Reviewer: S. Randhawa, M.D., Allergist/Immunologist and Assistant Professor at LSU (Shreveport) Department of Allergy and Immunology
A 50-year old Korean female is self-referred to the allergy clinic for evaluation of "MSG allergy." She complains of nausea and headache within minutes of eating Chinese food with MSG. Symptoms occur every time she eats this type of food (every 3-4 months) for the last 10 years.
The patient would like to be tested for "MSG allergy." Her allergic rhinitis and conjunctivitis are currently not symptomatic.
Crystalline MSG. Image source: Wikipedia, Creative Commons Attribution ShareAlike license.
Past medical history (PMH)
Hypertension (HTN), allergic rhinitis and conjunctivitis.
Medications
Hydrochlorothiazide (HCTZ), lisinopril, Opcon-A (naphazoline and pheniramine) eye drops PRN.
Drug allergy
Penicillin (PCN), rash.
Family medical history (FMH)
Negative.
Social history (SH)
Quit smoking 20 yr ago, 5-pck/yr.
She has a dog.
Do you think this patient has an allergy to monosodium glutamate (MSG)?
There are no confirmed cases of allergy to MSG. The symptom complex is more characteristic of food intolerance rather than allergy.
Are there any tests for "MSG allergy"?
There are no skin tests or ImmunoCAP (R)/RAST for "MSG allergy."
What happened?
The patient was advised to avoid foods causing her symptoms and reassured.
Final diagnosis
Intolerance to Monosodium Glutamate (MSG).
Summary
MSG is a popular flavor enhancer that is added to many foods but that also occurs naturally. MSG is the sodium salt of one of the most common amino acids in the human body and occurs naturally in virtually all foods.
The classic example of MSG sensitivity is the MSG symptom complex, called the “Chinese restaurant syndrome,” characterized by a burning sensation of the back of the neck, forearms, and chest; (2) facial pressure or tightness; (3) chest pain; (4) headaches; (5) nausea; (6) upper body tingling and weakness; (7) palpitations; (8) numbness in the back of the neck, arms, and back; (9) bronchospasm (in asthmatic patients only); (10) drowsiness.
Adverse events due to monosodium glutamate (MSG) occur at high dose exposure. The intolerance to monosodium glutamate is not an IgE-mediated process, e.g., not an allergy.
References
Monosodium Glutamate. Adkinson: Middleton's Allergy: Principles and Practice, 6th ed.
Monosodium glutamate, from Wikipedia, the free encyclopedia.
References
Monosodium Glutamate. Adkinson: Middleton's Allergy: Principles and Practice, 6th ed.
Monosodium glutamate, from Wikipedia, the free encyclopedia.
Comments from Twitter:
@AllergyNet (Dr John Weiner): Also is there MSG asthma? Our 1998 JACI paper http://bit.ly/iHNtMZ
Dr Kelly Sennholz (@MtnMD): GREAT POST!! Thanks, Dr D.
Dr Kelly Sennholz (@MtnMD): GREAT POST!! Thanks, Dr D.
Published: 07/03/2008
Updated: 12/17/2011
34 comments:
I started taking lisinopril about a year ago and seemed to developed an MSG intolerance at about the same time.
I wonder if they're related.
If I eat out at times right after eating soup I get tight in the chest and have ifficulty breathing, just today I had potator and bacon soup and right afterward I got hot started sweating and had trouble brathing. Is this an MSG intolerance?
It could be. The best person to evaluate this is you primary care doctor. No medical advice is provided on this website.
i HAD THE SAME PROBLEM AS OTHERS WITH SOUP AND AFTER EATING OUT AT CERTAIN RESTAURANTS, NOT JUST CHINESE. IN FACT, I CAN HAVE WON TON SOUP AND FRIED RICE AND DON'T GET IT. AFTER EATING A COMBO AT CHILI'S OR THE FRIES AT APPLEBEES OR CHINESE FOOD WITH THE BABY CORNS I WILL GET ALL THE SYMPTOMS OF THE MSG POISONING. I WILL EVEN VOMIT.
I FOUND THAT DRINKING WATER AND EATING REAL EGGS FOR 2 DAYS WILL HELP. ALSO, PLAIN ROAST BEEF WITH NO MSG SEEMS TO EAT THE PROBLEM. I HAVE SINCE CHANGED TO NO MSG COLD CUTS AND ONLY ALLOW MYSELF 1 SOUP A WEEK, IF THAT MANY.
pROGRESSO SOUPS AND CAMPBELL CHICKEN NOODLE OR OYSTER STEW ARE THE WORST FOR MSG. WATCH MSG IN CRAB CAKES FROM TRADER JOE'S.
