Please help solve my hummus mystery!
August 3, 2011 7:54 PM   Subscribe

The mystery sesame allergy: WTH is going on here?

In the fall of 2009, I had a minor allergic reaction to hummus at a restaurant. I began avoiding hummus casually (which is so sad because it's delicious and I have had frequent opportunities to travel to the Middle East). On one trip to the region, I was able to eat one hummus-like dip without reacting, but another one caused a break out. I have since reacted to black sesame seeds, and this weekend the reaction progressed to anaphylaxis, pretty scary. I've been to the allergist and both skin and blood tests came back negatively for sesame, pine nuts, chickpeas and garlic. The planned next step was for me to sit in the allergist's office, eat some hummus and watch me react, but I don't want to do that since my allergy has progressed way beyond hives.

My questions: is there ANY possible way that I would react differently to sesame seeds and tahina? I had no reaction to eating a sesame seeded-bun a day before the anaphylaxis. On the other hand, I was in the Middle East earlier this year, and ate a bunch of plain tahina because it was yummy, and I did not react. I reacted to hummus when I ate it on this trip.

Am I confusing tahina with some other ingredient in Middle Eastern cuisine? If I'm actually confusing two foods, that would help me wrap my mind around the mystery.

Is there a difference between sesame species used culinarily? I've read some stuff about Mexican vs. East Asian sesame, but I can't tell if it's merely geographical difference or genetic variation. Would it even make sense to be allergic to one and not the other if there are two species?

How should I follow up with my allergist? Is there a point to sitting in the doctor's office, eating hummus and waiting for them to stab me with epinephrine? Is it worth it to ask for another round of blood tests?
If you have a sesame allergy, are there any non-obvious foods I should be looking out for? I realize I must tread very carefully within Middle Eastern and Asian cuisines from now on.

Thank you!
posted by emkelley to Health & Fitness (11 answers total)
I don't know about the allergy itself, but totally understand the trepidation about the plan with the allergist. I've been through that, and it's not a Pulp Fiction-like stab in the heart with an epi-pen. It's not pleasant, but it could definitely help narrow down what's going on, and it's totally controlled.
posted by xingcat at 8:01 PM on August 3, 2011 [1 favorite]

I used to make hummus at home and used a ton of fresh squeezed lemon juice. Could you be allergic to some component of the lemon?
posted by treehorn+bunny at 8:35 PM on August 3, 2011

What about cumin? That's in a fair amount of Middle Eastern recipes. How are you with Mexican food?
posted by sugarfish at 8:39 PM on August 3, 2011

A food challenge is really the only way to know, so you'll have to at least try a little under a dr's guidence. It's probably the chickpeas and not the sesame causing it. You can make hummus with other beans, but most recipes call for tahini regardless of the beans used.
posted by fiercekitten at 8:57 PM on August 3, 2011

treehorn+bunny: I think I asked to be tested for lemon, but I can't remember if that actually happened or not. But I put lemon in my water all the time, and I don't react.

Sugarfish, we have cumin in Indian and Mexican food at our house on a pretty regular basis, and I'm cool. Plus, after the black sesame seed incident, I asked the restaurant about the ingredients, and they did not list cumin.

So weird...
posted by emkelley at 9:05 PM on August 3, 2011

I wonder if it might be a cross-contamination issue, and you are maybe allergic to something else as yet unidentified. Can you ask for broader food/allergy testing?
posted by janepanic at 9:32 PM on August 3, 2011

I noticed a couple of items on the page for sesame:
This study reports on 9 cases of IgE-dependent allergy to sesame seed and/or sesame seed oil. Skin test results draw attention to the poor quality of a commercial sesame seed extract and the good sensitivity of skin prick tests made with a freshly prepared sesame seed flour extract.
~ and ~
Systemic urticaria, facial erythema, dizziness and loss of consciousness in a 36 year old baker. Commercial skin prick tests and CAP RAST tests were negative but a skin prick test done with crushed sesame seeds in sodium chloride solution was positive. (Woltsche-Kahr 2001 ref.4020 4)
These were for skin prick tests, and you say you've had both blood tests and skin prick test, but these notes would seem to suggest (and I'm soooo not a doctor! this is totally conjecture!) that the quality, purity, and/or freshness of the sesame may be a factor in some tests, and I'd have to guess, certainly, actual reactions "in the wild."

Plus, there are different types of tahini -- dark, light, hulled, unhulled, roasted, unroasted, sprouted -- and age, refrigeration, and processing may all make a difference. So, possibly, when you ate the one hummus and did not get a reaction, the type, processing, and/or content of the particular tahini used rendered it safer for you, while the black sesame seeds you ate were more pure/concentrated/fresher etc.
posted by taz at 10:13 PM on August 3, 2011

I said that both of the cited notes from the page were about skin prick tests, but actually, in the case of the baker, both skin prick and blood tests were negative
posted by taz at 10:15 PM on August 3, 2011

Could there have been eggplant in the dip that caused you to react, or could the restaurant have used the same utensils when serving something containing eggplant, like babaganoush?
posted by bcwinters at 4:47 AM on August 4, 2011

Taz's information seems really good. I just thought I would offer -is it possible that a different nut or seed was used in the hummus that caused a reaction? For example, I've made hummus with peanut butter in the past...
posted by kitcat at 7:43 AM on August 4, 2011

I wonder whether you have Oral Allergy Syndrome and are therefore reacting to a pollen contaminant specific to the region where the sesame was grown.

The linked Wikipedia article claims that:

In recent years, it has also become apparent that when tropical foods initiate OAS, allergy to latex may be the underlying cause.[10]

so I think you might want to consider getting tested for a latex allergy.
posted by jamjam at 12:30 PM on August 4, 2011

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