The term “food intolerance” is used to denote reactions to food which do not involve a known immune mechanism.

Caffeine

Caffeine intake is important as its ingestion may result in therapeutic doses of theophylline drugs reaching toxic ranges, as both are metabolised by the xanthine oxidase pathway.  Caffeine ingestion can occur in a variety of ways.  (Table 1.)  Chocolate and cocoa contain not only caffeine but theobromine which is metabolised to caffeine prior to complete metabolism.

Chronic, high caffeine intake, or toxicity, can result in headache, rhinorrhoea, nausea, anxiety, restlessness, irritability, dry mouth, tinnitus, palpitations, arrthythmius, tachypnoea, increased blood pressure, diuresis, sleep disruptions, gastrointestinal disturbances, and a variety of other symptoms.  Deaths related to caffeine are uncommon, an individual would need to consume approximately 75 cups of coffee or 200 colas.  Caffeine has also been reported to cause urticaria in susceptible individuals.

Caffeine crosses into breast milk.  Clearance is decreased by liver disease, pregnancy, and contraceptive use.  Clearance is increased by smoking.

Table 1: Sources of Caffeine

Other Sources:

Vitamin preparations and other tonics.

References (All)

1.Dahl R. Sodium salicylate and aspirin disease.  Allergy 1980; 35: 155-156.

2.Setlipane G.A., Chafee F.H., Klein D.E.  Aspirin Intolerance.  11.  A prospective study in an atopic and normal population.  J. Allergy Clin Immunol 1974; 53: 200-204.

3.James J. Warin R.P.  Chronic urticaria: the effect of aspirin.  Br. J. Dermatol 1970; 82: 204-205.

4.Hillerdal G., Lindholm H.  Laryngeal edema as the only symptom of hypersensitivity to salicylate acid and other substances.  J. Laryngol Otol 1984; 98: 547-548.

5.Williams W.R., Rawlowitz A., Davies B.H.  Aspirin-like effects of selected food additives and industrial sensitizing agents.  Clin Exper Allergy 1989; 19: 533-537.

6.Szczeklik A.  Adverse reactions to aspirin and nonsteroidal anti-inflammatory drugs.  Ann Allergy 1987; 59: 113-118.

7.Allen D.H., Delohery J, Baker G.  Monosodium L-glutamate-induced asthma.  J. Allergy Clin Immunol 1987: 80(4): 530-537.

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