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Who Should Avoid Citric Acid? Understanding Dietary Sensitivities

5 min read

While the FDA classifies manufactured citric acid as “generally recognized as safe” (GRAS), a 2018 report in Toxicology Reports documented multiple case studies of inflammatory reactions in individuals consuming products containing this ubiquitous food additive. This raises the important question of who should avoid citric acid?

Quick Summary

Certain individuals, including those with acid reflux, digestive disorders, mold allergies, or specific inflammatory conditions, may need to limit or avoid citric acid. Sensitivity can be to the acid itself or to remnants of the Aspergillus niger mold used in its manufacturing process.

Key Points

  • Manufactured vs. Natural: Most dietary citric acid comes from a manufactured form (MCA), fermented by the mold Aspergillus niger, not from fruits.

  • Digestive Concerns: Individuals with acid reflux, GERD, gastric ulcers, or IBS should limit citric acid intake to avoid aggravating symptoms.

  • Mold Allergies: People with mold sensitivities or compromised immunity may react to trace remnants from the Aspergillus niger production of MCA, leading to inflammatory responses.

  • Dental Health: Excessive consumption of citric acid erodes tooth enamel, increasing sensitivity and risk of cavities.

  • Inflammatory Symptoms: Some people experience joint pain, muscle pain, and fatigue after consuming MCA-containing products, suggesting a link to inflammatory reactions.

  • Check Labels: MCA is widespread in processed foods, beverages, and supplements, making diligent label reading necessary to avoid it.

In This Article

Citric acid is a weak organic acid found naturally in citrus fruits like lemons and limes. However, the vast majority of citric acid used in processed food and beverages today is manufactured citric acid (MCA), which is produced through a fermentation process involving a fungus, Aspergillus niger (black mold). While beneficial for many, as a flavour enhancer, preservative, and antioxidant, this common additive can trigger adverse reactions in certain individuals. Understanding the distinction between natural and manufactured sources, as well as the underlying health conditions, is crucial for those who suspect a sensitivity.

The Difference: Natural vs. Manufactured Citric Acid

It is important to differentiate between citric acid found naturally in whole foods and the manufactured version found in packaged goods. While chemically identical, the source and production method are key to understanding potential health impacts for sensitive people.

  • Natural Citric Acid: This form is a naturally occurring compound in fruits like lemons, limes, and oranges. When consumed as part of a whole-food diet, it is typically well-tolerated, though its high acidity can still be problematic for those with sensitive digestive systems, such as people with GERD.
  • Manufactured Citric Acid (MCA): Accounting for approximately 99% of global citric acid production, MCA is derived from the fermentation of sugar solutions (often corn syrup) by the Aspergillus niger fungus. For individuals with a genetic predisposition to mold allergies or heightened immune responses, trace contaminants or proteins from the mold remnants in MCA may trigger inflammatory reactions, unlike naturally sourced citric acid. The ubiquity of MCA in our food supply makes it a frequent exposure for many people.

Health Conditions Aggravated by Citric Acid

Several health conditions can make individuals more susceptible to adverse reactions from citric acid, particularly the manufactured form. These reactions can range from digestive upset to systemic inflammation.

Acid Reflux and Digestive Disorders

High acidity from consuming citric acid can exacerbate symptoms for those with existing gastrointestinal issues. For individuals with conditions like GERD (Gastroesophageal Reflux Disease), IBS (Irritable Bowel Syndrome), or gastric ulcers, citric acid can increase stomach acid levels and irritate the stomach lining and esophagus. This can lead to increased heartburn, abdominal pain, bloating, and other discomfort. Processed tomato products, for instance, are high in both citric and malic acid, making them a common trigger.

Mold Allergies and Inflammatory Responses

For those sensitive to mold, the manufacturing process of MCA can pose a significant risk. The Aspergillus niger mold used in fermentation is a known allergen. Even after extensive processing, trace mold proteins or other by-products may remain in the final product and trigger an inflammatory cascade in susceptible individuals. This can manifest as a variety of systemic symptoms, including:

  • Joint pain and stiffness
  • Muscle pain
  • Fatigue and enervation
  • Respiratory symptoms, such as asthma flare-ups
  • Gastrointestinal issues like cramps and diarrhea

Dental Health Risks

Frequent and high intake of citric acid, especially from beverages like sodas and juices, is a major contributor to tooth enamel erosion. Enamel is the protective outer layer of the teeth, and its degradation can lead to increased tooth sensitivity, discoloration, and a higher risk of cavities. Using a straw for acidic drinks and rinsing the mouth with water afterwards can help mitigate some of this damage.

Histamine Intolerance

Though not a primary source of histamine, citric acid is sometimes considered a "histamine liberator," meaning it may trigger the release of the body's own histamine. In individuals with histamine intolerance, where the body struggles to break down histamine effectively, this can worsen symptoms like headaches, hives, and digestive problems.

