Allergy to coffee: a complete guide

This article provides valuable and scientifically backed up information on coffee allergy, its various symptoms, such as dermatological (e.g. rash), gut (e.g. diarrhea or vomitting) and cardiopulmonary (breathing problems, blood pressure increase) manifestations. Alternatives to coffee when allergic to it are also described. Have a good read!

What is coffee?

Coffee is a brewed drink that is prepared from roasted coffee beans derived from the Coffea plant and has a stimulatory effect on humans because of its caffeine contents. Are you the one who needs a strong punch of coffee every morning to get up and go to work? If yes then you’re not alone in this. Throughout world, millions are addicted to coffee. In fact, it is one of the most consumed beverage worldwide. It’s often said that coffee stimulates brain owing to its caffeine content. But is consuming coffee completely safe? The one word answer to this question is no. It’s now an established fact that some people may develop allergy to coffee. It’s important to know if you’ve coffee allergy or not because this is perhaps one of the most undermined allergies out there. Here is a complete guide on coffee allergy that can help you understand and cope with this phenomenon. 

Allergy

Over the last two decades the prevalence of allergic diseases is on the rise worldwide, be it the developed countries or the developing ones. Moreover, it is not only the number of people who are progressively becoming allergic that is increasing but the number of food items to which they are allergic at a time that is on the rise. This increase is especially problematic for the children who are bearing the major brunt of this rising trend. It is common nowadays to see children allergic to not one but two, three or more foods.

Topmost among the allergic diseases are the food allergies which are proving bothersome for the government and the health services. Food is necessary for survival yet it can be deadly too. People who suffer from food allergy need not only identify the food item to which they are allergic but they also need to avoid and scrutinize the list of ingredients of every food item they take in order to make sure that it is safe for them; something that proves to be quite troublesome.

Coffee allergy

Allergy to coffee is something that is not so common at present. But, coffee is being extensively consumed worldwide. It’s only a matter of time before people might start developing allergy to this refreshing drink. Before that happens, you should look out for this allergy and know most about this condition.

Everyone is different physically and genetically. Your immune system might consider coffee as a harmful substance and may develop allergic reaction to coffee. In case you are suffering from coffee allergy, every time you drink coffee or in case of some people even touch coffee grounds you would experience an allergic reaction that can vary from mild to moderate to severe. Some suffer from allergy to smell of coffee yet others experience allergy to coffee creamer.

Allergy or food intolerance?

First and foremost you need to determine whether you are allergic to coffee or not. People tend to overestimate the percentage of food allergies; the rates of perception of food allergies are up to four times greater than the rates of true food allergies. This is so because people confuse food intolerance, certain cases of mild food poisoning and hypersensitivity-metabolic conditions, such as celiac disease and lactose intolerance which do not involve the immune system, with allergy. Medically, an allergic reaction is one in which there is an IgE mediated immune response against a specific allergen which most of the times is a protein (it can also be non food proteins, medications, certain toxins that interact with proteins and one can have genetic susceptibility to it too).

Allergy and intolerance can be differentiated based on the spectrum of symptoms. For instance, if a person is suffering from lactose intolerance, he will develop symptoms only after consuming dairy products- not otherwise. Allergy, however, can develop even at the slightest consumption, smell or coming in contact with the food. Also, the symptoms of lactose intolerance, for instance, are mostly gastrointestinal like flatulence and diarrhea. The symptoms of allergy are widespread including body redness, rash, other body derangements and even anaphylaxis.

Occupational coffee allergy: various coffee allergens

Little information is available in medical literature regarding the allergic reaction to drinking coffee. However, coffee allergy has been well documented in terms of occupational allergy. The first report of occupational type 1 allergy to coffee dates as far back as the 1950s and the 1960s when the workers experienced the symptoms of asthma and nasal allergies when exposed to the dust of the green coffee beans (2). As per study published in 2012 by researchers from Germonay conducted on 17 symptomatic coffee workers, a class III chitinase of C. Arabica was identified to be the first known coffee allergen, Cof a 1 (3). In another study conducted on 18 symptomatic coffee workers two new coffee allergens, C. Arabica cysteine rich metallothioneins of 9 and 7 kDa, were identified by sequence analysis and included in IUIS Allergen Nomenclature as Cof a 2 and Cof a 3 (4). These may have a potential for the specific diagnosis and therapy of coffee allergy. A method was also developed by the researchers to test for this allergen with a blood test.

