I've been trying to make sense of all the new information that has emerged from the discovery of Samter's Triad. If Wikipedia and one or two other articles are to be believed, this is quite a well researched condition.
The following is an entirely unscientific account of the situation pieced together in my head over the last 24 hours:
The salicylate hypersensitivity seems to be caused by an interaction of salicylate and omega-6 fats, perhaps only some omega-6 fats as it's a substance called arichadonic acid. This interaction leads to excessive production of inflammatory substances called leukotrienes. So it seems the problem we have is not with the body's handling of salicylate but with its handling of omega 6.
Omega 6 and omega 3 are essential fatty acids, found in various mixtures in most oils and fats. Sunflower oil is rich in omega 6 and rapeseed oil in omega 3.
It's the leukotrienes that cause a range of allergy-like symptoms. Unlike pure allergy, however, they may not represent an immune reaction. Singulair works by blocking them - so must be pretty good.
So the worst thing possible would be a diet rich in omega 6 and salicylate. The ideal diet would be low in omega 6 and zero salicylate. And a low salicylate, rich omega 6 diet might also prove not very effective - and that may explain why attempts to reintroduce are not very successful.
Now I've been avoiding sunflower oil and all unspecificied vegetable oils, especially margarine, because I thought they might contain salicylate. And I've been using rapeseed oil because I thought it was zero salicylate. So that's just a lucky coincidence.
Interestingly a couple of weeks ago a bottle of sunflower oil popped up in our shopping and that was about the time I got terrible rheumatism of the neck and shoulders. Last night I went to a function and had lots of cheese, ham and egg sandwich. This morning I've woken up with a sore eye and other minor symptoms. Good chance they were spread with margarine.
Of course omega 6 is found all over the place. The really bad news is that it's rich in cashew nuts, which are the only salicylate free nuts. I've been relying on them for snacking and quick lunches, although I must admit I've had my doubts about whether they are okay.
So what would be the impact of trying to eliminate omega 6 from the diet? Apparently it's an essential fatty acid - that means you have to have it in the diet. If you follow the links through Wikipedia you come to prostaglandins and it becomes very unclear how important they are. I think I read that omega 6 deficiency leads to hair loss, dry skin and possibly increased prostate cancer risk. Dry skin sounds familiar.
But if the body isn't handling omega 6 well in any case and is wrongly converting it to leukotrienes rather than other substances, are we already sufferring from the effects of omega 6 deficiency?
Wiki-browsing leads me to a biologist called Ray Peat who suggests there may be other ways of compensating for essential fatty acid deficiencies. I'm posting the link without even having read his work yet - but will be browsing it.
I promised an unscientific run-around. If you're an expert, I'd welcome your comments but do try not to make them too technical.