My Sesame Seed Challenge

Please bring one of the following items:

  • 2 tablespoons (30 mL) of tahini mixed with 1 tablespoon (15 mL) honey (or we can mix for you)

  • Kevala Sesame Choco Butter or Sesame King Chocolate Tahini

  • Three (3) or more ounces (90 mL) of hummus that contains tahini (though direct tahini preferable)

  • For the above, you may bring bread or crackers the patient tolerates on which to spread the tahini or butter, especially if you think greater volumes (ex. 1 tablespoon) may be difficult to eat alone.

  • Sesame seed brittle – how to prepare (do not use if contains food allergen for patient):

    • Heat 3/4 cup sugar, 1/4 cup honey, pinch of salt, 1/4 teaspoon of ground nutmeg (optional), and 1 Tbsp (15 mL) water in a small (1 1/2 quart), thick-bottomed saucepan on medium heat and stir until a smooth slurry is formed. Stir in 1 cup raw sesame seeds.

    • Cook the sesame seed mixture, stirring often, until the mixture turns an amber caramel color, about 5 to 10 minutes. If you have a candy thermometer, the temp should be 300°F.  At this point, remove the pan from the heat.

    • Stir in 1 teaspoon of vanilla extract and 2 teaspoons butter (or alternative).

    • Once the butter has completely melted into the mixture, stir in 1/4 teaspoon of baking soda. The mixture will foam up a bit after you stir in the baking soda, as the baking soda reacts with the acid from the caramelization of the sugar.

    • Pour the mixture out onto a baking sheet. Once completely cooled and hardened (about 15-20 minutes), break into pieces.




Can we have a Food Challenge if the patient is sick?

If the patient has a fever, flu-like symptoms, cough, wheeze, hives, worsened eczema, widespread rash, throat symptoms, vomiting, or other significant illness symptoms, the procedure will most likely not be done.  Please contact the office to discuss symptoms and reschedule the challenge if needed.  You may also keep the appointment to have a full illness assessment and to determine if the food challenge should be cancelled.


Food Challenge guidelines and what to expect

  • Please stop using antihistamines beginning 3 days prior to appointment. There is no need to stop asthma medications or nasal steroid sprays. Please call the office if you are unsure what medications to stop.

  • No food should be given to the patient 2 hours before arriving for challenge. Clear liquids are okay.

  • Please be prepared for the challenge appointment to last 2 to 4 hours.

  • The patient will be given small, increasing doses of the product every 15 minutes until a full serving size has been ingested. We will watch closely for any signs of a reaction, and vital signs will be taken before each dose and for an observation period after the last dose.


What are the risks of having a Food Challenge?

An allergic reaction may happen. The reaction may be similar to the patient’s first reaction or it could include new symptoms. Symptoms may include hives, swelling, shortness of breath, wheezing, coughing, vomiting, or diarrhea.


What happens if patient has a reaction?

The practitioner will examine the patient, and depending on symptoms, medications may be given such as antihistamine, anti-inflammatory steroid, or an epinephrine injection in the thigh. The patient will stay extra time for observation until stable to leave the office.


Expectations after passed challenge

  • Patient will be cleared to eat food item 24 hours after challenge is completed.

  • The food should be included in patient’s diet at least once a week or as directed by the practitioner.

  • Follow up with your practitioner with any other questions or concerns.