The fact that coffee allergens survived the roasting process suggested that drinking coffee can be expected to cause allergic reactions in certain people. Coffee itself alone may not be the sole culprit. Various components in the coffee may be the real problem causers such as caffeine. Most people who experience the variety of symptoms after drinking coffee have either non allergic food intolerance or the pharmacologic side effects from the caffeine present within the coffee.

The various substances present in coffee

Depending upon the variety of seed used (Arabica or Robusta) and the method of preparation (espresso, drip or percolation), an average cup of coffee contains 80-175mg of caffeine. Caffeine is one of the most widely consumed psychoactive drugs throughout the world but unlike the other psychoactive drugs its sale and consumption is legal and unregulated in almost all parts of the world.

Coffee contains over 200 other substances, including liverine, theobromine, theophylline, paraxanthine, methylliberine, theacrine, bases (betaine, choline, niacin, trigonelline), carbohydrates (arabinose, fructose, galactose, glucose, inositol, mannitol, mannose, sucrose, xylose), lipids, minerals and acids (chlorgenic, acetic, citric, formic, fumaric, lactic, malic, oxalic, quinic, quinides) (1).

According to Veronika Somoza, PhD, of the University of Vienna in Austria, and Thomas Hofman, PhD, of the Technische Universitat Munchen in Germany, their research for the first time shows that chemical-substances called N-alkanoly-5-hydroxtryptamides, catechols and caffeine stimulate molecular mechanisms of stomach acid secretion in human stomach cells. These components of coffee are the cause of stomach aches and heartburn that the coffee sensitive individuals experience and the reason as to why up to 40 million people in USA alone can’t drink coffee as much as they want to or have to shun it completely.

World over 1.4 billion cups of coffee are consumed everyday with the highest consumption being in Europe.  Many studies and researches have been conducted in order to determine the effect of coffee on the human health. However, so far results vary in terms of the relative benefits of coffee.

Can you develop allergy to coffee?

According to a report from Italy published in 2008, a 55 year old father and his 22 year old daughter experienced coffee allergy after having contracted a helminth infection (Clonorchis sinensis). They reported that the diarrhea and urticaria they suffered from became evident after meals particularly after breakfast when they drank coffee only. After the coffee was eliminated the said symptoms resolved.  In both father and daughter the blood test and skin prick test proved to be positive together with the presence of specific serum IgE antibodies against coffee. It was hypothesized by the authors of the report that that the parasite may have damaged the intestine because of which coffee allergy developed (5). So the answer to the question that can you develop allergy to coffee is yes you can develop allergy to coffee.

Allergic reaction to coffee

The various symptoms of allergy to coffee are as follows:

Respiratory problems

People who have coffee allergy may also suffer from flu like symptoms. Runny watery discharge from the nose or congestion is a typical symptom of food allergy. The person may also experience dry cough. In people who have allergy to coffee - sneezing is a very common symptom. The condition may be severe enough to be constituted as life threatening. The breathing tube may swell up thus restricting the airflow and result in the production of whistling sound during breathing known as wheeze. If immediate medical treatment is not provided, breathing can become extremely difficult.

These symptoms usually develop when you inhale coffee powder. When the coffee powder enters your air passages, the immune system of body recognizes this powder as allergic foreign material. This way an aberrant immune response in triggered in the body. This immune response mainly involves the release of inflammatory mediators and antibodies. The air passages get irritated due to the secretion of these chemicals and the person develops asthma like symptoms.

Also coffee has been suspected of leading to development of chronic obstructive pulmonary disease (COPD) and bronchial cancer (6).