BY THE WAY, DRINKING MILK SEEMS TO HELP THE ITCHINESS IF YOU ARE NOT NAUSEOUS.
I have symptoms, headache, heart palpitations, swelling, red face, diarrhea after eating in certain restaurants especially McDonalds and Olive Garden.Plus my blood pressure goes up. I've been buying soups that say msg free, one is Progresso. Now I've read that that may not be true on the label if the word "added" is present. It might just have MSG. I'm confused and concerned. I'm thinking about going on a natural diet for a month to see what happens, but where do I start? Is there a list of foods with no MSG's out there? Thanks for listening ,Sick of being sick
Years ago I quit eating at fast food restaurants after getting what I call "killer" headaches which send me to bed for 3 to 4 days. I especially liked Taco Bell and the seasoning seemed to be a major contributor to my headaches. It feels as it my brain has swelled and the skull is too small to contain it.
I have studied the various names used on labels and found I need to take the list with me, even to health food grocers. It is difficult to avoid and indeed is naturally occurring in many foods, however it seems that when it is added to foods, (and often I do not know the form or type used)it affects me adversely. Perhaps I am hypersensitive to msg, and maybe just in some forms. Since I am not willing to be a guinea pig for experimentation (too much pain) I have found that I eat very few processed foods now, and a lot of produce, organic when I can get it or grow it.
When I do have a very occassional reaction (always after eating out or ingesting food at a potluck) I find that taking large doses of vitamin C, and drinking a lot of water seems to flush it out of my system and the headache lasts only 24 to 48 hours, rather than the usual 3 to 4 days. I do not know if a list of msg foods does exist anywhere because it naturally occurs in most everything. It is the added msg, in any of its many names that seems to be the problem.
I forgot to add that I too, experience an big increase in my blood pressure after ingesting msg containing foods. It rather concerns me that it might lead to a stroke, so I am careful.
If you are intolerant to MSG you are also intolerant to Glutamate. When you eat MSG the monosodium separates from the glutamate as soon as it touches your tongue. You therefore ingest glutamate on its own, and not as MSG. You therefore have a GLUTAMATE intolerance, NOT MSG!!
Glutamate is an amino acid that is present in high concentration in many very natural foods including; broccoli, parmasan cheese, chicken and tomatoes to name a few.
If you do have an intolerance to glutamate you will also have symptoms when consuming these foods, regardless of how they are prepared and whether they have MSG included or not.
I have a glutamate intolerance. I was diagnosed at the age of 3 (I am now 33). I have no other health problems and am healthy overall. Over the past year I have found other labels for glutamate. Hydrolyzed plant protein, hydrolyzed vegetable protein, autolysed yeast extract, yeast extract, yeast culture, disodium inosinate, disodium guanylate, and labels such as vegetarian/natural flavours, spices and seasonings can contain the above ingredients. I have also reacted severely to the ingredient malt extract (cereals), which I found on the Internet is hydrolyzed malt. I experienced chronic symptoms which I think is related to dose: nausea, burning sensation below my rib cage, poor memory/concentration and communication ( my sentences get mangled or I choose the wrong word, weight gain and chronic fatigue. These reactions disappeared when I avoided the above ingredients within 2 weeks. I hope this helps.
Within 15 minutes: facial pressure above eyebrows, around my cheeks, around my temples and ears. I often rub my face with my hands. My verbal communication becomes slow and poor. I use the word "so" way too often, mangle my sentences and will choose the wrong words. IE: I asked the waiter for a glass of milk, when I wanted a glass of water. I have not drank a glass of milk in 18 years.
Within 15-30minutes: my head feels pressure, my eyes feel swollen (but not).
Within 1hour: migraine sets in. This lasts for 36 to 48 hours. Sometimes it is accompanied by a high fever. I am not able to move, external stimuli (lights, sound) are intrusive. I avoid eating and drinking.
Day 3: migraine is gone. However, I am unable to participate in conversation and cannot read as it makes me very nauseous. I can watch a non-action movie and I take naps throughout the day. Sometimes this continues into day4. My body and brain recover by day5. Although, I now have to catch up with life responsibilities.
