Adverse Reactions to Food Additives and Preservatives

In This Article

There are thousands of substances added to various foods for the purposes of coloring, flavoring, and preserving. Additives are usually only a very small component of foods but a small number of them have been suspected of causing various adverse reactions.

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Food Additives

Food additives include the following groups:

  • Food dyes and colorings (such as tartrazine, annatto, and carmine)
  • Antioxidants (such as BHA and BHT)
  • Emulsifiers and stabilizers (such as gums and lecithin)
  • Flavorings and taste enhancers (such as MSG, spices, and sweeteners)
  • Preservatives (such as benzoates, nitrites, and acids)

The Food and Drug Administration (FDA) keeps a list of all of the food additives currently used in the United States.

Reactions That May Occur as a Result of Food Additives

There are many types of adverse reactions that can occur as a result of food additives. Some of these reactions suggest an allergic cause, while many others do not appear to be allergic, but rather an intolerance or sensitivity. Reports of reactions to food additives have included the following:

  • Skin reactions:
  • Urticaria (hives)
  • Angiodema
  • Atopic dermatitis
  • Sweating
  • Itching
  • Flushing
  • Gastrointestinal reactions:
  • Abdominal pain
  • Nausea/vomiting
  • Diarrhea
  • Respiratory reactions:
  • Asthma symptoms
  • Cough
  • Rhinitis
  • Anaphylaxis

Diagnosing Allergies and Adverse Reactions to Food Additives

You may suspect a food additive reaction if you experience symptoms with processed foods and/or restaurant-prepared meals but do not experience these with similar foods prepared from scratch.

Various seemingly unrelated foods might, in fact, have common ingredients, such as food colorings or preservatives.

Once a food or food additive is suspected, allergy testing (using skin testing or RAST) may be possible for certain natural substances such as annatto, carmine, and saffron.

Many food additives, however, are synthetic and testing for such substances is not possible or reliable. A trial of a preservative-free diet may be attempted to assess for symptom resolution.

In many instances, the only way to truly diagnose an adverse reaction to food additives is to undergo an oral challenge with the suspected additive under the close supervision of an allergist.

Problematic Food Additives

These are nine of the most commonly problematic food additives that may cause allergic or adverse reactions

1. Tartrazine

Also known as FD&C Yellow No. 5, tartrazine has been suspected as the cause of many reactions, including urticaria (hives), asthma, and other illness. Recent studies have disproven the thought that aspirin-allergic asthmatics were especially sensitive to tartrazine. Other studies suggest a role of tartrazine as worsening atopic dermatitis.

The FDA says tartrazine can cause hives in approximately one in 10,000 people or fewer.

2. Carmine

Carmine is a red food coloring made from a dried insect called Dactylopius coccus Costa which can be found on a particular type of cactus plant. This coloring is also found in various cosmetics, drinks, red yogurt, and popsicles.

Reactions to carmine include anaphylaxis and occupational asthma and are probably due to allergic antibodies.

3. Annatto

Annatto is a yellow food coloring made from the seeds of a South American tree, Bixa orellana. This additive has been found to cause allergic reactions, including anaphylaxis and urticaria/angioedema.

4. Antioxidants

Antioxidants such as BHA (butylated hydroxyanisole) and BHT (butylated hydroxytoluene) are added to prevent the spoilage of fats and oils. Both BHA and BHT are suspected of causing urticaria and angioedema (hives).

5. Emulsifiers and Stabilizers

Emulsifiers: Lecithin is an emulsifier made from soybeans or eggs and may contain soybean proteins. Reactions to soy lecithin are rare, even in soy-allergic people, since the level of this additive is usually very low in most foods.

Gums: Various gums are used as food additives and function as emulsifiers and stabilizers. Major gums include guar, tragacanth, xanthan, carrageenan, acacia (Arabic), and locust bean.

Many of these gums are known to worsen asthma, particularly in the occupational setting, when airborne. Others are known to cause allergic reactions when present in foods. Guar gum can cause severe anaphylaxis.

6. Monosodium Glutamate

Monosodium glutamate (MSG) is a flavor enhancer added to various foods, and also occurs naturally. Reactions to MSG have been called the “Chinese Restaurant Syndrome,” and symptoms include numbness on the back of the neck, shoulders and arms, weakness, and palpitations.

