When I first met my husband, he was such a carnivore he used to joke that the only way he’d eat a vegetable was via pizza. He also told me that he was allergic to raw fruits and vegetables. All raw fruits and vegetables. Needless to say, I was skeptical.
When I joked to our allergist that my husband was peddling his “allergy story” as an excuse to eat more steak, the doctor and nurses just stared. Instead of laughter, they gently whispered that what he was experiencing was a real thing called oral allergy syndrome. The joke was definitely on me.
Oral Allergy Syndrome (OAS) is experienced by so many people – as many as 1 in 3 people with seasonal allergies – that it is likely the most common form of food allergy in adults. Those with OAS react to certain (usually fresh) fruits, vegetables, and nuts usually at the same time they have hay fever and environmental allergies. In other words, if you suffer and sneeze when the spring pollen comes blowing in, you may experience itchy ears and lips when you eat almonds, peaches or carrots. This is not considered a separate food allergy but rather a cross-reaction from the weed and tree pollen found in fruits and other plant-based foods in a distant form.
Sufferers of oral allergy syndrome may notice that they experience symptoms more frequently during spring pollen season. Some sufferers may ONLY experience symptoms during peak periods of pollen and some experience them year-round.
OAS symptoms tend to occur within moments of eating a trigger food. Symptoms of oral allergy syndrome include:
- Itching or burning of lips, mouth, ear canal, or throat;
- Swelling of lips, tongue or uvula;
- Eye, skin and nose reactions are common;
- Tightness of the throat;
- If the allergen is not digested fully, it may delay releasing histamine resulting in vomiting, diarrhea, indigestion, and/or cramping;
- Rarely, wheezing, vomiting, hives and/or low blood pressure.
Oral allergy syndrome rarely results in anaphylaxis – the most severe form of food allergic reaction.
An allergy to certain pollens can correspond to oral allergy syndrome to certain foods. See the chart below to explore which pollen (and their variants) are found in which foods.
If you believe you experience OAS, you should make an appointment with an allergist to confirm your suspicions and rule out a true food or latex allergy. As you lead up to your doctor’s visit, it’s a great idea to begin a food journal to chart and track symptoms which may relate to this condition. Once at the allergist’s office, you can expect them to go over your food diary, symptoms, your personal medical history and – if necessary – give a skin prick, blood test or set up an oral food challenge. As with a regular food allergy, an oral food challenge is the gold standard for diagnosis.
Treatment options are similar to those for environmental allergies since they are interrelated. Allergists may suggest that you avoid your trigger foods or eat them only when they are cooked for a certain length of time at a certain heat (since this alters the protein that sets off an allergic reaction). In some cases, a doctor may treat the environmental allergy with antihistamines or steroids and occasionally will prescribe an epinephrine auto-injector in case of severe reaction. Be sure to ask your allergist about immunotherapy. Allergy immunotherapy had been reported to help both the environmental as well as oral allergy syndrome symptoms.