The Friday Column - Oral Allergy Syndrome

Ah the innocuous apple...

Sadly for me and many others not so innocuous it would seem. Just like Snow White one bite causes me problems.

It wasn't always this way. I absolutely love pretty much all fruit and when I was younger would eat copious amounts of it.

Something odd happened in my late teens. I would eat strawberries and noticed a tingling/itchy sensation in my mouth and throat, then the same thing happened with apples, kiwis, tomatoes, plums, peaches and nectarines, pears, apricots and cherries, the list goes on. As I got to my mid 20's if I took one bite of a gorgeous juicy peach my lips would swell up and resembled someone who had had collagen injected in them.

I first discovered apples being a problem when I was on holiday in San Francisco and there was this gorgeous chocolate shop selling dipped chocolate apples. The window display tempted me and my dad bought me an apple dipped in chocolate (it may have also had chopped nuts on top). Big mistake! My lips swelled, my throat itched and it dried my skin out and made it so sensitive I couldn't wear any make up for the rest of the holiday :-(

However, my worst reaction was after picking and eating a handful of mixed nuts (hazelnuts, almonds and others which I do not remember) from a bowl at my parent's house. I started coughing which went on for ages, my throat was incredibly itchy and I was finding it hard to collect my breath. Id did at this point get extremely worried..

I didn't seek help in those days, I just avoided the offending items but after the nut incident I did some research on the net and found out that what I was experiencing had a name! Oral Allergy Syndrome.

What is Oral Allergy Syndrome?


Definition from Allergy UK Website -


Oral Allergy Syndrome is the medical term for an allergic reaction to food which is limited to the lips, mouth and throat.

Symptoms include:
Itching and/or swelling of all or part of the lips
Itching or tingling and/or swelling of the mouth
Itching or tingling and/or swelling of the throat

This Spring on holiday I discovered that even food prep can cause issues - I peeled an apple for my little boy and then started getting hay fever symptoms - the itchiest eyes you could ever imagine. It then dawned on me I must have touched my eyes with the hands that had the juice of the apple on it.. I try to avoid peeling now or wash my hands immediately to avoid cross contamination and take an antihistamine tablet.

It turned out that this allergy is related to Hay Fever.  

Again taken from Allergy UK

The key to understanding the problem is the association of groups of food allergies with seasonal allergic rhinitis or ‘hay fever’. Hay fever symptoms precede the onset of oral allergy syndrome, sometimes by some years. It has been shown that pollens from trees, grasses and weeds contain proteins of similar structure to those present in certain fruit, vegetables, nuts and even spices. These proteins are found in several different plants as they have essential roles in plant growth and defence against disease. These proteins are recognised by the immune system of a hay fever sufferer, and can trigger an allergic reaction in a susceptible person. Fortunately, in most cases the allergens are easily inactivated by cooking, processing and digestion. The result is the symptoms tend to be limited to the mouth and throat.

So that explains it.

There is an excellent chart on the Allergy UK website that lists which pollens cause which allergies - looking at  what I suffer from I can see that the offending pollen is tree pollen. This does make a lot of sense, my hay fever is worse at the start of hay fever season when tree pollen is at its highest and reduces as the grass pollen season starts.

Recognised associations between pollen and food allergies

Pollen	Fruit	Vegetable	Nuts	Spices
Tree Pollens
Birch, Hazel, Alder	Apple (raw) Peach Pear Plum Cherry Nectarine Apricot Kiwi	Carrot Celery Potato (raw) Beans and Peas Mange Tout Soya and Soya Milk	Hazelnut Peanut Almond
Grass Pollens
All	Apple Peach Plum Cherry Melon	Tomato Beans and Peas Gourds	Peanut
Weed Pollens
Mugwort Ragweed	Melons Banana	Celery Carrot Parsley Fennel Gourds Cucumber		Coriander Cumin Aniseed Caraway

I have a suspicion that my strawberry allergy is unrelated however and most of the time I can now eat them without any or a very mild reaction.

Although some raw fruits are a no go for me, I can eat them if they have been cooked. This is important as a) I love fruit and b) just think of all the goodness I would be missing out on!

Apple Pie anyone?

For more details on oral allergy syndrome visit the Allergy UK website