmus to a diet eliminating synthetic food colors, synthetic food flavors, the antioxidant preservatives butylated hydroxytoluene (BHT) and butylated hydroxyanisole (BHA), and a small group of foods thought to contain a natural salicylate radical. A brief discussion of the hyperkinetic syndrome is offered with the proposal that a variety of neurologic and neuromuscular disturbances (grand mal, petit mal, psychomotor seizures; La Tourette syndrome; autism; retardation; the behavioral component of Down's syndrome; and oculomotor disturbances) may be induced by identical chemicals, depending upon the individual's genetic profile and the interaction with other environmental factors. It is perhaps the failure to integrate all the signs presented by the various clinical patterns with hyperkinesis or Minimal Brain Dysfunction (MBD) under a single heading that eye muscle involvement manifested as either nystagmus or strabismus has not been emphasized as part of the hyperkinetic syndrome.

4. Feingold BF. Hyperkinesis and learning disabilities linked to artificial food flavors and colors. Am J Nurs. 1975;75(5):797-803. http://www.feingold.org/Research/PDFstudies/Feingold75.pdf

Abstract The author reports a rapid improvement in behaviour and learning abilities in H-LD children following dietary management eliminating artificial food colours, flavours and naturally occurring salicylates. Preliminary work in several research programs now under way confirms his observations which, if proven, will offer hope to many troubled children and parents.

5. Caterina MJ, Schumacher MA, Tominaga M, Rosen TA, Levine JD, Julius D. The capsaicin receptor: a heat-activated ion channel in the pain pathway. Nature. 1997 23;389(6653):816-24. http://www.ncbi.nlm.nih.gov/pubmed/9349813

Abstract Capsaicin, the main pungent ingredient in 'hot' chilli peppers, elicits a sensation of burning pain by selectively activating sensory neurons that convey information about noxious stimuli to the central nervous system. We have used an expression cloning strategy based on calcium influx to isolate a functional cDNA encoding a capsaicin receptor from sensory neurons. This receptor is a non-selective cation channel that is structurally related to members of the TRP family of ion channels. The cloned capsaicin receptor is also activated by increases in temperature in the noxious range, suggesting that it functions as a transducer of painful thermal stimuli in vivo.

6. Jordt SE, Julius D. Molecular basis for species-specific sensitivity to "hot" chilli peppers. Cell. 2002;108(3):421-30.
http://www.ncbi.nlm.nih.gov/pubmed/11853675

Abstract Chilli peppers produce the pungent vanilloid compound capsaicin, which offers protection from predatory mammals. Birds are indifferent to the pain-producing effects of capsaicin and therefore serve as vectors for seed dispersal. Here, we determine the molecular basis for this species-specific behavioral response by identifying a domain of the rat vanilloid receptor that confers sensitivity to capsaicin to the normally insensitive chicken ortholog. Like its mammalian counterpart, the chicken receptor is activated by heat or protons, consistent with the fact that both mammals and birds detect noxious heat and experience thermal hypersensitivity. Our findings provide a molecular basis for the ecological phenomenon of directed deterence and suggest that the capacity to detect capsaicin-like inflammatory substances is a recent acquisition of mammalian vanilloid receptors.

7. Ohta T, Imagawa T, Ito S. Involvement of transient receptor potential vanilloid subtype 1 in analgesic action of methylsalicylate. Mol Pharmacol. 2009;75(2):307-17. http://www.ncbi.nlm.nih.gov/pubmed/18987162

