Food Allergy & Chinese Herbs
John K. Chen, Ph.D., Pharm.D., O.M.D., L.Ac.
Mar 9, 2026
Allergy is the over-reaction of the body’s natural defenses to the exposure to a particular substance. Mild to moderate allergy may cause symptoms such as hives, eczema, redness of the skin, itchy mouth, nasal congestion or a runny nose, sneezing, and others. Severe allergy may cause obstructive swelling of the lips, tongue, and/or throat, trouble swallowing, and shortness of breath or wheezing.
Major categories of food allergies include milk, egg, fish, crustacean shellfish, peanuts, tree nuts, soybeans, and wheat, which together account for over 90% of food allergies according to the FDA. It is estimated by the CDC that food allergies affect 4 to 6% of children and 4% of adults. While these individuals may know their food allergies, they are not likely to know their Chinese herbs allergies. Therefore, the TCM practitioner must inquire the known allergies among their patients, and identify which Chinese herbs and formulas pose risk to induce direct allergy or cross allergy. Such prudent actions will minimize and prevent allergic reactions to Chinese herbs. Listed below are the major categories of allergen, relationship with Chinese herbs and formulas, and suggested substitutes.
Approximately 2 to 3% of children under 3 years of age are allergic to milk and dairy products. Fortunately, approximately 20% of children outgrow it by age 4, and 80% of children outgrow it by age 6.
Milk is NOT used in Evergreen Herbs products.
Approximately 2% of children are allergic to eggs and the proteins in egg whites or yolks. Fortunately, approximately 70% of children with an egg allergy will outgrow this condition by age 6.
Egg is NOT used in Evergreen Herbs products.
Fish allergy affects adults much more than children. Risk of cross allergy is relatively low with fish, as having an allergy to one type of fish (i.e., bass, flounder, or cod) does not necessarily mean there will be cross allergy to other type of fish (i.e., tuna) or shellfish (shrimp, crab and lobster).
Fish is NOT used in Evergreen Herbs products.
Crustacean shellfish has a hard shell and no backbone, such as crab, crayfish, lobster, prawns and shrimp. Crustacea has a high risk of food allergy, approximately 0.5-2.5% of the general population has allergy to shellfish.
Crustacean shellfish is NOT used in Evergreen Herbs products.
Note: Cicadas and shellfish (e.g., shrimp, lobster, crab) are arthropods and contain a common muscle protein called tropomyosin, which may trigger allergic reactions. It is important to note that tropomyosin is a muscle protein that is mainly present in the body of cicada, but not in the exoskeleton. This cross allergy is often observed and reported in individuals who eat the body of cicada (e.g., cicada in tacos), but not the exoskeleton (e.g., cicada moulting, Chan Tui (Periostracum Cicadae), in Chinese herbal formulas). Therefore, it is generally considered safe for individuals with shellfish allergy to use cicada shells/exoskeleton/moulting in herbal preparations.
Peanut allergy is linked with anaphylaxis – a serious and potentially life-threatening condition that require immediate treatment. Fortunately, approximately 20% of children who have peanut allergy eventually outgrow it, according to National Institute of Health.
Note: A peanut is not a tree nut, but a legume (in the same family as soybeans, peas and lentils).
Peanut is NOT used in Evergreen Herbs products.
Tree nuts come in many shapes and sizes. Though delicious, tree nuts may be linked to anaphylaxis. Tree nut allergies often last a lifetime, and the chance to outgrow it is less than 10 percent. Tree nuts with high risk of food allergy include: almond, black walnut, Brazil nut, California walnut, cashew, filbert/hazelnut, heartnut/japanese walnut, macadamia nut/bush nut, pecan, pine nut/pinon nut, pistachio and walnut (English, Persian). Among the tree nuts listed above, He Tao Ren (Semen Juglandis) is the only Chinese herb that has tree nut allergy risk.
Tree nuts are NOT used in Evergreen Herbs products.
Soy is a common ingredient in infant formulas and many other processed foods. Allergy to soy is most common in infants and children under 3 years of age. Fortunately, most children outgrow soy allergy by age 10. In Chinese herbal medicine, soybean may be used as an herb or to process other herbs.
