Oral Allergy Syndrome
By Dr. Anthony Ham Pong, M.B., B.S., Paediatric
Allergist - Ottawa Ontario.
Published in the June 2000 AAIA newsletter.
Oral Allergy Syndrome is an allergy to certain raw fruits, vegetables,
seeds, spices and nuts causing allergic reactions in the mouth and
throat. These allergic reactions happen mostly in people with hayfever,
especially spring hayfever due to birch pollen, and late summer
hayfever due to ragweed pollen (Webmaster note: there is no ragweed
pollen in British Columbia west of the Rockies).
An allergic reaction happens while eating the raw food, and causes
itchy, tingly mouth, lips, throat and palate. There may be swelling
of the lips, tongue and throat, and watery itchy eyes, runny nose
and sneezing. Handling the raw fruit or vegetable e.g., peeling
it or touching the juice to the lips, may cause rash, itching or
swelling where the juice touches the skin, or sneezing, runny nose
and water eyes. Sometimes, more severe symptoms can happen such
as vomiting, cramps, diarrhea and, on rare occasions, life threatening
reactions with swelling of the throat, wheezing, trouble breathing
|Fruit, Vegetable & Nut Allergies Associated
with Spring Allergies
(due to tree pollen)
Webmaster note: For more foods, see the "Botanical
List of Food Families" article
APPLE family (apple, pear)
PLUM family (plum, peach, prune, nectarine, apricot, cherry)
PARSLEY family (carrot, celery, dill, anise, cumin, coriander,
POTATO family (potato, tomato, green pepper)
Hazelnut, walnut, almond
Peas, beans, peanut
Ragweed allergy (which causes hayfever in August and September)
can be associated with allergies to raw bananas, and the members
of the gourd family (melon, watermelon, honeydew, cantaloupe, zucchini
Grass allergy can be associated with allergies to orange, melon,
watermelon, tomato, kiwi, peanut.
These allergic reactions usually occur only when the food is raw.
People who are allergic to the raw food can eat it cooked, canned,
microwaved, processed or baked. For example, someone allergic to
raw apples can eat apple sauce, apple jelly, apple juice, apple
pie and dried apples. However, nuts may cause allergic reactions
whether raw or cooked. This problem is usually life long. Allergy
tests to these foods may sometimes be negative unless a fresh fruit
is used for the test (instead of a commercial allergy extract).
The allergic reaction to these foods can occur anytime of the year
when eating the foods but can be worse during the pollen season
and especially if hayfever is very troublesome that year.
The allergic reaction is not due to pesticides, chemicals or wax
on the fruit. Howeve,r because the more allergic part of the fruit
may be in the skin, some people allergic to fruits, e.g., peaches,
can eat the flesh without reaction if the skin is peeled away. Similarly
for apples, some brands of apples cause more allergic reactions
than others. Freshly picked apple, e.g., straight from the tree
or an unripe apple, may cause fewer allergic reactions than one
which is very ripe or one which has been stored for weeks after
Severe allergic reactions to foods causing Oral Allergy Syndrome
are most likely to occur with celery, kiwi, peaches, apricots, apples
and nuts, especially hazelnuts.
Management of Oral Allergy Syndrome
- These allergies are caused by the raw fruit or vegetable and
therefore, once they are cooked or processed, they can usually
- You do not need to avoid all the foods on the chart in the table
above. Avoid only those particular ones which have caused allergic
- Be aware, however, that if you do have Oral Allergy Syndrome
to some of the foods, you can develop allergies to other foods
on the chart.
- If an allergic reaction occurs to one of these foods, stop eating
it immediately. Severe reactions may happen if you keep eating
that food. Allergic reactions may be treated with antihistamines.
- If you have had severe symptoms including trouble breathing,
when eating the foods, you may need to carry injectable medication
with you to treat these reactions (e.g.,
- For mild Oral Allergy Syndrome, try peeling the fruit, or eating
unripe or partially ripe fruits, or picking them directly from
the tree so that they are quite fresh. If you react, do not keep
eating the food.
- Microwaving briefly to a temperature of 80°-90° C (176°
- 194° deg F) may allow you to eat the food.
- Nuts which cause Oral Allergy Syndrome should be totally avoided,
whether fresh or cooked, because of the higher risk of severe
- Allergy shots for hayfever may sometimes help associated food
Substitute Raw Fruits
Berries* (strawberry, blueberry, raspberries, etc.), citrus* (orange,
mandarins, etc.), grapes, currants, gooseberries, guava, mango,
figs, pineapple, papaya, avocado, persimmon, pomegranates, watermelon*.
Substitute Raw Vegetables
MUSTARD family (cabbage, cauliflower, broccoli, watercress, radish
GOOSEFOOT family (spinach, swiss chard)
COMPOSITE family (green onions)
Peanut*, cashew, pistachio, brazil, macadamia, pine nut.
*May occasionally cause Oral Allergy Syndrome.
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of Use: The information
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general information only. We cannot be held responsible for anything
you could possibly do or say because of information on this site.
Consult your family physician or allergist for specific questions
This article courtesy of the Allergy/Asthma
Information Association at www.aaia.ca and the Calgary Allergy Network
web site at www.calgaryallergy.ca. May be reproduced for educational,
non-profit purposes with proper attribution.
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