Abstract Methylsalicylate (MS) is a naturally occurring compound that is used as a major active ingredient of balms and liniments supplied as topical analgesics. Despite the common use of MS as a pain reliever, the underlying molecular mechanism is not fully understood. Here we characterize the action of MS on transient receptor potential V1 (TRPV1). In human embryonic kidney 293 cells expressing human TRPV1 (hTRPV1), MS evoked increases of [Ca(2+)](i), which declined regardless of its continuous presence, indicative of marked desensitization. TRPV1 antagonists dose-dependently suppressed the MS-induced [Ca(2+)](i) increase. MS simultaneously elicited an inward current and increase of [Ca(2+)](i) in the voltage-clamped cells, suggesting that MS promoted Ca(2+) influx through the activation of TRPV1 channels. MS reversibly inhibited hTRPV1 activation by polymodal stimuli such as capsaicin, protons, heat, anandamide, and 2-aminoethoxydiphenyl borate. Because both the stimulatory and inhibitory actions of MS were exhibited in capsaicin- and allicin-insensitive mutant channels, MS-induced hTRPV1 activation was mediated by distinct channel regions from capsaicin and allicin. In cultured rat sensory neurons, MS elicited a [Ca(2+)](i) increase in cells responding to capsaicin. MS significantly suppressed nocifensive behavior induced by intraplantar capsaicin in rats. The present data indicate that MS has both stimulatory and inhibitory actions on TRPV1 channels and suggest that the latter action may partly underlie the analgesic effects of MS independent of inhibition of cyclooxygenases in vivo.

8. Holzer P, Pabst MA, Lippe IT. Intragastric capsaicin protects against aspirin-induced lesion formation and bleeding in the rat gastric mucosa. Gastroenterology. 1989;96(6):1425-33. http://www.ncbi.nlm.nih.gov/pubmed/2785466

Abstract Previous work has indicated that capsaicin-sensitive afferent neurons are involved in gastric mucosal defense mechanisms. The present study investigated whether stimulation of these neurons by intragastric administration of capsaicin would protect against aspirin-induced mucosal damage in the luminally perfused rat stomach. Capsaicin (25-640 microM), administered together with acidified (pH 1.5) aspirin (25 mM), inhibited macroscopically visible lesion formation and gastric bleeding in a concentration-dependent fashion. Capsaicin (160 microM) also attenuated the aspirin-induced fall in the gastric potential difference. An inhibitory effect of capsaicin (160 microM) on aspirin-induced gastric injury was also seen by light and scanning electron microscopy. Aspirin alone caused a vast ablation of the gastric surface epithelium, resulting in exposure of the lamina propria. In the presence of capsaicin, the depth of mucosal injury, the area totally deprived of surface epithelial cells, and the severity of surface desquamation were diminished. As capsaicin is a selective stimulant of thin afferent neurons, it would appear that these neurons participate in mechanisms of gastric defense against aspirin injury. Prevention of hemorrhagic damage seems to be the primary effect of afferent nerve-mediated gastroprotection, although injury to the surface epithelium is also reduced to some degree.

9. Cruz L, Castañeda-Hernández G, Navarrete A. Ingestion of chilli pepper (Capsicum annuum) reduces salicylate bioavailability after oral asprin administration in the rat. Can J Physiol Pharmacol. 1999;77(6):441-6.
http://www.ncbi.nlm.nih.gov/pubmed/10537230

Abstract The bioavailabilities of aspirin (acetylsalicylic acid) and of salicylic acid were studied in male Wistar rats after acute and chronic administration of a Capsicum annuum extract, containing 100 mg of capsaicin per gram. With a single administration of 100 mg/kg of the extract, aspirin blood levels remained unchanged, but salicylic acid bioavailability was reduced in 44% compared with control animals. With a single administration of 300 mg/kg of the extract, aspirin blood levels were undetectable while salicylic acid bioavailability was reduced in 59%. Chronic administration once daily for 4 weeks of 100 and 300 mg/kg of the extract resulted in undetectable aspirin blood levels, while salicylic acid bioavailability was reduced in 63 and 76%, respectively, compared with controls. Results show that Capsicum ingestion reduces oral drug bioavailability, likely as a result of the gastrointestinal effects of capsaicin.

