Phenols, Salicylates & Additives

Phenols, salicylates and additives are a problem that typically needs to be addressed after the Gluten Free / Casein Free (GCFC) diet has been started. Generally it is recommended to address foods high in phenols or salicylates, and additives about 2-6 months after you start a GFCF or other similar diet.

Phenols are a unique properties that can be high or low in foods. The higher level of phenols found in food seems affect children on the autistic spectrum or individuals with sensitive guts or immune systems. In addition, salicylates and additives can also have a negative affect and in many cases these need to be avoided all together.

It is important to note that almost all foods have phenols, just some have more phenols than others, and a child with PST has trouble processing them, so you want to reduce the HIGHLY phenolic foods so the child's body does not get overloaded in trying to process the phenols it is getting anyway.

People who eat a large quantities of phenolic foods or foods containing salicylates or additives can experience some of these negative side affects:

  • laughing at in appropriate time (at night or when something is not funny.)
  • strange rashes that appear on the body
  • erratic behaviors and moods
  • self stimulatory behaviors
  • night wakenings
  • have a difficult time with their stools (with constipation, diarrhea or undigested foods.)
  • headaches

It is important to note that these symptoms above can also be due to autism, or other medical issues. It is also common for some to experience some of the issues above and not all of them. For many families with children on the spectrum by eliminating or greatly reducing phenols, salicylates, and additives they had a child that was much happier and had less issues.

In the case of my son, I also found he craved foods high in phenols, salicylates or that contained additives. For example, he would crave and eat as many bananas that I would let him (up to six a day,) or seek foods that caused him to feel poorly and experience many of the symptoms above.

The only way to know if phenols, salicylates or additives affected him was to remove them as much as possible from the diet. Within 2 weeks of eliminating foods high in phenols and removing foods that contained salicylates or additives my sons symptoms for the most part his negative symptoms went away only to return when there was a forbidden food infraction.

There are hundreds of products that contain high phenols, salicylates and countless food sources with dyes and additives. This is the list I work off of and keep out of his diet as much as possible.

It is important to not that my son was a very limited eater and EVERYTHING he eats now is LOW in sugar (or no sugar,) NO yeast and completely gluten free, casein free, soy, egg, and yeast free as well.

These items we eliminated: TRY THESE IN THEIR PLACE!

  • Anything with a name you cannot pronouce! JUST AVOID!!!
  • food dyes just avoid!
  • tomatoes just avoid for a period of 3-6 months!
  • apples Pears are a good replacement
  • PEANUTS Almonds & Cashews in stead!
  • Bananas Fresh Pineapple, Mangos & Papaya are good!
  • ORANGES See other fruits!
  • Cocoa Try GFCF Carob
  • red grapes Try GREEN grapes (sparingly)
  • Vanilla w/ alcohol Frontier vanilla without alcohol
  • DYES Anything with a dye – RUN!
  • Preservatives Common preservatitves are BHA and BHT – AVOID!
  • Natural Flavors RUN! Or verify what these flavors are!

Some good fruit choices include FRESH: orange, persimmon lemon, coconut, cherries, kiwi’s, avocado, peaches, nectarines, plumbs, strawberries, apricots and cranberries.

It is important to note:

  • Some phenols are concentrated in the skin and the seeds.
  • Roasted nut, juices, and dehydrated foods can cause a phenolic response. It is best to go for raw alternatives.
  • Yeasty based foods such as bananas can cause a negative but different reaction. It is worthwhile to test yeast levels as well. (For some families it is not clear if their child has a yeast OR phenol/additive issue. Sometimes they have both issues. Both yeast and phenol/additive issues need to be addressed and monitored in many children.)
  • Avoid natural flavors or processed foods (my rule, anything with more than 10 ingredients DOES NOT make it in my sons stomach!)
  • KEEP A food journal. Track what your child eats and watch bevaviors (extra hyperness, stimmy outbreaks,) rashes on face / bottom, violent outbreaks, or night wakenings. My son used to laugh at night for an hour (scary!) I removed bananas and these episodes are gone! We replace them with PEARS, MANGOS and do not have a problem.

There is some great information on phenols from www.feingold.org.

Feingold recommends to avoid phenolic fruits that are"colored fruits". Watermelon is red, so that is a definite flag, cantaloupe is orange which is better.

PHENOLIC AND SULPHUR TRANSFERASE ABSNORMALTIIES TECHNICAL DESRIPTION

Sulphur Transferase Abnormalities
Waring (1993), encouraged and supported by O'Reilly (1993) and other parents, has published data which convincingly demonstrates deficiencies in the sulphur- transferase capabilities of people with autism. They have demonstrated also that this inadequacy is the consequence not of an absence of the responsible enzyme (sulphur transferase) but of the sulphate ions which are needed if the sulphation is to be accomplished.

If this sulphation process is not functioning satisfactorily there are many possible consequences which may be of relevance in the autistic syndrome. These have been described elsewhere (Waring 1993). It is worth recording that similar deficiencies have been reported in people with migraine, rheumatoid arthritis, jaundice and other allergic conditions all of which are frequently reported as being common in the families of people with autism. I am unaware of any survey which actually demonstrates this and nothing better than anecdotal evidence exists.

