Mustard
Allergy Facts, Symptoms, and Treatment

Mustard plants are herbs usually grown in the world's temperate regions. The two main varieties are brown mustard (aka Indian), which is native to the Himalayan region, and white mustard (aka yellow), which originated in the Mediterranean.1 As a condiment, mustard is made by grinding the seeds of the mustard plant and mixing them with water, vinegar, or other liquids and perhaps other ingredients such as salt, sugar, and flour. However, both the condiment and mustard seeds are used in a wide range of foods and cooked dishes.2

Mustard allergy is considered a serious issue in countries such as Spain and France, the latter of which is the largest producer and consumer of mustard.2,3 In addition, mustard is on Canada's list of top 11 food allergens, and it is one of 14 major allergens that must be declared on prepackaged food in the European Union.2,4

Where is mustard found?

Although the condiment version of mustard is made from the ground seeds of the mustard plant, other foods are derived from the same herb, including mustard oil, sprouted mustard seeds, and mustard leaves and flowers, all of which may cause reactions in mustard allergic individuals.2 Mustard is used in a wide range of foods and cooked dishes, such as salad dressings, crackers, appetizers, salad oils, pickles, soups, fritters, pizzas, sausages, processed meats, mayo, barbeque sauces, fish paste, ketchup, tomato sauces, and marinades.2,3 In addition, Indian cooking often uses mustard seed and mustard oil, and Italy employs a sweet mustard syrup called mostarda as a meat relish.2 Mustard can even be present in baby food, and at least one mustard seed species is used in pharmaceutical plasters or poultices.3

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Are there other allergens I could be sensitized to?*

Some people with mustard allergy may also experience symptoms when eating other seemingly unrelated foods. This is called cross-reactivity and occurs when your body's immune system identifies the proteins, or components, in different substances as being structurally similar or biologically related, thus triggering a response.9 The most common cross-reactivities with mustard are other seeds.14

If you experience an itchy mouth or throat after eating mustard or other related fresh fruits or raw vegetables, you may suffer from Oral Allergy Syndrome (OAS), sometimes called Pollen Food Allergy Syndrome (PFAS). This condition is also caused by your immune system's reaction to similar proteins, or components, found in plant foods and tree pollens.7 It is quite common, with up to 25 percent of children with allergic rhinitis (i.e., hay fever) also suffering from OAS when eating fruits or vegetables.10 Mugwort is a common pollen allergy that could cause OAS when eating plant food.14

Do I need to avoid all forms of mustard?

The major allergy inducing proteins in mustard are not greatly affected by food processing and are heat resistant. As such, those allergic to mustard may react to mustard in both processed and heated forms.2 Dietary precautions are mandatory because it takes a minimal amount of mustard to cause a reaction; plus, the allergen is highly resistant to stomach digestion and is often hidden in prepared foods.3

*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.

How do I manage my allergy?

Because there is no cure for food allergies, your healthcare provider may recommend a plan that includes the following.11-13,15

  • Read ingredient labels and "may contain" advisory panels on food and nonfood products carefully, and avoid all foods and products containing any form of the allergen. Note that these lists and panels may not appear on the same side of a product's packaging and that manufacturers frequently change ingredients. If you're unable to obtain a list of ingredients, it's safest to avoid that item.
  • Avoid cross-contamination when cooking by using two sets of cooking and eating utensils, with one exclusively for the allergic individual. Wash all dishes and utensils in hot soapy water between uses.
  • Craft an action plan with a list of steps for you and others to take should you accidentally ingest the allergen. Print out a copy of the plan and carry it with you.
  • Talk with restaurant chefs about your allergy and order food that's simply prepared and void of any form of the allergen. Avoid desserts, as they often contain or have come into contact with food allergens.
  • Plan ahead for traveling to ensure your food allergy will be managed and any emergency medication is always available.
  • Wear a medical ID bracelet identifying the allergen to which you're allergic.
  • Carry any recommended or emergency medication with you at all times.
  • Teach children with food allergies which foods to avoid. Work with caregivers and school staff to eliminate or reduce exposure to the allergen and to ensure they understand when and how to use medication to treat symptoms.

Your healthcare provider may direct you to take one of the following medications:

  • Epinephrine auto-injector when there are signs of an acute severe event, aka anaphylaxis (see below). Ensure your family members know how to administer it in case of an emergency.
  • Antihistamines as a supplement may be useful in relieving mild symptoms (e.g., itch); however, they do not halt the progression of an allergic reaction.
  • Bronchodilator (albuterol) as a supplemental therapy for respiratory symptoms, especially in those with a history of bronchospasm or asthma.

If you're with someone who's having an allergic reaction and shows signs of shock, act fast. Look for pale, cool, and clammy skin; a weak, rapid pulse; trouble breathing; confusion; and loss of consciousness. Do the following immediately:

  • Call local emergency services.
  • Ensure the affected individual is lying down with legs elevated.
  • Administer epinephrine immediately for any obvious signs of anaphylaxis.
  • Check the affected individual's pulse and breathing and administer CPR or other first-aid measures if necessary.