10. Yeoh KG, Kang JY, Yap I, Guan R, Tan CC, Wee A, Teng CH. Chilli protects against aspirin-induced gastroduodenal mucosal injury in humans. Dig Dis Sci. 1995;40(3):580-3. http://www.ncbi.nlm.nih.gov/pubmed/7895549

Abstract Capsaicin, the pungent ingredient of chilli, has a gastroprotective effect against experimental gastric mucosal injury in animals. Such an effect has not, however, been documented in humans to date. Eighteen healthy volunteers with normal index endoscopies underwent two studies four weeks apart. Each subject took 20 g chilli orally with 200 ml water in one study and 200 ml water in another study. In each case this was followed half an hour later by 600 mg aspirin BP with 200 ml water. Endoscopy was repeated 6 hr later. Gastroduodenal mucosal damage was assessed by a previously validated scoring system. The median gastric injury score after chilli was 1.5 compared to 4 in the control group (P < 0.05), demonstrating a gastroprotective effect of chilli in human subjects.

11.Kizawa K, Kitahara T, Horii A, Maekawa C, Kuramasu T, Kawashima T, Nishiike S, Doi K, Inohara H. Behavioral assessment and identification of a molecular marker in a salicylate-induced tinnitus in rats. Neuroscience. 2010;165(4):1323-32.
http://www.ncbi.nlm.nih.gov/pubmed/19958810

Abstract Tinnitus is a non-observable phantom sensation. As such, it is a difficult condition to investigate and, to date, no effective treatment has been developed. To approach this phantom sensation, we aimed to develop a rat behavioral model of tinnitus using salicylate, an active component of aspirin known to induce tinnitus. We also aimed to establish a molecular marker of tinnitus by assessing the expression of transient receptor potential cation channel superfamily V-1 (TRPV1) in the rat auditory pathway during salicylate-induced tinnitus. Animals were trained to perform "an active avoidance task": animals were conditioned by electrical footshock to move to the other side of the conditioning box when hearing a sound. Animals received a single injection of saline or salicylate (400 mg/kg i.p.) and false positive responses were measured 2 h after injection as the number of movements during a silent period. The number of responses in salicylate-treated animals was highest when the conditioned stimulus was 60 dB sound pressure level (SPL) and 16 kHz. This indicates that animals could feel tinnitus 2 h after salicylate injection, equivalent to that induced by 60 dB SPL and 16 kHz. By means of real-time PCR and western blot analysis, TRPV1 expression was significantly upregulated in spiral ganglion cells 2 h after salicylate injection and this upregulation together with the increase in the number of false positive responses was significantly suppressed by capsazepine (10 mg/kg i.p.), a specific antagonist of TRPV1. This suggests that salicylate could induce tinnitus through activation of TRPV1 in the rat auditory pathway.

12. Baudoin T, Kalogjera L, Hat J. Capsaicin significantly reduces sinonasal polyps. Acta Otolaryngol. 2000;120(2):307-11.
http://www.ncbi.nlm.nih.gov/pubmed/11603795

Abstract Some reports indicate that topical nasal treatment with capsaicin, which is usually effective in reducing symptoms of vasomotor rhinitis, may also reduce symptoms in patients with nasal polyps. The aim of this study was to investigate the effect of topical capsaicin treatment in severe sinonasal polyposis. Nine non-allergic, non-asthmatic patients with diffuse eosinophilic nasal polyposis were subjected to topical capsaicin treatment: for 3 consecutive days 0.5 ml 30 micromol/l capsaicin solution and on days 4 and 5 100 micromol/l capsaicin solution was sprayed into each nostril. Coronary computed tomography (CT) images were made shortly before treatment. Baseline nasal lavages and a questionnaire containing subjective symptoms and nasal endosocpy were taken just prior to the first application. Nasal lavages were performed prior to and after the last treatment and over 4 weeks, endoscopy and subjective scores at each weekly visit, and correspondent CT scans 4 weeks after the treatment. CT images were analysed by computer, calculating the nose sinuses air volume (NSAV) from the surface of aerated parts of nasal and sinus cavities for each slice per patient prior to and after treatment. Statistical analysis was performed comparing NSAV, subjective scores, endoscopy scores and eosinophil cationic protein (ECP) levels in nasal lavages prior to and after treatment. Topical treatment with capsaicin significantly increased NSAV and very significantly improved subjective and endoscopy scores, but did not significantly alter ECP levels in nasal lavages.

