Salicylate Sensitivity

Assorted fresh berries and mint leaves on a dark background.

Understanding Salicylate Sensitivity

Salicylates are naturally occurring phenols found in plants. They act as preservatives, protecting plants from decay and defending against harmful bacteria and fungi. Concentrated in bark, leaves, roots, and seeds, these compounds are the basis for salicylic acid, the active ingredient in aspirin, which was originally derived from plants.

While salicylates are common in many foods, medicines, and personal care products, some individuals are highly sensitive to them. These people often experience adverse reactions and must avoid aspirin and high-salicylate foods to manage their symptoms effectively.

Salicylate Sensitivity: An Evolving Perspective

In the early days of my naturopathic practice, few people mentioned conditions like histamine or salicylate sensitivity, Mast Cell Activation Syndrome, or even gluten intolerance. Patients typically presented with concerns about food allergies, irritable bowel syndrome, Candida, or what we now refer to as small intestinal bacterial overgrowth (SIBO).

Salicylate sensitivity, much like histamine intolerance, was virtually unheard of, and those affected were often “mystery patients,” moving from clinic to clinic in search of answers for chronic issues like nasal congestion, nasal polyps, or persistent throat irritation.

Before the internet era—when Google was still a decade away—credible medical information was confined to textbooks, which were seldom read outside medical circles. Naturopaths like myself relied heavily on extensive research, clinical experience, and elimination techniques to unravel these puzzling cases.

Although disease labels and descriptions have evolved, I believe the underlying health issues remain fundamentally the same, just repackaged with new terminology.

Helping Patients Through Targeted Elimination

A person in a kitchen holding a notepad and marker while looking confused, surrounded by various vegetables, herbs, and olive oil bottles on the countertop.

Over the years, our clinic has worked with many patients who found relief from salicylate sensitivity through a structured elimination diet.

A two-week withdrawal from high-salicylate foods can be a turning point, especially when it comes to helping patients identify triggers and understand how their diet influences their symptoms.

This method is just as effective for salicylates as it is for histamine-intolerance or gluten-related sensitivities. Identifying and eliminating the right foods can lead to the “light bulb” moment that transforms a patient’s health journey.

Key Takeaways

Salicylate sensitivity can mimic other conditions, often making diagnosis challenging.
Structured elimination diets remain one of the most effective tools for identifying and managing this sensitivity.
Salicylates, while natural, can trigger significant reactions in sensitive individuals, necessitating careful dietary and lifestyle adjustments.

By understanding salicylates and their role in both plants and human health, you can take proactive steps to improve your well-being if sensitivity is suspected.

Elderly man with white hair and beard sneezes into a tissue. He's wearing a gray sweater and a checkered shirt, sitting indoors. He has immune dysfunction.

Salicylate Sensitivity Symptoms: What to Look For

Salicylate sensitivity can manifest through a variety of symptoms affecting the skin, respiratory system, gastrointestinal tract, and even behaviour or mood.

Common indicators include coughing, sneezing, postnasal drip, rashes around the mouth, and nasal polyps. In more severe cases, symptoms such as chronic gastrointestinal irritation, asthma-like reactions, or even anaphylaxis may occur after consuming high-salicylate foods or medications like aspirin (Baenkler, 2008).

Understanding these symptoms can help identify a potential salicylate intolerance and guide appropriate dietary and lifestyle adjustments.

Below is a comprehensive list of the most commonly reported signs associated with salicylate sensitivity:

If you experience any of these symptoms after exposure to salicylates, consult with a healthcare professional to explore diagnostic and management options.

