Crouching Tiger, Hidden Citrus

I did it again – fell for the old chestnut of “apple and mango aren’t citrus fruits, so this soft drink will be fine!” and casually forgetting the metric tonne of citric acid in there as a flavour enhancer.

I believe I mentioned during the 30 Day Chronic Illness Challenge the vindictive little person who lives behind my kidneys wielding some sort of mighty war hammer. It’s called Aegis-fang, and no I don’t have a good reason for that.

Well, except that R. A. Salvatore’s The Spine of the World annoyed me immensely and so do the person and the hammer. 

(Aegis-fang. On paper there's no reason at all I shouldn't get on very well with R. A. Salvatore's books - except the actual writing. Image from forgottenrealms.wikia.com)

This is what normal people would call Interstitial Cystitis, but that’s a mouthful in conversation.

Well, unsurprisingly after this dose of unexpected citric acid said little person (and Aegis-fang) were both wide awake and rather busy, and I spent most of today wincing and trying to find once more the mythical balance between enough water to try and cleanse the system and too much which just exacerbates the already every-fifteen-minute-trip-to-the-ladies situation.

The thing is, avoiding citric acid isn't as simple as you might think. Also, you may find you are able to tolerate some sources and not others in the absence of any rhyme or reason as to why this is so. For a personal example, on the soft drink front as long as I only have one in a given day I can get away with a J2O - even orange and passion fruit flavour, which seems illogical – however the apple and mango drink (neither of which are citrus fruits) set me off within a couple of hours.

As an aside, it is worth noting that ALL fruits naturally contain citric acid. Citrus fruits naturally contain higher levels (the clue is in the name….) and so do exotic fruits. All vegetables contain citric acid too, although usually less than fruit with the notable exceptions of tomatoes and potatoes (personally though, I’ll fight tooth and nail before I give up mashed potato.)

It’s often in things you wouldn't expect too, as citric acid and citrate are commonly used as flavour enhancers and pH balancers.  

Here’s a list of some foods you might not suspect of containing citric acid:

Milk and dairy

Milk naturally contains citric acid, but a lot of dairy products add in extra on top. Surprisingly, a lot of cheeses are manufactured using citric acid too.  Many butter and margarine products are vegetable based and may contain soy. Yep, soy beans contain citric acid too. Which means….

Dairy alternatives

... Are also something to be a little careful with. Soy is personally above my tolerance level, but it’s worth trialing rice and almond based products rather than assuming they’ll be OK if soy isn't  Many of those contain citric acid too.

Grains

In their natural form, all grains except corn are citric acid free. That doesn't mean grain products such as bread and pasta necessarily are though. A lot of bread and pastry products also contain soy traces. Rice and rice based products tend to be safest in this regard, and when looking for soy-free grains organic ranges are a good place to start. 

Soups

The best approach here is to read the list of ingredients and make a choice from there, although if it's a tomato based flavour you are probably best steering clear. Most soups however contain either vegetable derivatives or products from the groups above. 

Jams and spreads

All fruit jams contain citric acid from the fruit, however further citric acid is often added as an additional preservative. Peanut butter contains citric acid from the peanuts, and a lot of other spreads will contain soy traces. This is another area best judged on the ingredients list.

(Citric acid, *shakes fist*. Image from vinmetrica.com) 

Whilst there are plenty of things that are sensible to cut out for IC patients straight away (citrus fruits, alcohol and tannin amongst others) there are plenty of things that are worth a trial and error approach until you discover your own tolerance level and the peculiar quirks thereof, as there’ll probably be a few.

A good place to start is the IC Network’s Food list, which splits things into categories of best avoided, worth trying and usually IC tolerable.You will probably find some individual differences but the list at least saves a good deal of research for the completely unfamiliar.

Adventuring in the realms of Interstitial Cystitis can be a perilous business, but there are people who have been there, done that and reached Level 80, and plenty more who are still constantly learning through trial and error just the same way you are. The elusive final boss of a cure might remain hidden, but while that remains so it never hurts to stick your head above water and ask questions. I'm happy to answer anything I can here for example, and sites like the IC Network are full of people old and young, newly diagnosed and long standing veterans. 

Between the whole lot of us, somewhere we may just have the answer.


Wishing you all many spoons xxx