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Daniel More, MD

Are You Allergic to MSG?

By February 19, 2013

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I frequently encounter patients in my clinic who wonder if they are allergic to MSG. Most of these people describe a situation in which they were eating at an Asian restaurant, after which they experienced a sensation of feeling flushed along with mild shortness of breath and chest tightness. Usually, the symptoms are mild and resolve within a short period of time and without treatment. And yet, these reactions are so distressing as to cause the person to avoid Asian restaurants for fear of MSG allergy.

MSG, or monosodium glutamate, is a flavor enhancer added to various foods, but can also be present in foods naturally. Reactions to MSG have been previous called the "Chinese Restaurant Syndrome," although are now referred to as the "MSG Symptom Complex". Symptoms are often mild and can include numbness and tingling on the arms and neck, palpitations and drowsiness. Other symptoms may include headaches, nausea, chest pain and worsening asthma symptoms.

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February 21, 2013 at 5:08 pm
(1) Miro says:

Dr. More,
I was surprised by you addressing monosodium glutamate (MSG) alone, since it is one of the forms of non-protein glutamate present in foods. Also, it is added to food in several forms (Maggi cubes, soy or fish sauce, parmesan cheese, ketchup) to enhance flavor. One of “added” forms is MSG.

The original report on a possible association between MSG ingestion and asthmatic attacks (Allen and Baker, New Eng. J. Med. 1981: 278:796) was followed by 3 clinical studies conducted in 1990s.

Woods trial (Clin. Exp. Allergy 39:1998:640) was better conducted and controlled; and it reported absence of allergic reactions following oral challenge with 5.0g MSG in 12 subjects with clinically documented asthma, and a perception of MSG allergy. The average intake of food-added MSG in the Western World is around 0.6 g/day (van Dokkum Br. J. Nutr. 48: 1982: 223).

Woessner (J. Allergy Clin. Immunol. 104:1999:305) recruited 100 subjects, thirty of whom claimed a history of asthma attacks linked to food and the remaining patients had suspected aspirin-sensitive asthma. The Woessner study (1999) used first a single- and subsequently a double-blind protocol. The authors concluded that, “For patients with an MSG-positive history, the exact 1-sided 95% CI for the probability of MSG sensitivity in this study was 0% to 0.07%, which is somewhat wider because of the smaller sample size.”

No reliable clinical evidence links MSG used in food to allergy or asthma. Williams & Woessner (Clin. Exp. Allergy 39:2009:640) recently wrote, “Despite concerns raised by early reports, decades of research have failed to demonstrate a clear and consistent relationship between MSG ingestion and the development of these conditions.”

Arbitrary mentioning MSG in this context further diminishes already bad name of the substance and thus strengthen negative public perception.

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