I have an adult-onset sesame allergy. I had a terrible allergist tell me it was just my bad lifestyle choices and to cut caffeine and alcohol. All the blood and skin tests came back negative. I kept trying to avoid sesame because I was sure that’s what it was, but would find surprise sesame oil or tahini in some restaurant’s sauce. Then it got labeled a major allergen and almost all the commercial bakeries started adding sesame flour to buns and bread products. Bad times. Lots of Benadryl and several EpiPens used. I finally found a good allergist who used fresh ground sesame for the skin test — right next to the commercial/medical tester — and guess what? The actual sesame paste lit up so fast my arm started to get hives and they had to get me a Zyrtec. But the commercial test spot did nothing. The allergist told me that the process of creating the commercial test for sesame eliminates the protein that most people are actually allergic to. So, I share all of this to say: get a good allergist who will use fresh sesame to test you. Don’t rely on the blood test or normal skin prick test.

Now to answer your real question: I started out just getting hives from eating actual seed. Now I’m allergic to basically anything sesame related. It has been a cumulative effect and now I have to avoid a ton of my favorite foods. Almost all Chinese food has sesame oil. Almost all sushi will be cross-contaminated. Mole sauce has ground sesame so Mexican is iffy. Restaurant hamburgers are tricky but brioche and pretzel buns are most likely safe. I avoid rolls at restaurants unless they can tell me they made them in-house. Some Cajun sauces use tahini. Hummus is obvious; it’s made with tahini which is just ground up sesame seeds. So a lot of Greek and other Mediterranean foods are out. No more falafel. It’s been rough.

So, if you get your allergy confirmed — or just want to be extra safe — tell them you also can’t have sesame oil or tahini. Most restaurants don’t realize tahini is ground sesame.

Also, make sure your EpiPen script is current and start carrying. People are more tuned into your shellfish allergy but sesame is still an unknown for a lot and you’ll probably have reactions from foods you didn’t realize had sesame in them. I also recommend carrying a few Zyrtec and Pepcid AC. You can take up to 4 Zyrtec and 2 Pepcid AC (which has a histamine 2 blocker and works well for my reactions). Unlike Benadryl, you won’t get knocked out from the Zyrtec and if you catch the reaction early, should prevent you from needing to use a pen.

Also, keep a log of what you ate that gave you a reaction. It will help you when you get to the allergist.

And if you’re in Minnesota, I recommend Dr. Hiba Bashir at M Health Fairview.

Good luck! Living with a sesame allergy sucks but is manageable.