Can A Food Be Too Spicy to Eat?

Inspired by a social media challenge, a teenager died after eating a spicy tortilla chip. But is it possible that the chip itself caused his death?

“It’s a terrible story and fortunately rare, but it is true that eating a spicy chip, or any extremely spicy food, can cause an overwhelming neurologic pain response that can cause death,” says Joyce Yu, MD, a pediatric allergist and immunologist. “This is not an allergic reaction.”  

Though some symptoms can feel like an allergic reaction, a response to spicy food is not an allergy or food intolerance. It is a complex response caused by pain receptors. We asked Yu to explain the differences.

Let’s start with the basics: What is a food allergy?

A food allergy is an immune response to a specific food protein of varying severity—coughing, itching, hives, diarrhea, vomiting, swollen lips and/or airways, and more. When someone has an allergy, their immune system mistakenly identifies the food protein as harmful and launches an attack. In some people, it takes only a small amount of the food to trigger the response.

When we feel heat when we spicy foods, is that an allergic reaction?

Definitely not. If you are reacting to the spiciness or heat of a food, the reaction does not involve the immune system and, therefore, is not an "allergic" reaction. You can be allergic to another component of a chili pepper (protein), but most reactions are “non-allergic”. To have an allergic reaction, your immune system must react to one of the protein components in that spicy food.

What is a food intolerance? Can it cause a reaction against spicy food?

Food intolerance is an example of a non-allergic reaction. It’s more common, and uncomfortable, but less serious, and does not involve the immune system.

Spicy foods can be irritants, but when it comes to reacting to spice, it’s generally not food intolerance, either. We do not yet know what causes food intolerance. We suspect it’s a relationship between the GI and neurological systems (gut-brain axis).

Spice—specifically capsaicin, a chemical component of chili peppers that is an irritant and neurotoxin for humans and animals—triggers the “pain” receptors in the body. Therefore, a reaction to spicy food is not an allergic reaction. 

People tend to link "allergic" and "reaction" into one word: "allergic reaction" or they automatically assume all “reactions” are allergicThat’s not correct. People can have many different types of reactions to food. "Allergic" only describes one type of reaction.

Is having a reaction to spicy food something to worry about?

Usually, no. Tingling lips, stomachache, diarrhea, vomiting, and other digestive symptoms are unpleasant but usually resolve on their own. If you regularly have reactions to spicy food or other food, mention it to your primary care doctor or nurse practitioner. You may need to see a GI.

If the reaction does not resolve or is severe— and causes trouble breathing or intense abdominal pain, for example—call 9-1-1.

Can you die from eating spicy food?

High doses of capsaicin can lead to injury to the heart or abnormal heartbeat (dysrhythmia), which can be fatal. Capsaicin is in pepper spray and bear spray which can harm humans. We don’t exactly know what happened with regards to the social media challenges in the news, but it’s possible that exposure to capsaicin to be deadly, although it is extremely rare.

How do you know how tolerant of spicy food you are?

This is a question of neuroscience, not allergy. Research shows that the more spicy food you eat, the more you can down-regulate your body’s pain receptors. Some people who eat spicy regularly feel the pain less. There is no test to determine spice tolerance. But there is a remedy: dairy products. Capsaicin does not dissolve well in water. Go to milk, ice cream, and cheese to temper the pain.

Is there one question every patient asks about spicy food?

Am I allergic to spice?

The answer is almost always no. You could have an allergic reaction to the proteins in a spice, but they are not common. There are many reactions to foods with symptoms that mimic with allergic reactions. But the majority of reactions to spicy foods are not allergic reactions. Usually, a reaction to spice is "allergic-like" because it’s not immunologic.

What’s the one thing you wish everyone knew about food allergies?

People mistakenly link "allergic" with "reaction" even though they are two different things. Do not presume you have an allergy if you react to food. Often symptoms that feel like allergic reactions may be GI issues.

Talk to your primary care doctor or nurse practitioner if you have recurring symptoms with eating any particular foods.