Spices could be to blame for uncontrollable allergies

Estimates indicate that spice allergy is responsible for 2% of food allergies, but they are underdiagnosed, particularly due to the lack of reliable allergy skin tests or blood tests, according to data presented during the American College of Allergy, Asthma and Immunology Annual Scientific Meeting.

Spices are one of the most widely used products found in foods, cosmetics and dental products, and because the FDA does not regulate spices, they often are not noted on food labels. This makes them difficult to identify or avoid, according to Sami Bahna, MD, professor of pediatrics and medicine and chief of allergy and immunology section, Louisiana State University Health Sciences Center, Shreveport, La.

“While spice allergy seems to be rare, with the constantly increasing use of spices in the American diet and a variety of cosmetics, we anticipate more and more Americans will develop this allergy,” Bahna said in a press release from the ACAAI. “Patients with spice allergy often have to go through extreme measures to avoid the allergen. This can lead to strict dietary avoidance, low quality of life and, sometimes, malnutrition.”

Common spice allergy triggers include cinnamon and garlic, but can also range from things such as black pepper to vanilla. Several spice blends contain three to 18 spices, and the hotter the spice, the greater the chance for allergy.

“Boiling, roasting, frying and other forms of applying heat to spices may reduce allergy-causing agents, but can also enhance them depending on the spice,” Bahna said. “Because of this allergy’s complexity, allergists often recommend a treatment plan that includes strict avoidance, which can be a major task.”

In his presentation, Bahna said various hot spices (pepper, paprika, cayenne or chili) can affect the barrier function of the mucosa, and plants may contain detergent substances such as saponin, which also affect the epithelial barrier. In addition, piperine in black pepper inhibits paracellular transport by producing cellular swellings, and capsaicin (found in paprika, chili and cayenne pepper) can enhance the paracellular transport of these spices across the intestinal epithelia.

Bahna also said food is not the only way patients come in contact with spices. They are also used in many women’s cosmetics, along with makeup, body oils, toothpaste and fragrances. Therefore, women are more likely to develop spice allergy. In addition, patients with birch pollen or mugwort allergy are also more prone to spice allergy.

Spice allergy should be suspected in anyone who has multiple reactions to unrelated foods or those who react to foods when commercially prepared but not when cooked at home.

For more information:

Bahna S. International Food Allergy Conference: Spice allergy. Presented at: ACAAI Annual Scientific Meeting; Nov. 8-13, 2012; Anaheim, Calif.

Chen JL. Ann Allergy Asthma Immunol. 2011;107:191-199.