• Allergies, Asthma, and Lung

Could an Oral Allergy Be Tickling Your Tongue?

You’ve heard people say it: “I’m allergic to fruit.” On a believability scale, it’s right up there with “The dog ate my homework.” Turns out, however, some people who profess an allergy to fruit may, in fact, be telling the truth. 

Fresh fruits and raw vegetables typically top the list for any healthy diet. But if you have oral allergy syndrome, these normally good-for-you foods may not feel so good going down the hatch. When they come in contact with areas of your mouth — your tongue, cheeks, throat and lips — they can cause itching and inflammation.  

What’s Causing That Itchy Mouth?

Oral allergy syndrome is the result of a cross-reaction of allergens from inhaled pollen and consumed raw fruits, vegetables and some tree nuts. This reaction occurs because the proteins found in some fruits and vegetables are very similar to those found in pollen. This confuses your body’s immune system and triggers it to create an allergic response when you eat these foods. 

Heat destroys the allergens so you can still enjoy many of these foods without worry when you cook them.

People with oral allergy syndrome typically have allergies to birch, ragweed or grass pollens (hay fever). However, having any one of these allergies doesn’t necessarily mean you’ll develop the syndrome.

Considered a mild allergy, oral allergy syndrome is more common in older children, teens and young adults. It’s not the same as a food allergy, which causes symptoms beyond the mouth such as your skin, gastrointestinal tract, cardiovascular system and respiratory tract. 

The easiest and safest way to treat oral allergy syndrome is to avoid foods that trigger an allergic response.

What are Symptoms for Oral Allergy Syndrome?

The most frequent symptoms include itchiness or swelling of the mouth, face, lip, tongue and throat, but they also can mimic the common cold. Itchy ears are sometimes reported. Symptoms are usually confined to one area and do not normally progress beyond your mouth.

Symptoms usually appear immediately after eating certain raw fruits or vegetables, although in rare cases, the reaction can occur more than an hour later.

Diagnosing oral allergy syndrome involves reviewing your medical history and food symptoms. In some cases, your doctor will conduct skin prick tests and oral food challenges with raw fruit or vegetables.

You should talk to your family doctor or allergist about your oral allergy concerns so she can help guide you, as well as keep your medical record up to date. You should also consult your doctor if your oral allergy symptoms are:

• Causing significant throat discomfort
• Getting progressively worse
• Caused by cooked fruits and vegetables
• Caused by nuts
• Spreading to other parts of your body, causing problems such as hives, vomiting or difficulty breathing

Although extremely rare, symptoms may occur in other parts of the body and may even cause anaphylactic shock.

Can Oral Allergy Syndrome Be Treated?

Symptoms usually subside quickly once the fresh fruit or raw vegetable is swallowed or removed from your mouth. Medical treatment usually is not necessary.

The easiest and safest way to treat oral allergy syndrome is to avoid foods that trigger an allergic response. Some people report a decrease in their symptoms after treating their hay fever or during seasons with lower pollen counts. 

The list below details cross-reacting allergens. Keep it handy for grocery trips and dinners out.

• Spring/birch pollen: apple, almond, carrot, celery, cherry, hazelnut, kiwi, peach, pear, plum
• Summer/grass pollen: celery, melons, oranges, peaches, tomato
• Late summer/ragweed pollen: banana, cucumber, melons, sunflower seeds, zucchini
• Fall/mugwort pollen: bell pepper, broccoli, cabbage, cauliflower, chard, garlic, onion, parsley and spices (aniseed, caraway, coriander, fennel, black pepper)

Source: American Academy of Allergy, Asthma & Immunology; American College of Allergy, Asthma & Immunology; U.S. National Library of Medicine