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Mustard Allergen Facts, Symptoms, and Treatment

Common Symptoms

Mustard allergy can range from mild to severe and may vary over time, resulting in mild symptoms during one episode and severe symptoms in another. Although food allergy symptoms can start a few minutes to several hours after ingestion, most begin within two hours.5 Symptoms may involve the skin, gastrointestinal tract, cardiovascular system, and respiratory tract, and may include one or more of the following:5,6

  • Abdominal pain, diarrhea, nausea, vomiting, stomach cramps
  • Hives (allergic urticaria), itching, eczema
  • Wheezing, nasal congestion, shortness of breath, repetitive cough
  • Shock, circulatory collapse
  • Tight, hoarse throat, trouble swallowing
  • Pale or blue skin coloring
  • Dizziness, lightheadedness, fainting, weak pulse
  • Anaphylaxis, a potentially life-threatening event

Symptoms may also include the following, which are associated with Oral Allergy Syndrome (OAS), aka Pollen Food Allergy Syndrome (PFAS):7

  • Itchy mouth and hives on the mouth
  • Scratchy throat
  • Swelling of the lips, mouth, tongue, and throat
  • Itchy ears

Contact dermatitis (eczema) after exposure to mustard also has been observed, along with observations indicating a relationship between eating mustard and atopic dermatitis severity.8

How do I know if I'm allergic?*

Together with your symptom history, skin-prick testing or specific IgE blood testing can help determine if you are allergic to a particular allergen. If you are diagnosed with an allergy, your healthcare provider will work with you to create a management plan.

*These products may not be approved for clinical use in your country. Please work with your healthcare provider to understand availability.

Is there a risk for a severe event?

Because food allergic reactions are unpredictable and symptoms range from local to systemic, it is recommended that an epinephrine prescription be considered for any patient with an IgE-mediated food allergy.11

If you have asthma, you may face a higher risk of severe mustard reactions, particularly if your asthma is poorly controlled.2

  1. Encyclopedia Britannica [Internet]. Chicago: Encyclopedia Britannica Inc.; 2020 Jan 10. Available from: https://www.britannica.com/plant/mustard.
  2. The Anaphylaxis Campaign [Internet]. Farnborough, UK: The Anaphylaxis Campaign; 2019. Available from: https://www.anaphylaxis.org.uk/wp-content/uploads/2020/01/Mustard-2019-V3-002.pdf.
  3. The University of Manchester [Internet]. Manchester, UK: The University of Manchester; 2006 Oct 18. Available from: http://research.bmh.manchester.ac.uk/informall/allergenic-food/index.aspx?FoodId=56.
  4. Government of Canada [Internet]. Ottawa, ONT, Canada: Government of Canada; 2017. Available from: https://www.canada.ca/en/health-canada/services/food-nutrition/reports-publications/food-safety/mustard-priority-food-allergen.html.
  5. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Available from: https://acaai.org/allergies/types/food-allergy.
  6. Mayo Clinic [Internet]. Rochester, MN: Mayo Foundation for Medical Education and Research; 2019 Nov 2. Available from: https://www.mayoclinic.org/diseases-conditions/food-allergy/symptoms-causes/syc-20355095.
  7. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Available from: https://acaai.org/allergies/types/food-allergies/types-food-allergy/oral-allergy-syndrome.
  8. Palgan K, Żbikowska-Gotz M, Bartuzi Z. Dangerous anaphylactic reaction to mustard. Archives of Medical Science. 2018;14(2):477 9. 
  9. EAACI, et al. Molecular allergology user's guide. Pediatr Allergy Immunol. 2016 May;27 Suppl 23:1-250. doi: 10.1111/pai.12563. PMID: 27288833. (199-212 p.) Available from: http://www.eaaci.org/documents/Molecular_Allergology-web.pdf.
  10. Roberts, Graham & Xatzipsalti, M & Borrego, Luis & Custovic, Adnan & Halken, Susanne & Hellings, Peter & Papadopoulos, Nikolaos & Rotiroti, G & Scadding, Glenis & Timmermans, Frans & Valovirta, Erkka. (2013). Paediatric rhinitis: Position paper of the European Academy of Allergy and Clinical Immunology. Allergy. 68. 10.1111/all.12235.
  11. Wright BL, Walkner M, Vickery BP, Gupta RS. Clinical Management of Food Allergy. Pediatr Clin North Am. 2015 Dec;62(6):1409-24. doi: 10.1016/j.pcl.2015.07.012. Epub 2015 Sep 7. PMID: 26456440; PMCID: PMC4960977
  12. American College of Allergy, Asthma & Immunology [Internet]. Arlington Heights, IL: American College of Allergy, Asthma & Immunology; 2014. Available from: https://acaai.org/allergies/types-allergies/food-allergy/food-allergy-avoidance.
  13. Harvard Health Publishing [Internet]. Boston, MA: Harvard Medical School; 2020. Available from: https://www.health.harvard.edu/healthbeat/6-tips-for-managing-food-allergies.
  14. Figueroa J et.al. Mustard allergy confirmed by double-blind placebo-controlled food challenges: clinical features and cross-reactivity with mugwort pollen and plant-derived foods. Allergy. 2005 Jan;60(1):48-55.
  15. Mayo Clinic [Internet]. Rochester, MN: Mayo Foundation for Medical Education and Research; 2019 Sep 14. Available from: https://www.mayoclinic.org/diseases-conditions/anaphylaxis/symptoms-causes/syc-20351468.
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