Why do some summer fruits itch, even if you're not allergic

Why do some summer fruits itch, even if you’re not allergic

It may have happened to you: you eat a piece of an apple, a kiwi, or some berries and you suddenly feel itchy around your mouth, even though you’re pretty sure you’re not allergic to the fruit you just ate. Why does this happen?

Experts refer to this phenomenon as oral allergy syndrome (OAS), also known as pollen syndrome (PFT). Unwellness is very common and is the result of cross-reactivity. Quite simply: your body recognizes the proteins in the fresh fruit you just ate as being similar to those in pollen, to which you are allergic.

What is allergic mouth syndrome?

According to the American Academy of Allergy, Asthma, and Immunology, OAS is “a form of contact allergic reaction that occurs upon mouth and throat contact with raw fruits and vegetables.” The most common symptoms, which usually occur immediately after ingestion, are ‘itching or swelling of the mouth, face, lips, tongue and throat’.

“It is usually a reaction to fresh fruits, nuts or vegetables seen in patients with hay fever, which is an allergy to tree pollen, grass, or wheat,” explained Dr. Svetlana Kriegel, a certified allergist from the University of Toledo. College of Medicine and Life Sciences and University of Toledo Medical Center. “About 15% of patients have a reaction to fresh fruits and vegetables because the immune system mistakes the fruit protein as a pollen protein.” Your body totally thinks you just ate the type of pollen you’re allergic to.

Dr. Katie Marks-Kogan, Head of Allergology at Ready, ready, food! “But when talking about these foods specifically, the reaction is usually caused by a cross-reactivity and this syndrome.”

The expert noted that the most common pollen allergies associated with OAS are birch trees, grasses, and certain types of wheat.

What are cross reactors?

In general, there are four classes of environmental allergens that react to the types of fruits, vegetables, and nuts that cause allergic-like reactions.

This chart from the American Academy of Allergy, Asthma, and Immunology is very useful for keeping track of foods that trigger reactions.

Just as some fruits are in season during certain times of the year, certain types of pollen are more visible during certain months. This means that the reaction that many people associate with summer fruits is not limited to that season, but simply refers to an allergy to one type of pollen. Some people deal with allergy-like symptoms during the winter, spring, and fall, as well as after eating foods that don’t appear in the summer months.

What are the symptoms of allergic mouth syndrome?

There are a few important things to keep in mind when analyzing OAS symptoms.

Cooking the fruit changes its composition, often making it less likely to provoke a reaction.

David Bishop Inc. via Getty Images

Cooking the fruit changes its composition, often making it less likely to provoke a reaction.

First of all, symptoms usually go down to the mouth. “When we digest fruits, vegetables, and nuts, the protein in our system is broken down and does not appear to have occurred when it first caused the reaction,” Marks Kogan explained. As a result, the most common symptoms include itching, tingling and possibly burning in the mouth, lips, and throat. Sometimes, runny eyes and nose and some sneezing may occur.

If you have had an allergic-like reaction to consuming any of these foods, you may actually be allergic to the fruits, vegetables, or nuts themselves — not just an allergy to cross-reactive pollen.

Is there a way to prevent a reaction?

The easiest way to avoid having a reaction to any of these fruits, vegetables, and nuts, of course, is to avoid eating them entirely. Cooking it or even putting it in the microwave for a few seconds may help you avoid symptoms, too.

Interestingly, reactions usually do not occur when people consume foods that are not raw, such as canned or cooked. This is because cooking fruits, vegetables, and nuts actually changes the makeup of the protein and the immune system will not attach said protein to various other allergens. So if you’re allergic to raw peaches, for example, you may not experience the same symptoms as when eating a baked peach pie.

“All of these allergens are affected by heat,” Kriegel explained. You can’t eat fresh apples but you can have apple jam for example. You can’t eat apricots but you can keep them. This is because, once cooked, its composition changes.”

Eaters should also keep in mind that the main allergens are in the skin and core (besides the seeds) of fruits, vegetables or nuts, according to Kriegel. Not eating those specific parts of the fruit may also ease your discomfort.

The most discussed treatment is allergen immunotherapy, which mainly consists of getting regular allergen injections. Once you identify the fruit or vegetable you interact with, you can do a skin test to check your allergy to pollen. The injections will then desensitize your body to the allergens in the environment, and hopefully, teach your immune system not to react to them.

“Once you stop reacting to pollen, your sensitivity to fruits and vegetables also decreases,” Kriegel said. “We use pollen extract in injections to get the body to tolerate the exposure to the protein without causing a reaction. The body will then say, ‘I already have a lot of pollen in my body, so why do I react when I’m having more of it when I eat, say, a cucumber or an apple?”

Simply “getting rid” of the syndrome by eating more fruits, nuts, and vegetables that causes a reaction rather than undergoing treatment has not been proven successful.

“There was anecdotal evidence,” Marx Kogan admitted. “But, as adults, it is difficult to know how much extract your body needs to ‘get used to.’ With young children, the immune system is forming so we advise exposure to potential allergens but as you get older it is more difficult to identify them.”

What do we do after the reaction?

Since these are not “real food sensitivities,” as experts note, symptoms usually subside on their own within minutes. However, taking an antihistamine (Benadryl, for example) will help soothe any kind of itch or burning relatively quickly.

In general, doctors recommend sensitization. After you know what kind of fruit, vegetables, and nuts cause a reaction, consider getting a skin test to see which pollen you’re actually allergic to.

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