13. Kang JY. Some observations on the epidemiology of peptic ulcer disease in Singapore. Singapore Med J. 1992:33(5):468-71. http://www.ncbi.nlm.nih.gov/pubmed/1455270

Abstract Several lines of evidence suggest that, of the three main races of Singapore, peptic ulcers are more common among the Chinese and Indians when compared to the Malays. These include studies on hospital series of patients with or without appropriate control groups, studies on the incidence of surgery for perforated ulcer as well as mortality statistics. A reduction in the Chinese:Malay difference in the incidence of perforated ulcer over three decades suggests that environmental factors are involved in producing these racial differences. However, we have to date been unable to determine the factor(s) responsible. The incidence of perforated ulcer in Singapore is increasing while ulcer mortality is declining. This is similar to the situation in Hong Kong but different from that in the western countries.

14. EU Scientific Committee on Food (2002). Opinion of the Scientific Committee on Food on Capsaicin. http://ec.europa.eu/food/fs/sc/scf/out120_en.pdf

Abstract The Committee concluded that the available data did not allow it to establish a safe exposure level for capsaicinoids in food. The human intake of capsaicinoids in India, Thailand and Mexico, where capsicum spices are heavily consumed, has been estimated to be 25 – 200 mg/day. The high consumption of chillies in Mexico and India was reported to be associated with cancer of the upper digestive tract. In contrast, the maximum daily intake from mild chillies and paprika in Europe was roughly estimated to be 1.5 mg/day. In the one study conducted in Europe, no increase in the incidence of gastric cancer was found in association with occasional and lower intakes of chillies.

15. Hodge L, Swain A, Faulkner-Hogg K. Food allergy and intolerance. Aust Fam Physician. 2009;38(9):705-7. http://www.ncbi.nlm.nih.gov/pubmed/19893799

Abstract This article forms part of a series looking at the relationship between diet and good health, and the role of the dietitian in the primary health care team. This article discusses adverse reactions to food including IgE mediated food allergy and nonimmunological food reactions.

16. S. Dengate (2007). The Failsafe Cookbook: reducing food chemicals for calm, happy families. Random House Australia ISBN 978-1-74166-876-6. http://fedup.com.au/order-books/sue-dengate-books-dvd-magnifying-cards/the-failsafe-cookbook

17. Ludy MJ, Moore GE, Mattes RD (2012). The Effects of Capsaicin and Capsiate on Energy Balance: Critical Review and Meta-analyses of Studies in Humans. Chem Senses. 2012;37(2):103-21. http://www.ncbi.nlm.nih.gov/pubmed/22038945

Abstract Consumption of spicy foods containing capsaicin, the major pungent principle in hot peppers, reportedly promotes negative energy balance. However, many individuals abstain from spicy foods due to the sensory burn and pain elicited by the capsaicin molecule. A potential alternative for nonusers of spicy foods who wish to exploit this energy balance property is consumption of nonpungent peppers rich in capsiate, a recently identified nonpungent capsaicin analog contained in CH-19 Sweet peppers. Capsiate activates transient receptor potential vanilloid subtype 1 (TRPV1) receptors in the gut but not in the oral cavity. This paper critically evaluates current knowledge on the thermogenic and appetitive effects of capsaicin and capsiate from foods and in supplemental form. Meta-analyses were performed on thermogenic outcomes, with a systematic review conducted for both thermogenic and appetitive outcomes. Evidence indicates that capsaicin and capsiate both augment energy expenditure and enhance fat oxidation, especially at high doses. Furthermore, the balance of the literature suggests that capsaicin and capsiate suppress orexigenic [appetite stimulating- S] sensations. The magnitude of these effects is small. Purposeful inclusion of these compounds in the diet may aid weight management, albeit modestly.

18. H. Allison (2002). The Chili Pepper Diet: the natural way to control cravings, boost metabolism and lose weight. HCI Florida ISBN-10: 1558749268 www.hci-online.com

More Information

• Introduction to food intolerance
• Salicylate factsheet

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The information given is not intended as medical advice. Always consult with your doctor for underlying illness. Before beginning dietary investigation, see our list of experienced and supportive dietitians http://fedup.com.au/information/support/dietitians 

© Sue Dengate March 2022