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Polysorbates (20 & 80): A Closer Look at Food & Medication Emulsifiers and Gut Health

Updated: Aug 28

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In our recent blog, Food Additive Emulsifiers: How They Affect Gut Health and What You Need to Know, we explored how emulsifiers in processed foods may disrupt the gut microbiome and contribute to digestive and metabolic concerns.


Building on that discussion, let’s take a closer look at polysorbates—one of the most widely used emulsifiers in both foods and medications—and examine how they may impact gut health, especially for individuals with conditions such as IBD, Autism, ADHD, PANS, and PANDAS.


What Are Polysorbates?

Polysorbates are nonionic surfactants used across pharmaceuticals, foods, and cosmetics. They are derived from polyoxyethylene sorbitan esters of fatty acids. The two most common types are:


  • Polysorbate 20 (polyoxyethylene sorbitan monolaurate)

  • Polysorbate 80 (polyoxyethylene sorbitan monooleate)


They serve multiple purposes:

  • Emulsifiers – blending oil and water into a stable mixture.

  • Stabilizers – preventing separation in food and drug formulations.

  • Solubilizers – dissolving essential oils and active ingredients.

  • Wetting agents – improving absorption and dispersion in the body.


Because of these functions, polysorbates are found in:

  • Packaged foods such as ice cream, creamy sauces, and baked goods.

  • Over-the-counter and prescription medications (e.g., liquid ibuprofen, vaccines).

  • Personal care items like creams, shampoos, and lotions.


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Polysorbates and the Gut Microbiome

While polysorbates improve product stability, research suggests they may also disrupt gut balance.


Some studies have found that polysorbates:

  • Promote gut inflammation, potentially contributing to inflammatory bowel disease (IBD) and metabolic syndrome.

  • Alter the gut microbiome, reducing beneficial bacteria and increasing harmful strains.

  • May aggravate conditions with strong gut-brain links, such as Autism, ADHD, PANS, and PANDAS, where many children already experience digestive imbalances.


A 2023 study in Allergy highlighted how polysorbate 20 and 80 impair the gut epithelial barrier, potentially triggering chronic inflammation. Another 2021 study in Microbiome found that several emulsifiers—including polysorbates—directly alter human gut microbiota.


A Clinical Perspective: Why This Matters

In my own practice, I noticed this issue when reviewing treatment plans for children with Autism, ADHD, PANS, and PANDAS.


Many parents rely on ibuprofen for pain and fever management. However, most over-the-counter formulations contain polysorbate 80, which may worsen gut inflammation. For these patients, I often recommend compounded versions of ibuprofen, free from polysorbates and other additives like carboxymethylcellulose.


This is also why I emphasize home-cooked meals and whole foods. Minimizing unnecessary chemical additives supports a healthier gut—and by extension, better neurological and immune outcomes.


Practical Takeaways for Parents & Practitioners

  1. Read Labels Closely

    Watch for ingredient names like:

    • Polysorbate 20, 60, or 80

    • PEG (polyethylene glycol derivatives)

    • Sorbitan compounds

    • Polyoxyethylene

  2. Reduce Ultra-Processed Foods

    Packaged snacks, frozen desserts, and creamy dressings are common sources of polysorbates.

  3. Support Gut Health Through Diet

    Choose fiber-rich foods, vegetables, fruits, and fermented products to encourage microbial diversity.

  4. Consider Compounded Medications

    For sensitive individuals, especially children with neurological or autoimmune conditions, ask your provider about cleaner formulations without polysorbates.


Final Thoughts

Polysorbates are everywhere—from the foods we eat to the medications we rely on. While they serve important roles in manufacturing, research suggests they may negatively affect gut health and the microbiome, especially in vulnerable individuals.


By staying informed, reading labels, and prioritizing whole foods and clean medications, families can take meaningful steps to protect both gut and brain health.


This deeper look at polysorbates continues our discussion on emulsifiers and highlights why ingredient awareness is a key part of holistic care.



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