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Also...in response to the information that people with a glutamate intolerance are also intolerant to foods high in natural glutamate such as tomatoes, grapes, mushrooms, Parmesan cheese and chicken will also experience these symptoms does not go along with my 33 years of experience. I eat all of these foods on a regular basis. I have no other allergies or intolerances to food, therefore my intolerance to processed glutamic acids/salts is quite clear. If you have questions my email is nicolebeaumont15@hotmail.com. I have made two posts on this blog: Nicole Canada and N.Beaumont
The symptoms outlined above "within 15min to 4 days" is the reaction I always get from consuming MSG. There are a few instances that I also experienced the same symptomolgy when I consumed: hydrolyzed vegetable protein, autolysed yeast extract (labelled as Vegetarian Natural Flavour - which the company disclosed) and malt extract that was an ingredient in an Organic cereal.
It angers me that MSG is considered just an "intolerance" when it is much more serious than that. MSG crosses the blood brain barrier and since it is an excitotoxin, which has the ability to fire nerves until they die. There are over 60 actual symptoms for a reaction to MSG and not just a handful. My thinking is that everyone is intolerant to MSG but some are less severe than others.
To the soup guy who commented above, more than 99% of all canned or to-go soups have MSG in them. It's inevitable due to lack of flavor for soups.
More importantly, how many of you have said that you were hungry again 30 minutes after eating a Chinese meal? Probably all of you. This is because MSG works in the same area of the brain that tells you that you're full or not. This is also why the Chinese restaurants started pulling the MSG out of their restaurant foods in the 80's. On that same note, how many of you have difficult dieting? It's pretty hard to diet when your brain is continually telling you that you're hungry and you're not. Instead, one will overeat very easily.
Worse yet is the addition of Aspartame if you are dieting. Aspartame is again another excitotoxin, which also causes nerves to fire until they die. Here, someone is trying to do themselves a justice by drinking Aspartame but instead it's biting them in the be-hind because it will as well make them feel hungry sooner.
Adding a diet soda with Aspartame to a meal with MSG is like fighting fire with fire and if you're on a diet, you'll never lose weight. - continued…………….
Besides the standard hydrolyzed veggie protein there are many, many more additives that legally have MSG in them that do not state so. Simply the word spices on a product most likely will have MSG mixed within it. There is a degree of MSG that the FDA will allow if it is a secondary ingredient within another ingredient.
I'm not going to give you the list because you will be disgusted with what the food industry is getting away with but let me give you one good example - and, a funny story at that.
About 9 years ago I started menopause, which was when I really paid more attention to what I was eating since I was experiencing many, many symptoms that were extremely uncomfortable.
The one thing us women always strive for during those weeks, months, years is Serotonin. The precursor to making Serotonin in the body is Tryptophan so it's commonplace to buy a good deal of foul during those times and my choice was turkey. I would buy a 20 pound turkey, cook it and freeze it for meals, sandwiches, etc.
I always had a tremendous amount of symptoms I couldn't figure out such as the ones mentioned above as well as 10+ more but here I was eating simply fresh turkey.
One day I decided to buy another turkey and I noticed one again that the turkey suppliers were including a 12% solution of something or other. That something or other was maltodextrin. The maltrodextrin was mixed with MSG as a secondary ingredient and again, that's legal according to the FDA. Worse yet is that they don't have to put the words monosodium glatamate on the label if it is a secondary ingredient since 'they' state it's too little of an amount to harm anyone. Beezwax. My turkey was the responsible party for making me so friggen miserable due to the small amount of MSG in the solution. Continued……
There are 66 different ingredients on our shelves that mince MSG in them and MSG will not be found on the label. Like the individual above, autolysed yeast is another where you'll find it mixed with MSG.
The reason why they do this is simple. All frozen foods, it matters not which ones, have MSG in them whether they state it or not - such as my turkey. This is due to the great loss of flavor from freezing. Shy of giving you the list of 66, the best thing you can always do for yourself is very simple. Stay out of the isles except for good things like rice, etc. Shop only in the outside isles for fresh meats, vegetables, etc. Buy absolutely nothing processed because the chances that you're consuming MSG without knowing it is very, very high. Eat nothing frozen, including sweet items because it's in sweet items too such as frozen pies.
The FDA's last test on the reaction of MSG in the brain was way back in the mid 80's. Things calmed down after that when the FDA made all of the spice manufacturers state MSG accordingly on their products - but, then those same manufacturers found another way of getting it into the food without having to do so.
