Do Some Raw Fruits Or Veggies Give You A Tingly Mouth? It's called Oral Allergy Syndrome (OAS)

If you suffer from pollen allergies and you’ve experienced an itchy mouth or scratchy throat after eating certain raw fruits or vegetables and some tree nuts, you may have oral allergy syndrome.

Symptoms of oral allergy syndrome include an itchy mouth, scratchy throat, or swelling of the lips, mouth, tongue, and throat. The symptoms are usually confined to one area and do not normally progress beyond the mouth. Because the symptoms usually subside quickly once the fresh fruit or raw vegetable is swallowed or removed from the mouth, treatment is not usually necessary.

Oral allergy syndrome does not typically appear in young children; the onset is more common in older children, teens, and young adults who have been eating the fruits or vegetables in question for years without any problems. Those with oral allergy syndrome frequently have an allergy to Birch tree, Ragweed or grass pollens.

Oral allergy syndrome occurs because the proteins in some fruits and vegetables are similar to proteins in some pollens and there is a cross-reacting allergen found in both. They are not identical proteins, but they are similar enough to confuse the immune system into having these reactions. That’s not to say that everyone with pollen allergies has oral allergy syndrome. A person may sneeze all spring long and not have any obvious food sensitivities.

Oral allergy syndrome may help explain , though, why some people have seemingly mysterious reactions to certain foods-- for example, someone who is allergic to birch may have a reaction when eating apples. That’s because there are proteins in raw apples that are very similar to the proteins in birch pollen. However, the individual may only have this reaction with raw apples and not cooked apples and the reason is that cooking the offending fruits and vegetables will usually alter the proteins, enabling people with oral allergy syndrome to eat them cooked without a problem. In addition to cooking the offending fruit, peeling the fruit first may help, since the peel of the fruit usually has more allergens than the meat. Many people who undergo allergy shots for pollen allergies will also experience relief from the oral allergy syndrome and can then eat the fruit without any obvious symptoms. However, it is important to note that treatment with immunotherapy should not be initiated for this reason.

Common foods associated with this syndrome are with these following allergens:

  • Birch pollen: apple, almond, carrot, celery, cherry, hazelnut, kiwi, peach, pear, plum & other “stone” fruits
  • Grass pollen: celery, melons, oranges, peaches, tomato
  • Ragweed pollen: banana, cucumber, melons, sunflower seeds, zucchini.

Because the reaction is usually localized to the mouth area, including lips, tongue, and throat, some people will choose to ignore the symptoms and continue to eat the offending foods. For people with reactions confined to itching of the mouth, this is a reasonable choice they could make. Patients can typically decide on their own, without any discussion with a doctor, whether they enjoy the apple enough to put up with an itchy mouth, or whether they hate the itchy mouth enough to avoid the apple. But in rare cases, people with oral allergy syndrome can experience anaphylaxis, a life-threatening reaction that may include blocked airways, low blood pressure, anxiety, vomiting and diarrhea or even death. If a person experiences a reaction beyond the mouth area after eating fresh fruit or raw vegetable, that food should be considered a risk for anaphylaxis, a very serious reaction that is rapid in onset and may require the use of an injection of epinephrine to subside. This is why many people with food allergies carry auto-injectors containing adrenaline for emergencies.

Diagnosis of oral allergy syndrome is reached after taking a patient’s clinical history and conducting allergy skin and blood tests and/or oral food challenges with the appropriate food. Combining the results of skin and blood testing and oral food challenges is the best way to provide patients with an understanding of why symptoms are occurring and the best actions to take to prevent them from continuing to occur. Undergoing comprehensive allergy evaluation and testing can identify your allergic triggers and help you avoid the substance(s) you should stay away from as much as possible. By doing so, you will be less likely to experience a flare up of your allergies.

If you or your loved ones are suffering from an itchy mouth or scratchy throat after eating certain raw fruits or vegetables and/or some tree nuts, you may have oral allergy syndrome.
Let us help you determine what you are allergic to and discuss the best treatment plan to alleviate your symptoms. Give us a call. We are here to help!

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