Dermatological manifestations

Some people suffering from coffee allergy experience skin eruptions when they touch the coffee beans. The skin breaks out into hives and becomes red, irritated and starts itching. These skin manifestations can also occur around the mouth after having a cup of coffee or depending upon the severity of reaction few hours after the hot cup of coffee has been taken.

These manifestations are mainly due to the release of inflammatory mediators by cells known as mast cells. When mast cells are exposed to some allergen, they respond by releasing some inflammatory mediators. These inflammatory mediators cause several effects. First, they cause intense itching and pain at the site of exposure. Second, these chemicals also increase the flow blood to the affected area. That’s why the affected area looks red and itchy. This is an important defense mechanism as it allows the body get rid of toxins and allergens.

In a 40-year-old woman who gave a 1-year history of a chronic paronychia involving the left thumb, nail-fold contact dermatitis from coffee powder was described (7).

Stomach and intestinal disorders

Food allergy causes flu like symptoms which might appear as early as after finishing drinking coffee or hours later as the allergen is travelling through the gastrointestinal tract. Belly cramps, nausea, vomiting and loose watery stools are some of the potential side effects experienced by the person who is allergic to coffee.

These symptoms are indeed a nuisance but these symptoms represent an important protective mechanism of your body. These symptoms usually surface when you consume the allergen containing substances. These allergic substances irritate the lining of the intestine and body starts an inflammatory response due to the presence of the allergic substance. The body responds by causing nausea and diarrhea. This is how the body flushes out toxins and allergens from the body.

According to yet another study conducted, consumption of coffee by people suffering from coffee allergy can also result in heartburn, dyspepsia and regurgitation (8). Moreover the symptoms of dyspepsia were found to be influenced by variations in both the characteristics of susceptible individuals and the coffee itself. Thus, coffee seems to play a role in gastro-esophageal reflux disease particularly in coffee sensitive individuals. As per study gastro-esophageal reflux and the symptoms of coffee sensitivity increased with the concomitant ingestion of food (9).

Cardiovascular System

Coffee causes a significant increase in the blood pressure (10), (11) which is particularly harmful for hypertensive individuals (12). After coffee consumption increase in heart rate has been observed and it has the potential to produce cardiac arrhythmias (13). According to another research coffee has been found to increase the serum cholesterol (14) and homocysteine levels (15) which increases the person’s risk of suffering from heart attack. It also increases the inflammatory markers such as interleukin 6 and C reactive proteins which have a negative effect on cardiovascular system (16). As per another study caffeine increases the stiffness of the aorta as well as the aortic pressure (17). It is a major contributing factor in coronary artery disease and arteriosclerosis. Caffeine also interferes with the binding of GABA on the GABA receptors thus compromising its role in stress management (18). Consequently constant psychological and social stress increases the risk of heart attack.

Anaphylaxis

Anaphylactic reaction is a potentially life threatening condition and is a medical emergency. After having a cup of coffee if a person experiences swelling around the lips or throughout the tongue or throat instant medical treatment should be sought. A weak pulse, chest pain and bluish discoloration are some of the few signs which suggest that something is very wrong. Due to the drop in blood pressure and decreased oxygen supply to the body tissues, especially the brain cells, the individual feels confused and may black out. These signs are not something to be taken lightly at all. A little delay and the person can lose his life (19).

Anaphylaxis results due to extensive release of inflammatory mediators my allergy causing cells. The body responds by causing intense vasodilatation. When the vessels dilate, the blood pressure drops immensely and the supply of blood to the vital organs drops significantly. Once the supply to the brain is compromised, the vitals become unstable and person may collapse.

According to a report, a 45-year-old woman developed chronic urticaria and anaphylactoid reactions after ingesting coffee and taking an analgesic drug. According to the authors, conclusive evidence such as the prick tests and oral provocation tests was present that anaphylactic hypersensitivity reaction against coffee was present together with the idiosyncratic reaction to metamizole (dipyrone), caffeine, acetylsalicylic acid and indomethacin (20).