This issue is very, very overlooked and dangerous, especially for babies and young children. Personally, I feel that this is actually responsible for kids being diagnosed with hyperactivity disorders and attention deficit disorders. Misdiagnosed rather. Some of the very same symptoms that those kids have are the same symptoms one will experience with a good dose of MSG. Science will figure it out someday, but in the interim we're all being taken for a ride.
If just one person here wants the list of 66 physical symptoms and list of 55 ingredients where MSG is being added to your food products without it being stated on the label - say so and I'll post it here for you.
Eat whole foods and never eat processed whether it bothers you or not. You don't really know what it's doing. But, one thing you do know is that it shouldn't be crossing the blood brain barrier, which it is.
One last thing, if you have grandparents or parents with arthritis, inform them especially since both MSG and Aspartame enhance arthritic pain enormously.
I would love to see the full list of 55 ingredients where MSG is being added.
I have had trouble with fast heart and admitted to Hospital twice...my doctor told me to take Vit B6 if I have a suspect food..it does seem to work I live in Australia and it isnt considered a problem here..pity for the ones whon have died even from its effects..KFC is supposed to be the worst with the stuff..regards Mervyn
Hey Mervyn,
I doubt that anybody died just from Monosodium Glutamate (MSG). Just saying...
I just found out I have Glutamate Intolerance. I get the reaction on MSG and the four other foods that are very high in glutamate (gluten, soy, corn and dairy). But my reaction is different than most: My lips swell up until they burst open and bleed when I smile. I become depressed and grouchy. I get cysts on my face and acne-like symptoms.
"My lips swell up until they burst open and bleed when I smile."
This doesn't sounds like a typical (or any) MSG reaction to me... You may want to see a board-certified allergist just to be sure.
I also would like to see a list of msg foods, or msg free foods. Thank you.
Glenn said
within 30 mins of eating something with msg i get diarrhea, not something easy to talk about but does anyone else
It's found in all foods that contain the following:
Modified corn starch,
Autolyzed anything,
yeast extract,
maltodextrin,
spices,
spice extract,
natural flavouring,
monosodium glutamate,
msg,
E621-E625!
Aspartame ****Has the same effect for me which you find in drinks (Not only soft drinks but also cordials like orange/blackcurrant and even some juices)
Stock and most sauces ***I'd recommend making your own boullion using fresh veg and herbs and then freezing it for use in risottos and making currys etc.
Hope that's some help!
I bought MSG to add to my chinese cooking when I was 21. I put about a tsp in my stir-fry. Immediately after eating the stir-fry, I began to hyperventilate and feel dizzy. I paced back and forth and thought I was having a heart attack at age 21. My boyfriend blew it off because he felt fine. I threw the MSG away, but have always wondered about the reaction. Now at age 48, I can't eat at many chinese restaraunts without getting instant diaarrhea and sometimes light-headed. Don't blow it off.
Ate out at Applebees and had portion of an Oriental grilled chicken salad. Was in the bathroom before I left and can barely pull myself off the couch this morning. Swollen face, especially eyes, heavy feeling in my chest, slow mental capacity. I have experienced this from breads, chinese food, many wines - but especially wine coolers. I am so sick of feeling bloated. Until I read these posts, I thought I was crazy to link these things together. I feel like I need to eat homemade food at all times as that is the only time I feel normal. At least I know I am not alone. Next time I see the doc, I will ask more questions. I wonder if anyone else has experienced cyst type symptoms. When I go off my homemade diet, I start gaining weight, but also get ovarian cyst and breast cyst growth that is an endless circle of tests by doctors. So far, every time they only confirm I am cystic, but no cancer (thank goodness). Just wondering if anyone else has had this problem? Also wondering about the link to skin eczema? Thanks..jv
When ever I have Chinese takeaway meal, 3 days later either my knee,able or foot swells up and I am subjected to the most excruciating pain, I have been examined by a rhumatologist for over 8 months, he discounted gout from the blood tests and just scratced his head and said don't eat Chinese food.....anyone have any ideas what it could be...??
My daughter has MSG sensitivity. To the poster...nobody has ever died from MSG...well maybe. MSG/Glutamate has set off a cascade of allergy symptoms for my daughter. But, one, cold urticaria, nearly killed her. She was actually allergic to the cold and went anaphalactic one time after exposure. That's just one of the many crazy effects of Glutamate.