Clearly, if there is a deficit of available sulphate in the body attempts can be made to replace it. Unfortunately, sulphate ions are not absorbed from the gut so this route is not a possibility. The main source of free sulphate in the body is the amino acid "cysteine" which is obtained from the breakdown of appropriate protein material and it is this stage which may be faulty in people with autism. Some parents have attempted to combat this by feeding their children with abnormally large doses of cysteine in tablet or powder form but, as far as I am aware, the only result is a high concentration of urinary cysteine. Other parents have introduced other sulphur containing amino-acids to the diet and claim these to be beneficial.

Unfortunately the claims are difficult if not impossible to assess since those parents experimenting with this intervention are likely to be experimenting simultaneously with many others. Interestingly, the sulphur containing amino-acid "Taurine" which may be given to patients for this purpose, is reported as having an anti-opioid effect (Braverman 1987).

Since free sulphate is not absorbed orally, parents have been experimenting with alternative routes. One route which is increasing in popularity, is the percutaneous one. Magnesium Sulphate (Epsom Salts) are placed in the bath water in the hope that the sulphate will enter the body, if not via the back door, via an alternative route. Many parents have claimed benefits from this therapy and some high functioning adults have tried it for themselves. The majority claim positive changes in behaviour but some of the high functioning people have reported increased irritability (and so stopped using this therapy). Any perceived benefits may, of course, be totally unrelated to the sulphate element of the salts. It could be that the Magnesium (which is often supplied as a supplement to people with autism,) is the significant component.
The question arises as to whether sulphate ions could enter the body in this way but, if so, it could provide an intellectually satisfying explanation for the long history of the use of spas in the treatment of rheumatic conditions.

Sulphur transferase activity is important for many biological reaction in the body and some of these may be of relevance in the aetiology of autism. For example, the system is involved in the breakdown of bilirubin and biliverdin, the breakdown products of haemoglobin which are seen where bruising has occurred. It may be pushing speculation a long way but it is possible that the dark rings so often seen around the eyes of people with autism may be evidence of a lack of activity within this system. This system is also required for the breakdown and removal of phenolic compounds, indeed the tests used for estimation of its activity relies upon the conversion of paracetamol to its sulphate.

An inadequately functioning system will also result in abnormal metabolism of some neurotransmitters. In particular, serotonin, (5-HT) metabolism will be affected and the appearance of unusual metabolites (such as the hallucinogen bufotenin) could be predicted. Such an observation has been reported (Himwich 1972) but its significance is uncertain.

Other Interfering Foodstuffs
As indicated above, an adequately functional sulphur transferase system is a prerequisite for the removal of phenolic compounds from the body. Since the availability of available sulphate ions is finite, the same will apply to the ability of the body to deal with such compounds. Thus when certain foodstuffs with high phenolic content are eaten they will utilise the available sulphur transferase resources of the body and thus exacerbate the problems referred to above.
Many parents have observed that apples, oranges and other citrus fruits, chocolate (possibly on account of the phenol flavouring vanillin) and certain other foods will induce severe deterioration in the behaviour of their children with autism. Interestingly, two parents (who must remain anonymous) have contacted me independently and stated that when this situation arises, they have observed that "Cranberry Juice" will markedly reduce or even eliminate these effects. Whether this due to the sulphur content of the juice or some other mechanism or whether the effects are imaginary remains to be determined.

Some parents have found that there ate other foodstuffs which can cause problems; in particular they have removed all traces of pigment form the diet of the child (Johnson 1995). Since all of these dietary exclusions tend to be in addition to gluten and casein removal, it is difficult to ascertain precisely which elements of the exclusion are of relevance to any reported improvements.

Synthetic Colourings
There has been considerable discussion in the media for many years about the involvement of synthetic pigments, in particular tartrazine, in worsening the symptoms of autism. Considerable anecdotal evidence exists for their role in increasing hyperactivity (where autism is not involved). Parental reports suggest that removal of synthetic pigments from the diet have, in the vast majority of cases, made no difference whatsoever.

-----------------------------------------------------------------------------

Salycilates Technical Summary

ELIMINATE SALYCILATES, ARTIFICIAL COLORS, FLAVORS, PRESERVATIVES

SALICYLATES: naturally occurring chemical compounds thought to interfere with the production of several brain chemicals, including norepinephrine, acetylcholine, and dopamine. Foods containing salicylates include apples, apricots, berries, oranges, nectarines, grapes, peaches, plums, cucumbers, tea, and tomatoes.

Also cut out aspirin-containing compounds and perfumes.

FOOD DYES AND OTHER ADDITIVES: it has been found (Dr. Feingold, Dr. Stephen Lockey, and others) that food dyes and food additives were responsible for the hyperactivity in many of the hyperactive children they had seen in their practice.  In particular red, orange, and green dyes were to worst offenders.  Preservatives should also be eliminated, especially MSG, BHA and BHT.