Why Some Summer Fruits Make Your Tongue Itchy Even If You Don’t Have Allergies

This has probably happened to you: you bite into an apple, kiwi or berries and suddenly feel itchy around your mouth, although you are almost sure that you are not allergic to the fruit you just ate. Why is this happening?

Experts call this phenomenon Oral Allergy Syndrome (OSA), also known as Pollen Fruit Syndrome (PFT). The malaise is quite common and is the result of cross-reactivity. Simply put, your body recognizes the proteins in the fresh fruit you just ate as those found in the pollen you are actually allergic to.

What is Oral Allergy Syndrome?

According to the American Academy of Allergy, Asthma, and Immunology, OSA is “a form of contact allergic reaction that occurs when the mouth and throat come into 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 that develops in patients with hay fever, which is an allergy to tree, grass or wheat pollen,” explained Dr. Svetlana Kriegel, a certified allergist at the University of Toledo. College of Medicine and Life Sciences and University of Toledo Medical Center. “About 15% of patients react to fresh fruits and vegetables because the immune system mistakes the fruit protein for the pollen protein.” Your body literally thinks you just ingested the type of pollen you are allergic to.

“In terms of ‘real’ food allergies, over 180 foods are known to cause them, some of them fruits and nuts,” explained Dr. Katie Marks-Kogan, chief allergist. Done, set, food! “But when talking specifically about these foods, the reaction is usually caused by cross-reactivity and this syndrome.”

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

What are cross reactors?

Generally speaking, there are four categories of environmental allergens that cross-react with fruits, vegetables, and nuts that cause allergic reactions.

This chart The American Academy of Allergy, Asthma and Immunology is extremely helpful in tracking down foods that cause reactions.

Just as certain fruits are in season at certain times of the year, certain types of pollen are more visible during certain months. That is, the reaction that many people associate with summer fruits is not related to this season, but simply indicates sensitivity to one type of pollen. Some people get better with allergy symptoms in the winter, spring, and fall, and after eating foods that don’t show up during the summer months.

What are the symptoms of oral allergy syndrome?

There are several important points to keep in mind when analyzing the symptoms of OSA.

David Bishop Inc. via Getty Images

Cooking fruits changes their composition, making it less likely to have a reaction.

The symptoms usually go down to the mouth first. “When we digest fruits, vegetables and nuts, the protein is broken down in our body and it no longer looks like it did when it first caused the reaction,” Marx-Kogan explained. As a result, the most common symptoms are itching, tingling, and possibly burning in the mouth, lips, and throat. However, runny nose and runny nose, as well as some sneezing, can sometimes be observed.

If you have an anaphylactic reaction to consuming any of these foods, you may be allergic to the fruits, vegetables, or nuts themselves, rather than simply being sensitive to their cross-reacting pollen.

Is there a way to prevent the reaction?

Of course, the easiest way to avoid reacting to any of these fruits, vegetables, and nuts is to stop eating them entirely. Cooking them, or perhaps even microwaving them for a few seconds, can also help you avoid symptoms.

Interestingly, reactions do not usually occur when people eat non-raw foods, such as canned or cooked foods. This is because cooking fruits, vegetables, and nuts actually changes their protein composition and the immune system will no longer bind said protein to various other allergens. So if you’re sensitive to raw peaches, for example, you may not experience the same symptoms when you eat a baked peach pie.

“All of these allergens are affected by heat,” Kriegel explained. “You can’t eat fresh apples, but you can, for example, eat apple jam. You can’t have an apricot, but you can have apricot jam. This is because after cooking, its configuration changes.”

According to Kriegel, eaters should also remember that the main allergens are in the skin and in the very core (next to the seeds) of fruits, vegetables, or nuts. Avoiding these specific parts of the fruit can also ease the discomfort.

The most discussed treatment is allergen immunotherapy, which mainly consists of regular allergy shots. Once you know the fruit or vegetable you’re having a reaction to, you can do a skin test to check your sensitivity to pollen. Vaccinations then desensitize your body to allergens in the environment, which will hopefully teach your immune system not to react to them.

“Once you stop reacting to pollen, your sensitivity to fruits and vegetables will also decrease,” Kriegel said. “We use an injectable pollen extract so that the body can tolerate the effects of the protein without causing a reaction. The body will then say, “I already have so much pollen in my body, why does it react when I encounter a lot of pollen when I eat, say, a cucumber or an apple?”

It has not been proven that it is possible to “outgrow” the syndrome simply by eating more of the fruits, nuts, and vegetables that cause the reaction instead of undergoing therapy.

“There is unofficial evidence,” admitted Marx-Kogan. “But as adults, it’s hard to know how much extract your body needs to “get used to it.” Young children are developing immune systems, so we advise exposure to possible allergens, but when you are older, this is more difficult to determine.

What do we do after the reaction?

Because it’s not a “true food allergy,” experts say, the symptoms usually go away on their own within minutes. However, taking antihistamines (such as Benadryl) will help soothe any itching or burning sensation relatively quickly.

In general, doctors recommend vigilance. Once you’ve figured out which fruits, vegetables, and nuts are causing the reaction, consider doing a skin test to find out which pollen you’re actually allergic to.

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