What Is a Sulfa Allergy?
A sulfa allergy is an adverse reaction to sulfonamide drugs, specifically antibiotics such as Bactrim or Septra (a class of trimethoprim-sulfamethoxazole antibiotics), Sulfasalazine (used to treat colitis, arthritis, and Crohn’s disease), and Dapsone (used for dermatitis and leprosy). There are also sulfa-related medicines such as nonsteroidial anti-inflammatory drugs, migraine medications, and diabetes drugs that should be avoided. There are many brand and generic names for sulfonamides, so make sure your doctor and pharmacist are aware of the allergy. A person with HIV/AIDS may be especially sensitive to sulfonamides.
Sulfer, Sulfa, and Sulfites–What’s the Difference?
There are many misunderstandings when it comes to sulfer and its related compounds. Sulfer is an essential element and part of many different amino acids. It’s the eighth most common element in the body and no one is allergic to sulfer. Sulfer is a chelating element and helps remove heavy metals from the blood.
Sulfa drugs (sulfanomide) do cause an allergic reaction in about 3.5 percent of the population, usually manifesting as a skin rash. The reaction is caused by the sulfanomide molecule attaching to a protein and forming a new, larger molecule that can trigger an immune response. It’s not the sulfer that causes the reaction; rather, it’s the new protein that is the allergen.
Since sulfer is not the cause of the allergy, people who suffer from sulfa allergies do not necessarily have problems with other sulfer compounds such as sulfites. Sulfites occur naturally in fermented food and beverages, but are also added to inhibit the growth of microorganisms. Many people blame red wine headaches on sulfites, but it’s a syndrome independent of sulfites. Other foods that contain sulfites are dried fruits, pickles, sauerkraut, olives, some seafood (shrimp, lobster, scallops), jams, jellies, and molasses.
Sulfa Allergy and Wine
If you have a sulfa allergy, there is no need to avoid wine or other foods containing sulfites. A sulfite sensitivity is not an allergy and does not provoke an immune response. There are many compounds in wine that people can be sensitive to, such as tannins, prostaglandins, and yeast. And red wine headaches are not a common symptom of a sulfite allergy, whose symptoms include nausea and diarrhea. For people with asthma, sulfites can trigger an attack, but this only affects about 5 percent of asthmatics. Only 1 percent of the general population has a sulfite sensitivity, while more than 3 percent of the population has a sulfa allergy.
There is no correlation between having a sulfa allergy and a sulfite sensitivity, and there’s very little evidence that it’s the sulfites that cause headaches from drinking wine. So don’t let a sulfa allergy stop you from enjoying the occasional glass of wine
The Institute for Traditional Medicines: “Differentiating Sulfur Compounds.” https://www.itmonline.org/arts/sulfa.html
WebMD: “What is Sulfite Sensitivity?” https://www.webmd.com/allergies/guide/sulfite-sensitivity
CellarRaider.com: “Sulfite Allergy or Red WIne Headache.” https://www.cellaraiders.com/SulfiteAllergyorRedWineHeadache.php