Never mind a sore head – just one glass of wine can give you an asthma attack
13:01 GMT, 5 June 2012
Most of us have at some point suffered the effects of one too many glasses of wine.
But it takes just a single glass to make Justine Bond ill, giving her a serious asthma attack.
It’s not the alcohol in the wine that’s the problem, but the sulphites. These additives are used in food and drink as preservatives and to prevent bacteria growth.
Red alert: Justine Bold's sulphite allergy means a single glass of wine can give her a severe asthma attack
It’s estimated that up to 10 per cent of us are sulphite sensitive, with reactions ranging from flushed skin and urticaria (nettle rash), to raised blood pressure, abdominal pain, nausea and diarrhoea. More serious reactions include asthma and, in rare cases, anaphylactic shock, which can be fatal.
But many people may not realise sulphites are behind their symptoms. Indeed, it took years for Justine to be diagnosed.
‘As a child, from time to time I had allergic reactions — itching inside my ears and mouth and hives on my face after I ate certain foods,’ says Justine, 43, a senior lecturer in health science at the University of Worcester. ‘My GP gave me antihistamines and basically told me not to be so silly.’
But the reactions continued and gradually worsened. She was prescribed asthma inhalers to tackle her symptoms. /06/05/article-2154693-12EBE592000005DC-126_233x423.jpg” width=”233″ height=”423″ alt=”Preservatives: Sulphites used to prevent bacteria growth in food and drink can trigger allergic reactions in one in ten of us” class=”blkBorder” />
Preservatives: Sulphites used to prevent bacteria growth in food and drink can trigger allergic reactions in one in ten of us
She’d had pickled ginger, soy, seafood and a glass of champagne, which all contain high levels of sulphites.
Her GP referred her to the Royal Brompton Hospital in London and after a year of testing, an allergy specialist identified the cause.
The highest levels of sulphites are found in dried fruit, wine, beer, cordial, convenience foods such as pizzas and oven chips, jam, some seafood products and processed meat.
Quite why they can cause a reaction is not clear, though it’s thought they form a gas in the mouth when they come into contact with saliva in some people, which causes the airways to tighten.
Another theory is that some people can’t convert sulphites in the liver, due to a failure of or lack of the enzyme sulphite oxidase, which results in excessive levels of sulphite in the body.
Up to one in ten of us may be sensitive or allergic to sulphites, according to research by Professor Hassan Vally from the School of Public Health and Human Biosciences in Melbourne.
And asthmatics may be particularly prone, says Professor Vally.
Sulphites have an irritant effect, so if your airways are already inflamed and itchy, as they are in asthmatics, then any substance that has an effect on this part of the body if you are sensitive to it will result in symptoms.
‘We know that if you expose individuals to sulphur dioxide gas (a type of sulphite additive), there is a point where all of us will react and experience bronchoconstriction, but the concentrations that trigger this response in asthmatics are much reduced,’ he says.
For 90 per cent of people, sulphites are not a problem, says Dr Adrian Morris, a specialist allergy consultant at the London Medical Centre and the Royal Brompton Hospital.
‘In those who do have a sulphite sensitivity, it will make them a bit wheezy and maybe they’ll get a bit of a rash. Some will have an anaphylactic reaction. It’s very difficult to diagnose — and there’s little you can really do about it.’
A blood test, known as a CAST test, is only 50 per cent accurate in diagnosing the condition.
Preservatives: Sulphites are found in convenience foods such as pizzas and oven chips as well as in dried fruit, beer, cordial, jam, some seafood products and processed meat
The only definitive way is a ‘challenge’ test, when the patient is taken to hospital and sprayed with sulphur dioxide or given a sulphite solution to drink and their reaction monitored.
However, these are expensive and time-consuming, since they need to be done in a hospital where there are resuscitation facilities available.
‘The best test if you think you are mildly affected is to eat dried apricots — they have a very high sulphur dioxide content, so if you react to them you are likely to have a sensitivity,’ says Dr Morris.
However, he warns against doing this if you believe you are highly sensitive to sulphites.
While most studies suggest sulphite sensitivity affects between 5 and 10 per cent of asthmatics, some researchers believe the number is much higher.
‘The problem with sulphite allergy is that most people don’t know they’ve got it, and their GP knows little about it, too,’ says Lesley Mcmanus of the charity Allergy UK.
‘It is not normally recorded until the sulphites have triggered asthma. And there are so few allergy services it’s hard for people to know what to do.’
Kay Richards, a 42-year-old library worker from Nottingham, says she had little support when she was diagnosed with sulphite sensitivity.
‘There were signs I had a sulphite allergy when I was a teenager, but about five years ago things started getting worse. I often felt slightly nauseous, and after drinking wine my nose pours and I cough and wheeze,’ she says.
‘Dried fruit does the same thing — it makes my face and mouth itchy and my eyes puff up.’
Kay’s GP prescribed an asthma inhaler and told her to take antihistamines, but offered little extra help. ‘He told me sulphites were the problem, but wasn’t that interested in doing much else.’
Now, she reads labels religiously and cooks everything from scratch. Under EU law, if the level of sulphite in food or drink is above 10 milligrams per kilogram or litre, it must be labelled ‘containing sulphites’.
All wine and beer contains sulphites — they form naturally as part of the fermentation process — but higher concentrations are found in alcohol that is mass- produced because the preservative is added to halt forced fermentation on production lines.
Organic wines contain the lowest sulphites levels.
‘Like anything, the more chemical additives it contains, the less good the wine will be for your body,’ says Leandro Bacheco, manager of London wine bar Terroirs, which specialises in low-sulphite and organic wine.
But Dr Morris cautions against avoiding sulphites unless you are sensitive. ‘Avoidance is like going on a wheat-free diet when you don’t have a wheat intolerance,’ he says. ‘I’d hate to think of people becoming obsessed by finding low-sulphite wine and diets.
‘Poor-quality wines have a lot of other substances in them than sulphites that will add to the hangover.’
But Justine Bond believes sulphite allergies should be taken more seriously and more must be done to raise awareness.
‘I had a takeaway curry one night and my lungs were constricted and I was wheezy for months,’ she says.
‘I was sent to an asthma unit at St Mary’s hospital in Paddington, where the consultant told me sulphite allergy did not exist. I felt so insulted I walked out.’
Justine’s allergy is so acute she must avoid cosmetics and medicines that contain sulphites — including drugs used by dentists and adrenaline.
‘I am unable to have a general anaesthetic because if I need adrenaline if things go wrong, the shots contain sulphites and it is a huge risk. How some doctors can say my condition is not life-threatening I don’t know.’