Pregnant women

There is an increased risk of neonatal apnea in newborns of pregnant females who consume large quantities of coffee daily (6).

Other symptoms

Reports regarding cheilitis (21) and eisinophilic cystitis (22) due to coffee ingestion have also been made.

Caffeine: A probable culprit

It may be highly likely that what the coffee drinkers experience is because of the caffeine in it. Therefore, any person who is thought to be allergic to coffee should be considered as being allergic to caffeine firstly and appropriate tests be carried out in order to determine whether it is allergy to coffee or caffeine.

Mode of action

As mentioned above caffeine is psychoactive drug that being both water and lipid soluble can cross the blood brain barrier. Therefore, in brain it reversibly blocks the action of adenosine on its receptors thus preventing the drowsiness that is induced by adenosine. It is also known to stimulate the medullary vagal, vasomotor and respiratory centers which results in decrease in the heart rate, constriction of the blood vessels and increase in the respiratory rate. The adenosine receptor antagonism promotes the release of various neurotransmitters, such as monoamines and acetylcholine, which are responsible for the stimulatory after effects of caffeine.

Effects

Caffeine has been known to cause skin problems (rash, acne, eczema, itching, urticaria (23)), migraines (24), lack of concentration, fatigue, anaphylactic reaction (25), palpitations, tongue, gland and throat swelling. Caffeine also stimulates the adrenal glands to produce stress hormones like adrenaline and cortisol. Consequently the person suffers from anxiety and panic attacks. He feels shaky, nervous, anxious, jittery, irritable, restless and experiences insomnia. The person may also experience nausea, vomiting, diarrhea and abnormal sugar levels.

How to know whether you suffer from coffee allergy or not?

If you believe that coffee is the root of your problems you can confirm it by eliminating coffee from your diet. If the symptoms resolve on their own then it means you are allergic to coffee and should go for some other brew instead of coffee.

Is it allergy to coffee or caffeine?

A person who develops various allergic symptoms after drinking decaffeinated coffee is more likely to be suffering from coffee allergy whereas the person who develops such symptoms after drinking caffeinated drinks, such as the cola, chocolate or tea, is probably suffering from allergy to caffeine.

Alternatives to coffee

Nowadays people have come up with alternatives to coffee when allergic. One of them is Dandy blend, a brew that is made from dandelion root. It tastes like coffee but one has to go slowly and build up gradually. The detoxifying effects of the dandelion results in increased gastrointestinal motility until the time the digestive tract adjusts to the brew.

Another effective substitute is Teeccino herbal coffee which is an alkaline, caffeine free herbal coffee. It has the same delicious, deep roasted coffee like flavor, enticing aroma and provides a natural energy boost.

According to some people green tea is a healthy alternative as it not only acts a good substitute for coffee but it also prevents various diseases such as hypertension, cardiovascular diseases, diabetes and many more.

Another way is to make a coffee substitute on your own. One such substitute is rooibos latte also known as red espresso or red tea.

Another healthy coffee substitute suggested by Sally Fallon Morell, President of the Weston A. Price Foundation, consists of 1 tablespoon molasses, 1 tablespoon coconut oil and 1/4 teaspoon organic powdered ginger all soaked in boiling water.

Decaffeinated coffee was once thought to be an alternative for the individuals who are allergic to caffeine however it is no longer considered so as people have come to realize that it is not 100% decaffeinated.

Moreover nowadays the researchers are looking for a stomach friendly coffee. One such coffee preparation contained N methylpyridium or NMP which seemed to decrease the hydrochloric acid production and thus helped in reducing stomach irritation. This compound was found to be present in higher quantities in the roasted variety of the coffee beans. However, research is still ongoing in order to find alternatives for the coffee for individuals who are allergic to coffee.

The bottom line

Allergy to coffee (caffeine) really exist and one should be careful when drinking coffee. Pregnant women and people with gut or cardiovascular disorders should only drink coffee when approved by their physician. There are some alternatives to coffee for people who are allergic to it, such as Teeccino herbal coffee, Dandy blend, etc.