The sesame plant’s edible seeds are a prevalent component in global cuisines, appearing in dishes ranging from pastries to sushi. Numerous reports indicate a substantial rise in sesame allergies worldwide over the last twenty years.
Sesame seeds can cause allergic reactions. Sesame seed allergy is a type of food allergy that occurs when the body’s immune system wrongly identifies a food as a threat. When this happens, the body releases chemicals, such as histamine, in response.
It is the release of these chemicals that causes the allergic symptoms. Severe food related allergic reactions can include life-threatening (anaphylactic) or even fatal reactions. Sesame seed allergy can start in childhood and usually carries on into adulthood.
Cross-reactivity versus Co-reactivity
Cross-reactivity and co-reactivity is an essential concept to understand when dealing with many food allergies. In terms of seeds, sesame has been shown to cross-react with poppy seed. There is very little information on cross-reactivity between other seeds, but there may be cross-reactivity between sunflower seed and mustard seed.
Sesame seed has been shown to cross-react with other foods including rye, kiwi, black walnut, hazelnut, macadamia, cashew, pistachio, and peanuts. It should be noted that just because people tolerate sesame seed oil does not mean that they will tolerate sesame seed paste, also known as tahini as sesame seed oil contains very little sesame seed protein whereas tahini contains a lot.
Additionally, there are people who can tolerate sesame seeds whole as they are often passed through the intestine without being broken down, but react to sesame seed paste (tahini), potentially triggering allergic responses leading to a range of symptoms and discomfort.
Sesame seeds share a similar biochemical structure with nuts, which can potentially trigger an allergic reaction, a co-reactivity. Therefore, individuals with sesame allergies may be at risk of experiencing an allergic reaction if they ingest peanuts and tree nuts.
It is crucial for individuals with sesame allergies to be vigilant and avoid sesame seed in foods, or any of its various derivatives, when eating and during food preparation. These include ingredients such as sesame flour, sesame protein, sesame oil, sesame salt, sesamol, and the aforementioned tahini, to list a few.
It is not just food containing sesame that can trigger an allergic reaction, because sesame seed is found in non-food items too. In non-food items, the scientific name for sesame, Sesamum indicum, may be on the label including:
- Cosmetics (including hair care products, soaps, body oils, and creams)
- Medications
- Nutritional supplements
- Perfumes
- Pet foods
Symptoms of a Sesame Seed Allergy
Sesame seed allergy symptoms usually come on quickly, within minutes of eating the food. Symptoms stemming from a sesame allergy response may span a spectrum from mild to the potential of anaphylactic shock. Mild to moderate symptoms may include:
- A red raised rash (referred to as hives or urticaria) appearing anywhere on the body
- A tingling or itchy sensation in the mouth
- Swelling of the lips, face, or eyes
- Stomach pain or vomiting
More serious sesame seed allergy symptoms are often referred to as the ABC symptoms and can include:
- AIRWAY – swelling in the throat, tongue or upper airways (tightening of the throat, hoarse voice, difficulty swallowing).
- BREATHING – breathing difficulty, sudden onset wheezing, noisy breathing.
- CIRCULATION – feeling faint, dizziness, tiredness, sudden sleepiness, confusion, pale clammy skin, loss of consciousness.
For those who have a severe sesame allergy, it is crucial to carry an epinephrine injection device with them at all times, as epinephrine serves as the primary treatment in cases of anaphylaxis.
Diagnosis and Testing
If you suspect your child might have a sesame seed allergy, it is important to consult a doctor for proper allergy tests leading to an allergy diagnosis. Even if your child’s symptoms were mild, it is essential to have food allergy management in place because future allergic reactions could be more serious.
Skin prick tests are a common method used to determine whether a child is allergic to sesame seeds. During this test, small amounts of tahini are placed on the skin and any local wheal (bump) is measured. Sesame seed extract has been shown to be less reliable than sesame seed paste (tahini) for testing. Blood tests to sesame seed and the main allergenic protein Ses e 1 also help diagnose the allergy, but none of these indicate the severity of a future reaction, only the likelihood.
The gold standard of testing for food allergy is the oral food challenge, which can be performed if there is uncertainty with the diagnosis or if the skin or blood tests indicate that your child has grown out of their sesame seed allergy. At Children’s Allergy Doctors, we can arrange an oral food challenge or supervised feed (in clinic) to confirm whether your child is allergic or tolerant to sesame seed.
Managing Sesame Seed Allergy
Once your child is diagnosed with a sesame seed allergy, there are several measures you can take to ensure their safety. Avoiding eating sesame seeds and products containing forms of sesame is the primary step.
Always read food labels carefully, as sesame might be present in unexpected places. Following the introduction of Natasha’s Law, food businesses are now required to include full ingredients on pre-packed for direct sake foods.
Note that in packaged foods manufactured prior to January 1 2023, sesame may appear undeclared in ingredients such as flavours or spice blends on food labels. From this date forward, labels must list sesame seed in plain language. If you are unsure whether a product could contain sesame seed, call the manufacturer to ask about their ingredients and manufacturing practices.
Always be cautious when dining out and inform restaurant staff about your child’s allergy to prevent cross-contact (previously known as cross-contamination) where traces of the allergen are present in the food due to the use of similar utensils or food preparation sites.
Oral Immunotherapy for Sesame seed
At Children’s Allergy Doctors, we are proud to offer Food Oral Immunotherapy (OIT) also known as Food Allergy Desensitisation, Oral Desensitisation (OD) or Food Desensitisation to sesame.
This is a process where you gradually introduce increasing amounts of the sesame seed paste into the child’s diet under supervision, to reduce the risk of allergic symptoms to accidental exposure to sesame and reduce severity of reactions, thereby reducing social restrictions and improving quality of life.
At Children’s Allergy Doctors, we offer this treatment for preschool children. The process takes 4-14 months depending on the sesame protocol your child is allocated to (which is personalised to their risk of reaction).
How can Children’s Allergy Doctors help?
Here at Children’s Allergy Doctors we provide a full range services for all allergy conditions. We aim to be with you every step of the way, from allergy diagnosis through to helping you with food allergy management and treatment.
Sesame seed allergy, like other food allergies, can be concerning for parents. Understanding the potential allergic reactions, cross-reactivity, and testing methods is essential for managing your child’s health effectively. With proper precautions and awareness, your child can lead a healthy and happy life, even with allergies.
If you would like to find out more about sesame seed allergy or any other aspect of children’s allergies, please contact our practice team on 0203 146 7721 or email admin@childrensallergydoctors.com.