I had a severe allergic reaction to lupin flour — what Canadians need to know about the emerging allergen

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As someone with a slew of life-threatening allergies, I can tell you from far too much first-hand experience: Anaphylaxis is not fun.

Beyond the physical symptoms, like the inability to breathe, head-to-toe hives and overwhelming nausea, there's also the food-related anxiety that frequently crops up.

Foods and restaurants you thought were safe turn out not to be — and sometimes you even discover brand-new serious allergies you never knew you had.

At least, that is what happened to me earlier this spring when I ate a gluten-free protein pancake made with lupin flour. Lupin flour, as it turns out, is an extremely volatile ingredient for those of us with peanut allergies. An ingredient that not only sent me to the emergency room with full-blown anaphylactic shock but, in the words of my ER doctor, is something he had never seen or heard of before.

I'm allergic to peanuts and lupin triggered severe anaphylaxis

While I've had a severe peanut allergy (tree nuts and sesame) for years, the rest of the legume family — peas, chickpeas, lentils and soybeans — have always been kind to me. Hence why, when I used a pre-made pancake mix with lupin flour, it never crossed my mind that a lupin bean would be the exception to the rule.

Within minutes of ingesting the pancake, I knew things were turning south. I took two Benadryl, administered my Epi-Pen and spent the better part of the evening in an emergency room hospital bed.

In 2017, Health Canada and the Canadian Food Inspection Agency (CFIA) put out an advisory warning Canadians with peanut allergies about the potential risks of lupin after a 10-year-old boy developed anaphylaxis to lupine flour. However, in the years following, there hasn't been many further developments, despite studies suggesting up to 28 per cent of people with peanut allergies could show similar symptoms if exposed to. lupin.

According to Food Allergy Canada, a peanut allergy affects every two in 100 children, meaning, if we average a 28 per cent reaction rate, nearly six out of every 1,000 children could have an undiagnosed lupin allergy.

In a country of 41 million people, roughly 1.2 per cent have probable peanut allergies. Sticking with the metrics above, that means out of 492,000 Canadians with peanut allergies, up to 137,760 people could negatively react to lupin.

What is lupin?

Lupin (also spelled lupine) is a legume from the same family as peanuts. While it's a relatively new food (or ingredient) in the Canadian market, lupin beans are commonly used in Mediterranean cuisine.

Like all legumes, lupin is gluten-free, which makes lupin flour an attractive alternative to gluten or soy products in baked goods, pasta, bread and sauces.

It's unclear if the form of ingestion (whole bean versus ground flour) affects allergy reactivity. In a study of 62 cases of lupin-induced anaphylaxis, the bulk of cases were linked to lupin as an ingredient in baked goods; however, that's likely due to its usage.

"Lupin as an ingredient is more challenging to avoid than whole lupin beans," says Jennifer LP Protudjer, an endowed research chair in allergy, asthma and the environment at the University of Manitoba.

Abstaining from a salad with lupin beans is one thing, but avoiding lupin flour in over-the-counter baked goods, pasta, sauces — and protein pancakes — can prove more challenging.

Who is at risk of a lupin allergy?

While some allergic reactions, including anaphylaxis to lupin, have been reported in people without pre-existing peanut allergies, most reported allergic reactions have occurred in people with a known peanut allergy.

Figures vary depending on the study you are looking at, but it's estimated that five to 28 per cent of people with peanut allergies will also show clinical symptoms of a lupin allergy. However, some research suggests even higher figures.

According to the University of Manchester, up to 50 per cent of individuals with a peanut allergy can react to lupin.

Another study showed a positive skin prick test for lupin in approximately one-third of individuals with peanut allergies — both nerve-wracking figures for nut allergy households.

Why isn't lupin a priority allergen in Canada?

Unlike in Europe, where lupin was classified as a priority allergen in 2006, and in Australia and New Zealand, where mandatory labelling laws changed in 2018, lupin is not on Health Canada's list of priority allergens.

The list currently includes 11 common allergens and gluten sources: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, wheat and triticale, sesame, mustard and sulphites.

As lupin is not considered a priority allergen, food manufacturers are not required to include it in a label's "contains" statement. However, ingredients derived from lupin, such as lupin flour or lupin protein, must be declared in the list of ingredients on the product label.

To be declared a priority allergen by Health Canada, "the prevalence of the food allergy, severity of reactions, as well as dietary consumption patterns of an area must be considered," Protudjer told Yahoo Canada.

Because lupin allergies are still relatively new to Canada — the first reported case of an allergic reaction was in 2017 — the jury's still out on who (and how many people) the food will impact. For many, unless they meet with an allergist, they may not be aware of an allergy until, as was my experience, they're made abundantly aware via a constricting airway.

"Health Canada is not planning to add lupin to the Canadian list of priority allergens at this time," the health authority said in an email statement to Yahoo Canada. "However, if new information becomes available that would support adding lupin to the list, we would take this into consideration."

I had never experienced sensitivities to legumes prior to lupin. If I can ingest peas, chickpeas, lentils and soy safely, how was I to know that lupin would cause such a serious reaction?

Be allergy-aware

As it stands, lupin is considered an emerging allergen in Canada. It is an ingredient that is becoming increasingly popular in foods, especially gluten-free products.

Just because you have a peanut allergy does not automatically mean you're allergic to lupin. However, Food Allergy Canada recommends anyone with a peanut allergy avoid all products containing lupin until they have consulted with their allergist.

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