Salicylate sensitivity, Chronic Fatigue Syndrome and the Microbiome

A friend message me about salicylate sensitivity [SS] which he had in the passed assumed was part of his condition.  I had not heard that term for a while and it occurred to me that some salicylate sensitivity symptoms could actually be a shift of the microbiome. An interesting question which I hope to explore in this post.

Robert H. Loblay, The Role of Food Intolerance in Chronic Fatigue Syndrome, in Dr.Hydes “The Clinical and Scientific Basis of M.E. / CFS [1992]” raises the issue, and was likely the source of many CFSers opting on the SS cart. There have been no PubMed studies following this hypothesis up, in fact, a salicylate is often used for treating Irritable bowel syndrome which is co-morbid with CFS.

This suggests that reaction to salicylates is more likely due to alteration of the microbiome profile (with possible die-off/herx of some bacteria) than true salicylate sensitivity.

  • “Four OTUs (Prevotella spp., Bacteroides spp, family Ruminococaceae, Barnesiella spp.) discriminated aspirin users from no medication (AUC=0.96; 95% CI 0.84, 1.00).” [2015]

So are you or are you not? The easiest way to test is to look at two lists of high histamine foods and see if you do not react to any items on the high list. List 1 and List 2. Salicylate sensitivity and histamine sensitivity are both easy “answers” to latch on to — often without anything solid to confirm it. It is good to be scientific and verify against detail, actually measured lists to see if there is actual consistency. Often the popular list miss some high items, which you may be eating with no side effects — no side effects calls the presumption of salicylate sensitivity into question.