Before we eliminated MSG, she had ciliac disease type symptoms but tested negative. She had behaviour problems, teeth problems, slow growth, reflux, heat and cold allergies, to name a few. However, when we eliminated MSG....all 66 varieties...her IEP for behavior is about to be removed at school, no tooth decay in 18 months, no reflux, grew 4 inches, and heat/cold allergies are gone!
Not everybody is going to be this sensitive, but some are. It's horrible that people don't believe how detrimental it can be to somebody's health. I wish we had better labeling available for this. It's no less important than gluten. We spend so much time pouring over labels to find these ingredients. But will continue because the payoff is HUGE. Good luck!
I was diagnosed with rheumatoid arthritis in 1996. About a year later, I was diagnosed with an MSG ALLERGY by an allergist, although it was based on symptoms as there was no skin test available. I go into anaphylactic shock. I typically run into issues when eating out, which I've noticed initially causes me to be quite impatient. It typically starts with nasal congestion, then moves to facial swelling, throat swelling, increased heart rate, fast breathing, itchiness, diarrhea, and vomiting. About 1/3rd of the time, I also get a few hives.
I occasionally have issues with natural foods (home grown tomatoes, but never store bought). 3 months ago, I started the Paleo Diet, eating a modern interpretation of what our hunter gatherer ancestors ate. This seems to have helped, although it's early to tell. I haven't had a reaction since starting the diet (I still avoid tomatoes, something the diet does allow). My RA is noticeably improved, but still isn't where I want it.
MSG also aggravates Restless Leg Syndrome. I have moderate RLS for which I take Mirapex. I ate KFC the other night and spent the night dancing and and boxing. Even with an extra dose of Mirapex. Trust me, when you want to sleep, the constant, 'painful'and uncontrollable urge to move your arms and legs can feel like it's driving you crazy.
My son who is 11 has had chronic eczema since he was about 1years old - however I found it flared up at certain times - his skin would go red and hot and get a hive like rash all over his legs arms and trunk. I did an elimination diet and sure enough it was MSG (glutamate) that was the trigger - I researched this and a lady called Sue Dengate (author of Friendly Foods) has alot of information on Ribo-rash, often mistaken for eczema/dermatitis. As soon as I elimated MSG from his diet (not party food, no 600's, yeast extract, HVP or HPP) his skin cleared up but BAM as soon as he as he eats the wrong stuff the next day the rash appears and he needs an antihistamine. MSG (in all its forms) is poison for some.
MSG is an excitotoxin. It has no nutritional value. It does nothing but excite your taste buds. Sure, it's "natural" so is cocaine and many people have died from it.
30% of the population has severe to moderate negative reactions to MSG. The only reason the FDA is still approving and allow it be hidden in ingredients such as "Spices", "Natural Flavor" etc. is because of financial influence. Like many other government organizations we have today, the FDA is a corrupt and useless organization which does little but help to suck our welfare state dry and prevent Canadians from importing beef now and then or approving foriegn drugs which don't meet up to their horrid standards.
Same thing with me. I took lisonopril about 2 years now and started developing an msg intolerance around the same time...
Hello, I work as a hospital librarian. There seems to be some confusion here between glutimate intolerance and other intolerances. There are several vasoactive amines (amines that excite) that cause problems in sensitive people; MSG is only one of them, others include histamine and tyramine to name a couple. Salicylates as well. IMO this whole issue is caused by gut dysbiosis, having too many of the "wrong" kind of bacteria, which naturally produce these substances, as well as a genetic predisposition to low clearance of these substances. Be careful about trying to self-correct this problem with probiotics as many of the so-caled "good for you" strains are amine producers and might worsen the problem. I suffer from this myself, have tried many things and find that nothing is helping. I am in the process of trying to find a good nutritionist; my local allergist is unfamiliar with these types of intolerances.
People have very likely died from MSG due to asthma or stroke from the high blood pressure it causes in some and how many migraines can you endure from dying nerves? I personally get migraines, high blood pressure that does not respond to medication and very painful sciatica that extends to my very painful feet leaving me virtually house bound. I honestly thought I was going to die not knowing what was killing me and then I solved what was causing it. I had been to 12 different doctors the past 17 years and just got worse and worse. A salad diet with Ranch dressing solved it. Ranch is loaded with MSG as are most dressings and sauces and spice mixes. My last severe episode was from Gerber's apple juice. Yes, it's even in that. Don't assume, read labels and look it up on the web because many foods companies disguise it under various names and even as "natural flavoring".
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