Other symptoms include facial pressure/tightness, headaches, nausea, chest pain, and drowsiness. MSG is also suspected of worsening asthma symptoms.

7. Spices

Spices are the aromatic part of various weeds, flowers, roots, barks, and trees. Because they are derived from plants, spices have the ability to cause allergic reactions, just like pollens, fruits, and vegetables.

The most common spices used include chili peppers, celery, caraway, cinnamon, coriander, garlic, mace, onion, paprika, parsley, and pepper.

According to a study published in the Annals of Allergy, Asthma, and Immunology, spice allergies are underdiagnosed.

8. Aspartame

Aspartame is a sweetener used in many sugar-free foods and drinks. This food additive has been suspected of causing such symptoms as headaches, seizures, and urticaria.

9. Sulfites

Sulfites or sulfate agents (in the forms of sodium sulfite, sodium bisulfite, sodium metabisulfite, potassium bisulfite, and potassium metabisulfite) are common preservatives used in various foods and medications.

Sulfites cause little to no problems in most people without allergies and asthma, even when large amounts are consumed.

The main therapy for people with adverse reactions to food additives is avoidance of the culprit food additive.

Sulfites may increase asthma symptoms in approximately 3 percent to 10 percent of adult asthmatics, particularly in adults with severe disease. Sulfites can also cause anaphylaxis in a small number of people.

Treatment of Allergy to Food Additives and Preservatives

Many of the reactions to food additives, such as with MSG, are mild and resolve without treatment. More severe reactions, including urticaria, angioedema, worsening asthma, and anaphylaxis may require immediate medical attention.

These reactions are treated much the same way as other food allergies. If reactions are severe, it may be necessary for you to be prepared for a severe reaction, such as carrying injectable epinephrine and wearing a medical alert bracelet.

The main therapy for people with adverse reactions to food additives is avoidance of the culprit food additive.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Food & Drug Administration. Overview of food ingredients, additives & colors. Updated April 2010.

  2. Mondal, S. Food Safety and Human Health. Amsterdam, Netherlands: Elsevier Science; 2019.

  3. Food Allergy Research & Education. Blood tests. Updated 2019.

  4. Asthma and Allergy Foundation of America, New England Chapter. Adverse reactions to food additives. Updated 2019.

  5. Smolinske, SC. CRC Handbook of Food, Drug, and Cosmetic Excipients. Boca Raton, FL: CRC Press; 2018.

  6. Michigan New, University of Michigan. Food dye can cause severe allergic reactions. Updated January 25, 2007.

  7. Myles IA, Beakes D. An Allergy to Goldfish? Highlighting the labeling laws for food additives. World Allergy Organ J. 2009;2(12):314-316. doi:10.1097/WOX.0b013e3181c5be33

  8. Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program. Soy lecithin, soybeans and soy lecithin. Updated August 7, 2019.

  9. Saha D, Bhattacharya S. Hydrocolloids as thickening and gelling agents in food: a critical review. J Food Sci Technol. 2010;47(6):587-97. doi:10.1007/s13197-010-0162-6

  10. Sampson, HA, Simon, RA. Food Allergy: Adverse Reactions to Foods and Food Additives. Hoboken, NJ: Wiley; 2011.

  11. Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program. Spices and herbs. Updated March 10, 2014.

  12. Adkinson Jr., NF, Bochner, BS, Burks, AW, Busse, WW, Holgate ST. Middleton's Allergy E-Book: Principles and Practice. London, UK: Elsevier Health Sciences; 2013.

  13. Institute of Agriculture and Natural Resources, Food Allergy Research and Resource Program. Sulfites - USA. Updated 2019.

Additional Reading
  • U.S. Food and Drug Administration (FDA). Overview of Food Ingredients, Additives & Colors. International Food Information Council (IFIC) and U.S. Food and Drug Administration. Updated December 2, 2014.

  • Chen JL, Bahna SL. Spice Allergy. Annals of Allergy, Asthma and Immunology. September 2011;107(3):191-9. doi:10.1016/j.anai.2011.06.020.
  • Simon RA. Allergic and Asthmatic Reactions to Food Additives. UpToDate. Updated May 4, 2017.
  • Vally H, Misso NL. Adverse Reactions to the Sulphite AdditivesGastroenterology and Hepatology From Bed to Bench. 2012;5(1):16-23.