What You Need to Know About a Spinach Allergy

Spinach is not a top food allergen, but some people are allergic to it. You may notice specific symptoms after you eat spinach if you are allergic, like gastrointestinal, nasal, respiratory, or skin problems.

This article explains spinach allergy symptoms, diagnosis, and treatment. 

Spinach Allergy and Histamine Intolerance Link

While histamine intolerance and food allergies share some symptoms, they are not the same thing. Histamine intolerance is when the body cannot process high histamine levels naturally present in some foods. The inability to process histamine occurs when the enzymes your body requires to break down histamines are inhibited. As a result, histamine enters the bloodstream and causes symptoms.

On the other hand, food allergies are an abnormal immune system reaction to food. Symptoms occur when the body misidentifies food as a harmful substance and overproduces histamine.

Spinach is a high-histamine food, which means it naturally has high levels of histamines. Histamine intolerance is difficult to diagnose. Often it requires ruling out food allergies first. If your healthcare provider suspects histamine intolerance, they may recommend a low-histamine diet to see if it helps.

Symptoms

Like other food allergies, a spinach allergy can produce a wide range of symptoms. These include:

• Itching
• Hives
• Congestion
• Sneezing
• Itchy nose and eyes
• Vomiting
• Stomach pain
• Diarrhea
• Swelling

In addition to the typical symptoms above, food allergies can cause a more severe reaction called anaphylaxis. Symptoms include:

• Hoarseness
• Tightness in the throat
• Wheezing
• Trouble breathing
• A tingling sensation
• A feeling of doom

Diagnosis

Diagnosing food allergies may require a skin test, blood test, oral challenge, and a food elimination test. Allergists and immunologists are doctors with specialized training in diagnosing and treating allergies. They may be best equipped to help you with a food allergy diagnosis.

Skin Test

Skin tests are considered the standard for diagnosing allergies. These tests introduce a potential allergen to your skin by scraping or injecting a small amount. A healthcare provider then watches your skin for a reaction. Developing a rash, bump, or hives indicates an allergy to that substance.

Blood Test

Blood tests are accurate and help when someone can’t tolerate a skin test. For example, small children might have difficulty sitting still and not scratching for a skin test. Blood tests look for immunoglobulin E (IgE) antibodies to different substances to confirm an allergy.

Oral Challenge

An oral challenge involves ingesting suspect foods under medical supervision. Then, after eating or swallowing a small amount of the potential allergen, a healthcare provider watches for a reaction, which would indicate an allergy to that substance. 

Elimination Diet

An elimination diet may be part of establishing whether you have a food allergy or sensitivity. Usually, before eliminating particular food(s), a healthcare provider will ask you to keep a food diary. In the diary, you’ll log everything you eat and any symptoms you notice. Then, after some time (maybe a few weeks), you’ll reintroduce foods, noting any symptoms that recur. 

Treatment

Treating a spinach allergy first and foremost involves avoiding spinach and foods that contain spinach as an ingredient. In addition, medications can help in the event of accidental exposure.

Antihistamines

As the name suggests, antihistamines block the chemical histamine. Therefore, they are the first-line treatment for allergy symptoms. Antihistamines are available over the counter (OTC) and by prescription. 

Antihistamines come in first-generation or second-generation forms. First-generation medications are the older types of medications. They tend to produce more side effects, like sedation. First-generation antihistamines include:

• Benadryl (diphenhydramine)
• Chlor-Trimeton (chlorpheniramine)
• Atarax/Vistaril (hydroxyzine)

Second-generation antihistamines produce fewer side effects. They include:

• Zyrtec (cetirizine)
• Allegra (fexofenadine)
• Clarinex (desloratadine) 
• Claritin, Alavert (loratadine)
• Xyzal (levocetirizine) 
• Astelin, Astepro (azelastine)

Epinephrine

Epinephrine (EpiPen) is a hormone that you use to treat anaphylaxis. The medication is usually offered to people who have a history of severe allergic reactions or an allergy to a substance known to be more likely to produce a severe reaction. 

Spinach is not typically a life-threatening allergy; however, if you have a history of severe allergic reactions, your healthcare provider may advise you to keep an EpiPen on hand just in case.

What to Avoid and Food Alternatives

Restricting your diet to avoid spinach is essential when you have an allergy to the food. So, in addition to avoiding spinach in its natural form, you will also need to be a detective when it comes to reading food labels and watching out for it as an ingredient. 

Fortunately, spinach isn’t a common additive to foods. But, you might find it in things like dips, pasta and egg dishes, salads, and soups. When eating out, inform your server about your allergy to avoid the likelihood of cross-contamination.

Alternatives to spinach include vegetables like kale, Swiss chard, and baby salad greens.

When to See a Healthcare Provider

If you suspect you may have a spinach allergy, you should be evaluated by a healthcare provider. Your primary care provider is an excellent place to start. They may be able to coordinate allergy tests, or they might refer you to a specialist. In addition, if you experience any severe anaphylactic reactions, seek medical attention immediately.

Summary

Spinach allergy is not a top food allergy, but an allergy to it can still occur. In addition, some people with histamine intolerance may react to eating spinach because it is a high-histamine food. Allergy symptoms can include skin, gastrointestinal, nasal, and respiratory problems. A severe anaphylactic reaction is less common with spinach but can occur with any allergy.

Diagnosis may involve tracking your food and eliminating spinach, reintroducing it, and evaluating symptoms. In addition, skin, oral, and blood tests can help pinpoint the allergy.

A Word From Verywell

If you have a spinach allergy, you'll need to avoid spinach in all forms, including whole spinach and small amounts that may be hidden in other dishes. It's also good to keep some antihistamines on hand if you accidentally ingest spinach. Work with a healthcare provider to identify which medication is best in your situation.