Spice allergy: Sugar and spice and everything not so nice

Spices are one of the most widely used products found in foods, cosmetics and dental products. The U.S. Food and Drug Administration does not regulate spices, meaning they often are not noted on food labels, making spices possibly the most difficult allergen to identify or avoid. According to rough estimates, spice allergy is responsible for 2 percent of food allergies. However it is underdiagnosed, particularly due to the lack of reliable allergy skin tests or blood tests.

"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," said allergist Sami Bahna, M.D., ACAAI past president. "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."

In his presentation, Dr. Bahna noted that due to the wide use of spice in cosmetics, women are more likely to develop spice allergy. Makeup, body oils, toothpaste and fragrances can all include one or more spices. Those with birch pollen or mugwort (a traditional herbal medicine used to relieve inflammatory conditions) allergy are also more prone to spice allergy.

Common spice allergy triggers include cinnamon and garlic, but can range from black pepper to vanilla. Several spice blends contain anywhere from 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," said Dr. Bahna. "Because of this allergy's complexity, allergists often recommend a treatment plan that includes strict avoidance which can be a major task."

An allergic reaction can be caused from breathing, eating or touching spices. Symptoms range from mild sneezing to a life-threating allergic reaction known as anaphylaxis. According to Dr. Bahna, spice allergy should be suspected in individuals that have multiple reactions to unrelated foods, or those that react to foods when commercially prepared but not when cooked at home.

Even someone that is allergic to only one known spice can have a reaction to several spice blends. According to Dr. Bahna's presentation, there are several unique characteristics about spice blends, including:

• A Five-Spice blend has seven spices, yet Allspice has one
• The same blend name doesn't mean same components
• There are several types of Curry, each is a different blend of many spices

Provided by American College of Allergy, Asthma, and Immunology