Identifying and Avoiding Citric Acid

Avoiding manufactured citric acid can be challenging due to its widespread use. The key is to be a diligent label reader and focus on whole, unprocessed foods whenever possible.

Where to Find Manufactured Citric Acid

Manufactured citric acid (MCA) is used as a flavouring agent and preservative in countless products. Be aware of the following common sources:

  • Beverages: Soft drinks, fruit juices, energy drinks, and flavored waters.
  • Sweets and Candies: Many gummies, hard candies, and packaged desserts.
  • Canned and Jarred Foods: Tomato products, pickles, sauces, and some canned fruits.
  • Processed Snacks: Flavoured chips and other snack foods.
  • Dairy Products: Some processed cheeses and yogurts.
  • Dietary Supplements: Effervescent vitamins and supplements often contain MCA.
Comparison Table: Natural vs. Manufactured Citric Acid Feature Natural Citric Acid Manufactured Citric Acid (MCA)
Source Found in fruits and vegetables like lemons, limes, and berries. Produced via fermentation of sugar (often corn syrup) using Aspergillus niger mold.
Purity Occurs with other natural compounds in whole foods. Isolated, industrial-grade chemical; potential for trace mold remnants.
Cost More expensive to extract commercially. Cost-effective, allowing for widespread use in processed products.
Potential Triggers Acidity can trigger GERD/reflux symptoms due to pH. Potential trigger for mold-sensitive individuals due to production process.
Labeling Not typically listed as an added ingredient; implied by natural ingredients. Clearly listed as "citric acid" or "citric acid anhydrous".

A Low-Citric-Acid Diet: Practical Tips

For those seeking to limit or eliminate citric acid, a targeted approach is needed:

  • Read Labels Diligently: Always check the ingredient list for "citric acid" or "citrate." This is especially important for processed and packaged items.
  • Focus on Whole Foods: Emphasize a diet rich in fruits and vegetables that are not highly acidic, such as melons, bananas, and green leafy vegetables.
  • Choose Freshly Prepared Foods: Limit consumption of pre-made and canned goods, which frequently contain MCA as a preservative. Cooking from scratch is the best way to control all ingredients.
  • Consider Substitutions: Use apple cider vinegar, which has a higher pH than citric acid, as an alternative for a tangy flavour in some recipes. For beverages, opt for water, herbal teas, or lower-acid juices like carrot or watermelon juice.
  • Consult a Professional: Before making significant dietary changes, especially if you have an underlying health condition, consult with a doctor or registered dietitian. They can help you identify potential triggers and ensure your nutritional needs are met.

Conclusion

While generally safe for the majority of the population, citric acid—and particularly its manufactured form—poses legitimate concerns for certain groups. Those with pre-existing digestive disorders, mold allergies, inflammatory conditions, or dental sensitivities should exercise caution and be mindful of their intake. By understanding the difference between natural and manufactured sources and by becoming a savvy label reader, individuals can take control of their diet and avoid potential adverse effects from this widespread food additive. If you suspect a sensitivity, a doctor's guidance is the best way to navigate dietary adjustments and improve your overall well-being.

A 2018 study in Toxicology Reports explores potential inflammatory reactions to manufactured citric acid.

Frequently Asked Questions

Natural citric acid is found in citrus fruits and other produce. The citric acid in most processed foods, known as manufactured citric acid (MCA), is created by fermenting a fungus (Aspergillus niger, or black mold) on sugar.

True allergic reactions to the citric acid molecule are rare. However, individuals may be sensitive or intolerant to the manufactured version (MCA), often reacting to residual mold proteins or other by-products from the fermentation process.

The high acidity of citric acid can increase stomach acid production and relax the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus and worsen reflux symptoms like heartburn.

Symptoms can include digestive issues (cramps, nausea, bloating), inflammatory responses (joint pain, fatigue), headaches, or skin reactions (hives, rashes). A process of elimination, guided by a healthcare provider, can help identify if it is a trigger.

Besides acid reflux and mold allergies, conditions like IBS, fibromyalgia, and juvenile idiopathic arthritis have been anecdotally linked to inflammatory reactions from consuming MCA.

Be cautious of naturally high sources like lemons, limes, and tomatoes, as well as processed items with added MCA, such as soft drinks, juices, energy drinks, candies, sauces, and some canned goods.

Yes. Limiting the consumption of high-acid foods and beverages that contain citric acid reduces exposure that can erode tooth enamel. This helps lower the risk of tooth sensitivity and cavities.

Certain medications, like some aluminum-based antacids, should not be taken with citric acid as it can increase aluminum absorption. Individuals on kidney-related medications, especially those managing sodium or potassium, should consult their doctor.

References

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Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice.