Sesame allergy
Sesame allergy, now a major labelled allergen.
About sesame allergy
Sesame is a seed used widely in bread, hummus, tahini, halva and many Middle Eastern and Asian dishes, and it is now recognised as a major allergen with mandatory labelling in the UK. Allergy to it can begin in childhood and is often persistent. The reaction is IgE-mediated, with the immune system producing antibodies to sesame proteins that trigger a rapid release of histamine and other chemicals when the seed is eaten.
Symptoms usually appear within minutes and range from an itchy mouth and hives to swelling, vomiting, wheeze and full anaphylaxis with breathing difficulty or collapse. Sesame can be hidden in unexpected foods such as dips, dressings, bakery items and spice blends, and tahini in particular is a concentrated source. Some people with sesame allergy are also sensitised to tree nuts or other seeds, though this varies and should be assessed individually rather than assumed.
Diagnosis uses skin-prick or specific-IgE blood tests, sometimes supported by component testing or a supervised food challenge. Management depends on strict avoidance and careful label-reading, made easier by rules requiring sesame to be declared on pre-packed foods. People at risk of severe reactions carry an adrenaline auto-injector and a written action plan. A severe reaction is a medical emergency: give adrenaline without delay and call 999.
Common triggers
- Sesame seeds and tahini\nHummus and halva\nBreads, burger buns and snacks
Symptoms
- Itching or tingling in the mouth
- Hives, itching or eczema
- Swelling of the lips, face, tongue or throat
- Stomach cramps, nausea, vomiting or diarrhoea
- Wheezing or trouble breathing
- In severe cases, anaphylaxis
Avoidance & management
- Read ingredient labels every time
- Ask about ingredients and cross-contamination when eating out
- Keep the food out of shared cooking areas
- Carry prescribed antihistamines or an adrenaline auto-injector
- Seek emergency help for any severe reaction
Sources & references
Allergy safety: what everyone should know
Mild-to-moderate reaction signs
- Itching, hives or a raised rash
- Swelling of lips, face or eyes
- Tingling mouth, sneezing, runny nose
- Stomach pain, nausea or vomiting
Anaphylaxis — call 999 (UK) or 112 (EU) immediately
- Difficult or noisy breathing, wheeze, persistent cough
- Swelling of the tongue or tightness in the throat
- Dizziness, collapse, pale and floppy (young children)
- Use an adrenaline auto-injector (e.g. EpiPen) at once if prescribed, then call an ambulance even if symptoms improve
Allergy or intolerance? A true allergy involves the immune system and can escalate quickly; an intolerance (e.g. lactose intolerance) is unpleasant but not life-threatening. The symptoms overlap, so self-diagnosis is unreliable.
Getting tested: home-testing kits based on IgG are not diagnostically valid. If you suspect an allergy, ask a GP for referral to an allergy clinic for skin-prick or specific-IgE testing and a supervised food challenge where appropriate.