Spices, herbs and allergic reactions in children: myth or reality?

Abstract

Spices and herbs are widely used for their flavor and therapeutic properties. This narrative review explores current evidence on spice and herb allergies in children, using a scoping approach to synthesize data from case reports, clinical, immunologic, molecular studies, regulatory sources, and previous reviews. Selected adult cases were included for context. Spice and herb allergies are increasingly recognized in children, with symptoms ranging from mild oral reactions to anaphylaxis. The most frequently implicated spices include mustard, celery, coriander, fennel, cumin, anise, pepper, and herbs from the Lamiaceae-family such as mint, oregano, and sage. Both IgE- and non-IgE-mediated mechanisms are involved, with cross-reactivity to pollens (birch and mugwort) being common. Diagnosis remains challenging due to limited standardized tests; oral food challenge is the gold standard. Management relies on strict allergen avoidance and emergency preparedness. Improved clinical awareness, diagnostic tools, and clearer labeling-especially regarding hidden allergens-are crucial for effective care.