Garlic Allergy More Common and Dangerous Than Suspected


According to data presented at this year’s AAAAI annual meeting in San Antonio, allergy to garlic (Allium sativum) may be more common and dangerous than medical providers realize.

Even though it is a commonly used ingredient, allergic reactions to garlic are rarely reported according to the research.

Dr Thomas B Casale, professor of internal medicine and pediatrics and chief of clinical and translational research in the division of allergy, asthma and immunology, University of South Florida Morsani College of Medicine, told Healio: “People need to be aware that it does occur, and it can be an issue.”

Analyzing data collected between May 2017 and October 2021, the researchers found 132 patients (58% female; 80% white) with garlic allergy among the approximately 13,000 entries in the Food Allergy Research & Education (FARE) Patient Registry.

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According to Casale, those patients reported allergies to over 200 different foods. Garlic was the leading allergen reported in the “other” category after the FDA Top 9 allergens: peanuts, tree nuts, milk, eggs, soy, wheat, fish, crustacean shellfish and sesame.

“This was very surprising to me,” Casale said.

There was a wide range of ages at diagnosis, with 36% diagnosed at age 10 years or younger, 23% diagnosed between ages 11 and 25 years, 37% diagnosed between ages 26 and 64 years, and 4% diagnosed at age 65 years and older.

Patients were likely to have comorbid allergic rhinitis, asthma, or atopic dermatitis, tended to have been diagnosed at a later age, and had a higher rate of family history of food allergies.

34 of the patients also reported an allergy to at least one other Allium species such as onion, shallot, leek, scallion, or chives. 

Dr Walaa Hamadi, MD, a second-year fellow in allergy and immunology at the Morsani College of Medicine, noted a number of patients were rushed to the hospital because their reactions were significant.

She said: “It wasn’t like, ‘I went to my allergist and got evaluated.’ It was, ‘No, I ended up in the hospital because of this reaction. I think that was what stood out to me the most.”

56% of the patients with a reaction to garlic allergy presented to the emergency department, 19% were hospitalized and 6% were admitted to the intensive care unit. Combined with the lack of awareness, these reactions present real dangers, the researchers said.

“A lot of times, we see patients that have an acute allergic reaction after they’re eating, and they have no idea where it came from,” said Casale.

Said Hamadi:

I feel it’s even more prevalent than peanut, because you can’t get away from it. Everything seems to have garlic extract, so it can be scary.

Keep in mind that garlic [allergy] might be more common than thought and to think about it when you find somebody and you’re not sure what they’re allergic to, but you’re convinced they have an IgE-mediated reaction to food.

Said Casale:

If patients do have garlic allergy, we would tell them to avoid it and to probably carry an EpiPen because garlic is in so many different things.

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Dave Bloom
Dave Bloom
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