Symptoms, what to avoid and more

Spinach is not a major food allergen, but some people are allergic to it. You may notice specific symptoms after eating spinach if you are allergic, such as gastrointestinal, nasal, respiratory, or skin issues.

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

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Spinach Allergy and Histamine Intolerance Link

Although histamine intolerance and food allergies share some symptoms, they are not the same thing. Histamine intolerance occurs when the body cannot process the high levels of histamine naturally found in certain foods. The inability to process histamine occurs when the enzymes your body needs 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 reaction of the immune system to food. Symptoms occur when the body mistakenly identifies a food as a harmful substance and overproduces histamine.

What is histamine?

Histamine is a chemical that sends messages between cells. Primarily, it works with the immune system to protect your body against foreign substances. With allergies, the immune system overreacts to harmless substances, the allergens. When this happens, it produces excess histamine, leading to allergy symptoms.

Spinach is a histamine-rich food, which means it naturally contains high levels of histamine. Histamine intolerance is difficult to diagnose. Often, food allergies must first be ruled out. If your healthcare provider suspects histamine intolerance, they may recommend a low-histamine diet to see if that helps.


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

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

  • Hoarseness
  • Tightness in the throat
  • Wheezing
  • Difficulty breathing
  • A tingling sensation
  • A feeling of unhappiness

Anaphylaxis is a life-threatening medical emergency. Therefore, if you experience severe symptoms, call 911 or go to the emergency room immediately.


Diagnosing food allergies may require a skin test, blood test, oral challenge, and food elimination test. Allergists and immunologists are physicians with specialized training in the diagnosis and treatment of allergies. They may be better equipped to help you diagnose a food allergy.

Skin test

Skin testing is considered the standard for diagnosing allergies. These tests introduce a potential allergen into your skin by scratching or injecting a small amount. A healthcare provider then monitors 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 cannot tolerate a skin test. For example, young children may have difficulty sitting still and not scratching for a skin test. Blood tests look for immunoglobulin E (IgE) antibodies against different substances to confirm an allergy.

Oral challenge

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

Elimination Diet

An elimination diet may be part of the facility if you have a food allergy or sensitivity. Usually, before eliminating one or more particular foods, a health professional will ask you to keep a food diary. In the diary, you will write down everything you eat and any symptoms you notice. Then, after a while (maybe a few weeks), you will reintroduce foods, noting any reoccurring symptoms.


Treating a spinach allergy primarily involves avoiding spinach and foods that contain spinach as an ingredient. Also, medications can help with accidental exposure.


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

Antihistamines come in either first- or second-generation forms. First-generation drugs are the oldest types of drugs. They tend to produce more side effects, such as sedation. First-generation antihistamines include:

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

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


Epinephrine (EpiPen) is a hormone you use to treat anaphylaxis. The drug is generally 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 generally not 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 a food allergy. So, in addition to avoiding spinach in its natural form, you’ll also need to be a detective when it comes to reading food labels and monitoring it as an ingredient.

Fortunately, spinach is not a common food additive. But, you might find it in things like dips, pasta and egg dishes, salads, and soups. When eating out, tell your server about your allergy to avoid the risk of cross-contamination.

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

When to See a Health Care Provider

If you suspect you may have a spinach allergy, you should be evaluated by a health care provider. Your primary care provider is a great place to start. They may be able to coordinate allergy testing or they can refer you to a specialist. Also, if you experience severe anaphylactic reactions, seek medical attention immediately.


Spinach allergy is not a major food allergy, but an allergy can still occur. Additionally, some histamine-intolerant people may react to eating spinach because it is a histamine-rich 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 diet and eliminating spinach, reintroducing it, and evaluating symptoms. Additionally, skin, oral, and blood tests can help identify the allergy.

A word from Verywell

If you are allergic to spinach, you will 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 antihistamines on hand if you accidentally ingest spinach. Work with a health care provider to determine which medication is best for your situation.

Frequently Asked Questions

  • What is the difference between spinach allergy and spinach intolerance?

  • Is spinach allergy more common in children than in adults?

    Food allergies are more common in children than in adults. However, anyone can develop a food allergy, including spinach, at any time in their life. Children are more likely to outgrow food allergies than those who develop them later in life.

  • Can you have an allergic reaction to raw but uncooked spinach?

    If you are allergic to spinach, your body’s immune system will react to the allergen, regardless of how the food is prepared. However, if you have histamine intolerance, the way a food is cooked can sometimes affect histamine levels. With spinach, however, research has shown that there is no difference in histamine levels depending on whether it is eaten raw or cooked.

  • Is spinach a common allergen?

    Spinach is not a common allergen. The main food allergens are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soy.

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