Sesame seed allergy: Why do some people get it?

A key ingredient used for seasoning in Asian cuisines, tiny black or white sesame seeds could give you a hard time if you are allergic to it. These seeds could be the cause behind itchy throat, swelling and rashes for some.

Widely used as flavouring agents and toppings on breads, crackers and burger buns, recently sesame was identified as the ninth most common allergen in the United States. Due to its high antioxidant and anti-inflammatory properties, the oil extracted from sesame seeds is also used as a popular cooking agent, says Dr Jasreen Kaur Jaura, Consultant Physician, Apollo Clinic, Wanowrie, Pune.

Dr Jaura says that although sesame allergy has not gained as much publicity as peanut and other allergies, efforts are on to spread awareness on it. “The reactions of sesame allergy could be very severe and result in the form of anaphylactic shock, a serious life-threatening allergic reaction. It is an important global allergen affecting nearly 0.1 per cent of the American and the Middle East population,” reveals Jaura.

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The study ‘Sesame allergy: a growing food allergy of global proportions?’ found evidence for increased reporting of sesame allergy in the past 5 decades, with reports mostly from developed countries.

The American Food Allergy Safety, Treatment, Education, and Research (or FASTER) Act of 2021 has added sesame seed allergy as the ninth most common allergy in the US, making it mandatory for food containing sesame to carry the caution label on the container, starting from January 2023.

“The reported cases of sesame allergy are not in big numbers in India, but the allergy is common,” says Ms Minal Shah, Senior Nutrition Therapist, Fortis Hospital, Mumbai. She said that in most cases, the allergy symptoms are mild in category due to which people with the condition don’t usually visit doctors. As a result, many cases go unreported.

“Sesame allergy also requires more awareness among people as it could be very serious for some. Most common food allergy that we see in India are related to peanuts, fish and prawns,” says Shah.

It’s the proteins in the sesame that triggers hypersensitive allergic reaction in some, said experts, adding that its prevalence is seen in Middle Eastern countries and the US, but India too has its share of sesame seed allergy cases.

Sesame allergy symptoms

 Dr Jaura and Shah listed out a few common symptoms for sesame allergy:

• Flushing of face
• Rashes on the skin or red hives
• Swelling of the face
• Swelling of lips and tongue
• Itchiness inside of the mouth
• Trouble in breathing, speaking or swallowing
• Anxiety, distress and fainting symptoms
• Abdominal cramps, diarrhoea, vomiting
• Drop in blood pressure, rapid heartbeat
• Loss of consciousness in extreme cases
• Diarrhoea
• Vomiting

Shah said that most of the symptoms of food allergies remain same and could be easily identified. She said that the reaction or the trigger could take from minutes to hours after consuming the allergic substance for one to respond and it differs from person to person. “For some people, the allergic reaction can be very severe and can have anaphylactic reaction. It is very important for people to look out for signs and symptoms and immediately rush to the nearest hospital for treatment. In severe cases there could be a shock, which might result in fatality if not attended or given immediate treatment,” she elaborates.

A study on sesame food allergy and sensitization in children found that sesame seed allergy symptoms tends to appear early in life, and skin was the most common site of involvement, followed by respiratory and gastrointestinal systems.

Test and treatment

Speaking about the tests and identification, Shah said that people can take up a skin prick test to identify the allergy as well.

Dr Jaura said that sesame seed allergy treatment is usually done in emergency as per the symptoms. She said that auto-epinephrine injections are available and anti-allergy medications along with steroids are usually prescribed in mild cases.

She adds that sesame allergy in children may be more severe than in adults and if found to be affected, kids would need immediate medical attention.

Cautions

Shah said that for those who have already been diagnosed with the allergy, it is important to carry the required medication/drugs to use when needed. “People with the allergy need to be careful with the food they consume especially bread and bakery items where sesame seeds are mostly used,” she said.

Shah added that both sesame seeds and oil extracted from the seed are commonly used in many South Asian dishes; therefore, people with allergies need to cross-check with the restaurants or the food manufacturers before consuming a particular food. “Ensure that you know the foods that contain sesame and avoid them – such as dressings of salad, seasoning, soups and dips like humus. Most packed foods list out ingredients used, which should be checked,” she said.

Talking about ways to stay away from sesame allergy, Dr Jaura suggested that food packages without the mention of the ingredients should be avoided, including junk food.