Wheat allergies develop when develop when the body’s immune system becomes sensitized and overreacts to wheat protein. Allergic reactions affect many parts of the body, including skin (i.e., rash or eczema), nose (i.e., stuffy nose, runny nose), lung (i.e., asthma), and others.
Sesame allergy affects a notable portion of people (estimated around 0.23% of U.S. children and adults), and reactions can range from mild to severe (including anaphylaxis). It's common in various cuisines, like in breads, tahini, sushi, or as a hidden ingredient in spices/flavor
Sesame is known as Hei Zhi Ma (Semen Sesami Nigrum) in Chinese herbal medicine.
| Evergreen Herbs Products Containing Sesame | |
|---|---|
| Single Herbs | Suggested Alternative |
| Hei Zhi Ma (Hu Ma Ren) (Semen Sesami Nigrum) | He Shou Wu [Zhi] (Radix Polygoni Multiflori Praeparata) |
| Herbal Formulas | Suggested Alternative |
| Qing Zao Jiu Fei Tang (Eriobotrya & Ophiopogon Combination)13 | Mai Men Dong Tang (Ophiopogon Combination) |
| Xiao Feng San (Tangkuei & Arctium Formula)13 | Silerex |
| Dermatrol (Dry)13 | Wen Qing Yin (Tangkuei & Gardenia Combination)Silerex |
| Polygonum 1413 | Qi Bao Mei Ran Dan (Seven-Treasures Formula) |
13 contains Hei Zhi Ma (Hu Ma Ren) (Semen Sesami Nigrum) |
|
Others
Gluten
Gluten is a protein found in wheat, barley and rye. Hypersensitivity to gluten may cause general signs and symptoms (i.e., diarrhea, constipation, abdominal pain or fatigue) and specific illness (i.e., celiac disease in which the lining of the small intestine is damaged).
Some Chinese herbs are derived from wheat, barley and rye, and may contain gluten.
Sulfite
Sulfites are preservatives and antioxidants. They are commonly used in food products to prevent food from turning color and bacteria from spoiling foods. Sulfite is commonly found in foods such as dried fruits (excluding dark raisins and prunes), bottled lemon juice (non-frozen), bottled lime juice (non-frozen), sauerkraut (and its juice), grape juices (white, white sparkling, pink sparkling, red sparkling), pickled cocktail onions, and wine. Sulfite allergy occurs in approximately 1% of population.
Evergreen Herbs products are tested to ensure they meet and exceed the FDA safety limit [< 10 ppm].
Latex
Natural rubber latex is derived from the sap of Hevea brasiliensis, a rubber tree found in Africa and Southeast Asia. Allergic reactions to products made with latex develop in persons who become allergic (or sensitized) to proteins contained in natural rubber latex. Products that contain natural rubber latex include: disposable gloves, dental dams, airway and intravenous tubing, syringes, stethoscopes, catheters, dressings and bandages. Latex also is found in many consumer products. These include condoms, handbags, balloons, athletic shoes, tires, tools, underwear leg and waistbands, rubber toys, baby bottles, nipples and pacifiers.
Du Zhong (Cortex Eucommiae) and Du Zhong Ye (Folium Eucommiae) are derived from the bark of Eucommia ulmoides, commonly known as hardy rubber tree that originated in central China. The bark and leaf of eucommia contain only a small amount of latex, approximately 4% by weight. Though natural rubber latex is a well-known contact allergen, it is unclear whether patients with topical latex allergy would respond adversely to oral ingestion of Du Zhong (Cortex Eucommiae) or Du Zhong Ye (Folium Eucommiae). Therefore, until more information is available, practitioners should use these two herbs with caution if the patients have known latex allergy.
Dr. John K. Chen, Ph.D., Pharm.D., O.M.D., L.Ac., is the lead author of Chinese Medical Herbology and Pharmacology (2003, Art of Medicine Press) and Chinese Herbal Formulas and Applications (2008, Art of Medicine Press). He maybe reached at This email address is being protected from spambots. You need JavaScript enabled to view it. or (626) 810-5530.
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- Food Allergy by National Institute of Health. https://www.niaid.nih.gov/diseases-conditions/food-allergy
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- Prevalence and Severity of Sesame Allergy in the United States