Fruit You Crave
I’ve found sometimes it’s the foods we crave and love the most can be the most problematic ones. Do you love one type fruit, maybe you snack on too much dried fruit? It’s really common!
Small Portion Sizes Only
Always keep fruit portion sizes down during any dietary change, gut cleanse, or Candida program. This helps keep the natural sugar and fibre content down, reducing the risk of developing bloating, gas, or uncomfortable bowel changes. It also allows beneficial bacteria levels to increase, especially if you take probiotics, or fermented foods as part of your diet. Fruit portion sizes can vary depending on the type of fruit and your individual needs.
Fruit Allergies
Some may have an allergy towards a certain fruit of fruit group. Don’t mistake an allergic response to a fungal, bacterial, or other gut-response to eating certain fruits. Once again, a fruit elimination and challenge dietary phase can reveal a fruit allergy at the time. Fruit that are more likely to provoke an unwanted allergic response include pineapple, oranges, but also mango, kiwifruit, and even bananas.
Keep a Food Diary
It makes sense to keep a diary or symptom tracker, that way you’ll be able to track any increase or decrease in symptoms. When you keep track of fruit introduction and withdrawal, along with any gut treatments and other dietary changes, you’ll be in a much better position to know when to introduce, cut-back, or avoid any specific fruit.
Fruit Can Be Acidic
Be aware that some foods may be acidic by nature and aggravate your stomach or gut. Some fruits can aggravate heartburn or an underlying digestive problem. Only trial and error will tell.
Fruit Can Be High-Fibre
While fibre is good our for digestion and overall health, consuming too much fibre from fruit, especially if you’re not used to it, can lead to digestive issues such as bloating, gas, or diarrhoea.
Timing of Eating Fruit
Some say it is best to consume fruit only on an empty stomach, and there is some merit to this, it may help prevent an “upset stomach” in some instances. Others say it’s fine to include a piece of fruit at the end of your main meal. It’s up to you to determine the best time for you to try a piece of fruit.
Exercise and Fruit
If you exercise, have a piece of fruit after, it helps replenish your muscle’s glycogen (blood-sugar) stores.
Eat Fruit Away From Main Meals
I highly recommend, especially if you have a current gut of Candida issue, to consume any piece of fresh fruit well-away from (or between) your two or three main meals. That way you’ll be able to tell if that fruit is a problematic addition to your diet.
Berries and Avocados
I’ve found berries (and avocado) to be exceptions when it comes to fruit-gut acceptance. Most people with all manner of gut complaints seem to be able to tolerate them to some degree – some more than others. I’ve always felt berries to be OK, especially with a little Greek yogurt.

Salicylate Sensitivity: Comprehensive Guide to Foods and Tips

A personalised low-salicylate diet may significantly reduce symptoms of asthma, sinusitis, and urticaria, as shown in research by Kęszycka (2021). Salicylates are naturally occurring chemicals found in many foods and personal care products. They are easily absorbed through the skin, making it essential to address both dietary and topical sources to reduce salicylate exposure.

Key Insights on Salicylates

Salicylate Levels and Food Maturity:
Less-ripe and less-cooked foods typically contain higher salicylate concentrations. Opt for well-cooked, ripe options when possible.
Effect of Drying Fruits:
Drying fruits dramatically increases their salicylate content. All dried fruits are generally unsuitable for individuals with salicylate sensitivity.
Peeling for Lower Salicylate Intake:
The skins of fruits and vegetables tend to have higher salicylate levels. Peeling them can help reduce exposure.
Trigger Foods:
Avoid habitual consumption of known high-salicylate foods, especially if they frequently trigger symptoms.

Salicylate Sensitivity Foods List

A colorful assortment of fresh fruits including grapes, bananas, strawberries, kiwi, mango, peaches, and a pineapple. This delightful mix features some of the best anti-inflammatory foods to help support your wellness.

If you suspect salicylate sensitivity, minimising or eliminating very high and high-salicylate foods in the early stages of gut treatment is important.

This approach gives your digestive system time to heal and adapt. Later, as your gut health stabilises, you can reintroduce these foods in small amounts to test your tolerance.

Taking these steps ensures a proactive approach to managing salicylate sensitivity while supporting overall gut health.

Salicylate Food Categorisation and Reintroduction Plan

To effectively manage salicylate sensitivity:

Very-High Salicylate Foods
Extreme caution is advised, especially if you react strongly to foods in this category. Avoid this group entirely until your gut function improves to a high-level. Caution advised with reintroduction.
High-Salicylate Foods:
Completely avoid these foods for 3 months to allow the gut microbiota to recover.
Moderate-Salicylate Foods:
Introduce these foods cautiously after two weeks, observing any reactions.
Low-Salicylate Foods:
These foods are generally OK, their salicylate levels are sufficiently low enough to not cause too many issues.

