Do I Have a Spice Allergy?

Diagnosis remains the biggest challenge

Black pepper
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A spice, defined as any part of a plant used for the purpose of seasoning food, is an unlikely source of an allergy. With that being said, spice allergies have been known to occur and can sometimes be serious.

According to research from the Louisiana State University Health Science Center, as many as 14 of every 10,000 people may have a spice allergy, manifesting with symptoms ranging from mild to life-threatening.

Symptoms

It can sometimes be difficult to tell whether a spice is causing an allergy or if you're experiencing a physiological response to the spice itself.

For example, eating chili or wasabi may cause your eyes to water and mouth to burn because the chemicals in the spice (capsaicin and allyl isothiocyanate, respectively) irritate the mucous membranes of the nose and mouth. In this instance, the effect is physiological and the response immediate.

With a spice allergy, the symptoms may be similar but usually take longer to appear. There may also be accompanied by other symptoms such as diarrhea, nausea, stomach upset, bloating, hives, nasal congestion, or the swelling of the lips. Others still may experience a shortness of breath or develop a rash where the spice has come into contact with skin (known as contact dermatitis).

Because of the delayed response, it may hard to tell whether the spice caused the reaction or the food on which it was applied.

Symptoms of Anaphylaxis

In some cases, the allergic reaction may be immediate. Events like these are concerning in that they suggest the immune symptom is responding in an extreme way. In some cases, this can lead to a potentially deadly, all-body reaction known as anaphylaxis.

Symptoms of anaphylaxis are typically severe and may include:

  • Wheezing and respiratory distress
  • Chest tightness
  • Hives (urticaria)
  • Swelling of the face, tongue, throat, hands, or feet (angioedema)
  • Nausea and vomiting
  • Diarrhea
  • Rapid and weak heartbeat
  • Confusion
  • Dizziness or fainting
  • A feeling of impending doom

Anaphylaxis is considered a medical emergency requiring immediate 911 assistance. If left untreated, it can lead to coma, shock, cardiac or respiratory failure, and even death.

Diagnosis

If a spice allergy is suspected, an allergy test may be performed. There are limitations, however, given that most commercial kits only test a small variety of spices.

As such, a homemade extract may be created with the suspected spice and applied to the skin for patch testing. In this form of testing, the adhesive patch is left on the skin for 24 to 48 hours. A positive result is confirmed by the appearance of a tiny rash or blisters.

However, not all spices can be tested this way, particularly hot spices which can inflame and irritate the skin. There are some blood-based allergy tests available, but, again, few that can test for the broad range of potential spice allergens.

Given these challenges, personal experience is often invaluable in making a diagnosis. Repeated episodes can usually narrow the search and lead investigators to the final culprit.

Treatment

The treatment of a spice allergy is largely dependant on the type and severity of symptoms experienced. Among the options:

    Allergy Prevention

    Ultimately, the best way to deal with a spice allergy is to avoid the spice in question. Unfortunately, this is easier said than done given that many foods are pre-seasoned or employ seasoning agents comprised of multiple herbs, spices, and chemicals.

    Moreover, a person is rarely allergic to just one type of spice. This is because there is a high cross-reactivity between spices, nuts, and even tree pollens. What this means is that the chemical structure of certain foods is so similar that they both can trigger an allergic response.

    Examples of cross-reactivity include:

    • Oregano and thyme
    • Onion and garlic
    • Paprika and mace
    • Mustard and rapeseed
    • Mustard and tree nuts
    • Sesame and tree nuts
    • Cottonseed and walnut
    • Birch pollen and various spices
    • Mugwort pollen and various spices
    • Celery and various spices
    • Carrot and various spices
    • Fenugreek and peanut

    Given these complications, a person with a severe allergy may need to avoid all spices until the causal allergen (or allergens) can be found. They may also need to carry a pre-loaded epinephrine syringe (such as an EpiPen) to use in the event of a severe reaction.

    Source:

    Chen, J. and Bahna, S. "Spice Allergy." Ann Allergy Asthma Immunol. 2011; 107:191-9. DOI: 10.1016/j.anai.2011.06.020.