Also indexed as: Chinese Restaurant Syndrome
MSG sensitivity, also known as Chinese Restaurant Syndrome, is a set of symptoms that may
occur in some people after they consume monosodium glutamate (MSG). The syndrome was first
described in 1968 as a triad of symptoms: “numbness at the back of the neck radiating to
both arms and the back, general weakness and palpitations.”1 Although some
Chinese (and other) restaurants now avoid the use of MSG, many still use significant
amounts.
MSG is used worldwide as a flavor enhancer. The average person living in an industrialized
country consumes about 0.3 to 1.0 gram of MSG per day. MSG is classified by the Food and Drug
Administration as “generally recognized as safe.” Indeed, many researchers have
questioned the very existence of a true MSG-sensitivity reaction. Most clinical trials,
including some double-blind trials, have failed to find any symptoms arising from consumption
of MSG, even large amounts, when taken with food.2 3 4
5 6 7 However, clinical trials have found that MSG taken
without food may cause symptoms, though rarely the classic “triad” described
above.8 9 10 A large trial and a review of studies on MSG
both suggested that large amounts of MSG given without food may elicit more symptoms than a
placebo in people who believe they react adversely to MSG. However, persistent and serious
effects from MSG consumption have not been consistently demonstrated.11
12 13
People sensitive to MSG may also react to aspartame
(NutraSweet®).14
Checklist for MSG
Sensitivity
What are the symptoms of MSG sensitivity? The symptoms of MSG
sensitivity have commonly been described as headache, flushing, tingling, weakness, and
stomachache. After eating meals prepared with MSG, people with MSG sensitivity may have migraine headache, visual disturbance, nausea, vomiting, diarrhea, weakness, tightness of the chest, skin rash, or
sensitivity to light, noise, or smells.
How is it treated? Doctors typically recommend that people
with MSG sensitivity avoid eating foods containing MSG. Severe reactions may be treated with
antihistamines. MSG sensitivity is not a universally accepted medical condition. Other than
avoidance of foods containing MSG, there is no conventional treatment for this condition.
Dietary changes that may be helpful: Simply avoiding MSG will
prevent MSG-sensitive reactions. MSG is found in some Chinese and Japanese food and is also
contained in some flavor enhancers, such as Accent® and the Japanese seasoning
AJI-NO-MOTO™. MSG may be difficult to avoid completely, as it also occurs in hydrolyzed
vegetable protein, textured vegetable
protein, gelatin, yeast extracts, calcium and sodium caseinate, vegetable broth, whey, smoke flavoring, malt extracts, and several other food
ingredients—including “flavoring” and “natural
flavoring”—without otherwise appearing on the label.
Nutritional supplements that may be helpful: Years ago,
researchers discovered that animals who were deficient in
vitamin B6 could not properly process MSG.15 Typical reactions to MSG have also
been linked to vitamin B6 deficiency in people.16 In one study, eight out of nine
such people stopped reacting to MSG when given 50 mg of vitamin B6 per day for at least 12
weeks.
The actual percentage of people with MSG sensitivity who are deficient in vitamin B6 and
who respond to B6 supplementation is unknown. Nonetheless, many doctors suggest that people
having MSG-sensitivity symptoms try supplementing with vitamin B6 for three months as a
trial.
Are there any side effects or interactions? Refer to the individual supplement for
information about any side effects or interactions.
References:
1. Kwok RHM. Chinese-restaurant syndrome. N Engl J Med
1968;278:796 [letter].
2. Prawirohardjono W, Dwiprahasto I, Astuti I, et al. The administration
to Indonesians of monosodium L-glutamate in Indonesian foods: an assessment of adverse
reactions in a randomized double-blind, crossover, placebo-controlled study. J Nutr
2000;130(4S Suppl):1074–6S.
3. Bazzano G, D’Elia JA, Olson RE. Monosodium glutamate: feeding of
large amounts in man and gerbils. Science 1970;169:1208–9.
4. Morselli PL, Garattini S. Monosodium glutamate and the Chinese
restaurant syndrome. Nature 1970;227:611–2.
5. Zanda G, Franciosi P, Tognoni G, et al. A double blind study on the
effects of monosodium glutamate in man. Biomedicine 1973;19:202–4.
6. Marrs TC, Salmona M, Garattini S, et al. The absorption by human
volunteers of glutamic acid from monosodium glutamate and from a partial enzymic hydrolysate
of casein. Toxicology 1978;11:101–7.
7. Tung TC, Tung KS. Serum free amino acid levels after oral glutamate
intake in infants and human adults. Nutr Rep Int 1980;22:431–43.
8. Schaumburg HH, Byck R, Gerstl R, Mashman JH. Monosodium L-glutamate:
its pharmacology and role in the Chinese restaurant syndrome. Science
1969;163:826–8.
9. Rosenblum I, Bradley JD, Coulston F. Single and double blind studies
with oral monosodium glutamate in man. Toxicol Appl Pharmacol
1971;18:367–73.
10. Kenney RA, Tidball CS. Human susceptibility to oral monosodium
L-glutamate. Am J Clin Nutr 1972;25:140–6.
11. Walker R, Lupien JR. The safety evaluation of monosodium glutamate.
J Nutr 2000;130(4S Suppl):1049–52S [review].
12. Geha R, Beiser A, Ren C, et al. Multicenter multiphase double-blind
placebo controlled study to evaluate alleged reactions to monosodium glutamate (MSG). J
Allergy Clin Immunol 1998;101:S243 [abstract].
13. Geha RS, Beiser A, Ren C, et al. Review of alleged reaction to
monosodium glutamate and outcome of a multicenter double-blind placebo-controlled study. J
Nutr 2000;130(4S Suppl):1058–62S [review].
14. Stegink LD, Filer LJ Jr, Baker GL. Effect of aspartame and sucrose
loading in glutamate-susceptible subjects. Am J Clin Nutr 1981;34:1899–905.
15. Wen CP, Gershoff SN. Effects of dietary vitamin B6 on the utilization
of monosodium glutamate by rats. J Nutr 1972;102:835–40.
16. Folkers K, Shizukuishi S, Scudder SL, et al. Biochemical evidence for
a deficiency of vitamin B6 in subjects reacting to monosodium-L-glutamate by the Chinese
restaurant syndrome. Biochem Biophys Res Commun 1981;100:972–7.
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The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in vitro),
clinical experience, or traditional usage as cited in each article. The results reported may
not necessarily occur in all individuals. For many of the conditions discussed, treatment with
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before making any changes in prescribed medications. Information expires December 2003.
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