Once your gut health improves, high-salicylate foods can be reintroduced slowly, one at a time, to monitor tolerance and any potential reactions.

High-Salicylate

Fruits: (Very High Salicylates)
Apricot, blackberry, blackcurrant, blueberry, boysenberry, cantaloupe, cherry, currants, dates, grapes, guava, loganberry, orange, pineapple, plum, prune, raisin, raspberry, redcurrant, strawberry, sultana.
Fruits: (High Salicylates)
Avocado, grapefruit, granny smith apple, lychee, mandarin, mulberry, nectarine, peach, tangelo, watermelon, dried fig, and passion fruit.
Nuts and Seeds: (Very High Salicylates)
Almonds, peanuts, water chestnuts.

High-Salicylate

Vegetables: (Very High Salicylates)
Avocado, grapefruit, granny smith apple, lychee, mandarin, mulberry, nectarine, peach, tangelo, watermelon, dried fig, and passion fruit.
Vegetables: (High Salicylates)
(alfalfa sprouts, artichoke, broccoli, cucumber, eggplant, fava beans, okra, spinach (fresh), squash, watercress, water chestnut, water cress)
Nuts and Seeds: (High Salicylates)
Pine nuts, macadamia nuts, pistachio nuts.

Medium-Salicylate

Fruits: Medium Salicylates
Lemon, loquat, mango, pear (with skin), persimmon, red apple, rhubarb, kiwifruit, fresh fig.
Vegetables: Medium Salicylates
Asparagus (canned), baby squash, beetroot (canned), broccoli, cauliflower, carrot, corn (canned), cucumber, eggplant, marrow, mushroom, onion, olives (black, canned), parsnip, pumpkin, snow peas, spinach, sweet corn, sweet potato, turnip, tomato (fresh), kohlrabi, black olive, chilli (yellow & green).
Nuts and Seeds: (Medium Salicylates)
Peanut butter, Brazil nuts, coconut, hazelnuts, pecans, sesame seeds, sunflower seeds, walnuts.

Low-Salicylate

Fruits: Low Salicylates
apple (golden & red delicious), cherries (canned), banana, lemon (fresh), mango, pawpaw, passionfruit, persimmon, rhubarb, tree tomato, pear (peeled)
Vegetables: Low Salicylates
Bamboo shoots, Brussels sprouts, cabbage, celery, chives, choko, green beans, green peas, leeks, lettuce, mung bean sprouts, shallots, potato (white), swede.
Nuts and Seeds: Low Salicylates
Cashew nuts, pecan nuts, poppy seeds) Other – (dried beans, rice, dried peas, lentils

Candida Cleanse Beginner

Just starting out? Looking for a quick non-fuss gut cleanse?

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A kiwi fruit cut in half showing its green flesh and black seeds, placed on a light-colored surface—an ideal addition to your candida detox diet.

You Don’t Have to Eliminate Several Fruits and Vegetables

Rethinking Candida Diet Fruit and Vegetable Elimination

Most Candida diets suggest minimising fruit or certain vegetables based on the sugar or starch content, favouring the lowest sugar content fruit and veg. However, based on extensive experience in gut health, whether dealing with Candida, SIBO, IBS, or IBD, it may not be necessary to completely eliminate most fruits and many vegetables from your diet.

Individual Impact: The effect of fruit on your health largely depends on your unique gut microbiota health and several other personal factors.

Potential Benefits: Some fruits have natural antifungal properties and may help combat Candida rather than worsen it. For example, several tropical fruits contain potent antimicrobial compounds (Budiati et al., 2022).

A recent study found that richness of fruit and vegetable associated bacteria in the human gut is associated with frequency and diversity of vegetables consumed by the person (Wicaksono et al., 2023).

Food Reactions Are Highly Individual

Dealing with Candida overgrowth involves more than just avoiding specific fruits. It requires understanding how different fruits affect your gut and applying an informed approach.

How does your gut feel and bowel react after certain fruits?

Fruit and Gut Health: Fruits contain various types of sugars and carbohydrates, which interact with the balance of bacteria and fungi in your gut.
Gut Microbiome: How fruits are accepted or rejected by your gut microbiome depends on this interaction.
Gas, Bloating, Bowel Frequency: How are certain fruits and vegetables affecting your bowel function?
Desire, Quantity, and Frequency: Could your “problem” fruit or vegetable simply be the one you eat too much, or much too often?

Focus on Refined Sugars First

Instead of immediately cutting out most fruits and several vegetables, it is often more effective to first reduce intake of simple sugars and carbohydrates that promote yeast, harmful bacteria, and parasites. Multiple studies have revealed that the increased consumption of purified wheat flour products and refined carbohydrates is strongly linked to the presence of gastrointestinal Candida numbers (Jeziorek et al., 2019).

Remember? – Prioritise Sugar Reduction: Reduce intake of sweets, refined foods, alcohol, sodas, and other sources of added sugars.
Nutritional Value: Fruits provide valuable fibre, antioxidants, vitamins, minerals, and polyphenols that are important for overall health.

Make Gradual Adjustments

Before making drastic changes to your fruit and vegetable consumption, observe how your gut microbiota responds to the removal of refined sugars and other problematic foods.

Monitor Gut Response: Allow several weeks for your gut to recover and adjust to dietary changes. Take probiotics to improve gut health more rapidly.
Adjust Accordingly: Based on your observations, make informed decisions about fruit consumption in line with your gut health needs.

A bowl of sauerkraut with a fork, garnished with parsley, next to two sausages on a dark surface.

Do You Get Food Reactions?

It can often be challenging to distinguish between food allergies, intolerances, and sensitivities. However, whether it’s an allergy or intolerance, the key to managing symptoms lies in the careful elimination and reintroduction of potential trigger foods. This systematic approach helps identify which specific food groups are causing issues.

Patience is crucial—removing one food or food group at a time is the most effective way to avoid confusion and accurately pinpoint the culprit. Occasionally, foods within the same group share similar proteins or sugars, leading to subtle, overlapping reactions. Many people don’t realize the connection until they eliminate an entire food group. This is especially important for those who have already tried various doctors, supplements, or treatments without success.

Top Tip: When eliminating a food group, I recommend avoiding it for at least 3 to 6 months. A short 2 to 3 week elimination may not yield clear results. In my experience, longer eliminations are far more effective at uncovering the true source of persistent “mystery” symptoms than brief exclusions.

Key Food Reaction Groups

Here are some common categories of food reactions:

Food Allergies: Reactions to specific proteins in foods. Symptoms can range from mild to severe, and in some cases, life-threatening.
FODMAP Foods: These are poorly absorbed sugars and starches found in certain fruits, vegetables, and grains. They can cause digestive issues like bloating and discomfort, especially for those with IBS or SIBO.
Histamine: Found in aged, fermented, or ripened foods, histamines can trigger reactions like headaches, hives, and digestive upset.
Salicylates: These are natural preservatives present in many fruits, vegetables, and spices. While they are beneficial to the plants, some people may experience adverse reactions.
Food Poisoning: Caused by bacterial toxins such as Salmonella or E. coli, this type of reaction happens after consuming spoiled or contaminated food.

Reactive Foods List

The most reactive foods vary depending on the individual, but many elimination diets tend to highlight certain culprits that trigger responses in people with food sensitivities.

The elimination diet helps isolate these triggers through the systematic removal and reintroduction of these foods. You may like to read The Low-Reactive Diet page.

Eric Bakker N.D.

Greetings! I am a naturopathic physician from New Zealand. Although I’ve retired from clinical practice since 2019, I remain passionate about helping people improve their lives. You’ll find I’m active online with a focus on natural health and wellbeing education through my Facebook page and YouTube channel, including this website.