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Ragweed and oral allergy syndromeBy Clifford W. Bassett, MD, FAAAAI, & Ilana Bragin, MD Does your mouth or throat become itchy after eating fresh fruits or vegetables during the fall season? For some people, seasonal allergy symptoms may be made worse by consuming fresh fruits or vegetables due to “oral allergy syndrome,” according to the American Academy of Allergy, Asthma & Immunology (AAAAI). Oral allergy syndrome (OAS) is a reaction to certain raw or fresh fruits or other foods that occurs in people who have been sensitized to airborne pollen. The syndrome is caused by a cross reactivity between airborne pollen proteins (tree, grass, weeds, plants), and proteins in fruits or vegetables. In people who are already allergic to pollen, the body’s immune system sees a similarity between the proteins of pollen and those of the food, and triggers a reaction. The most frequent reaction involves itchiness, and/or swelling of the mouth, face/lip, tongue and throat area. The symptoms usually appear immediately after eating raw fruits or vegetables, although the reactions can occur more than an hour later. Rarely, OAS can induce severe throat swelling or even a systemic reaction in a person who is highly allergic. However, severe reactions can occur even the first time an individual tries a food as well as to foods that have been consumed previously without any problem. “For the millions of people suffering from ragweed and weed al lergies i t i s impor tant t o know about pollenfood syndrome, also known as oral allergy s y n d r ome , ” s a i d Clifford W. Bassett, MD, FAAAAI. “If not properly managed, these symptoms can take a heavy toll on an allergy sufferer’s quality of life.” Oral allergy syndrome may be found in up to one third of allergy sufferers and can occur at anytime of the year when eating the foods. Although symptoms may be worse during allergy season, the reaction is not limited to the seasons that typically affect the individual. Although there is no definitive test for the syndrome, affected individuals often have a positive allergy skin or blood test for a specific food and/or pollen along with a suggestive history of local mouth, lip, tongue and/or throat symptoms after ingestion of the suspected foods. Individuals react to different foods based on what type of seasonal allergies they are affected by. Those with reactions to ragweed, the airborne a l l e r g en p r ima r i l y responsible for the onslaught of allergy symptoms in the fall, might experience symptoms when consuming foods such as banana, cucumber, melons (i.e. cantaloupe, watermelon, and honeydew), zucchini, sunflower seeds, dandelions, chamomile tea, and Echinacea. Those with allergic reactions to birch tree pollen, the primary airborne allergen responsible for symptoms in the springtime, may have a reaction triggered by peach, apple, pear, kiwi, plum, coriander, fennel, parsley, celery, cherry, carrot, hazelnut, and almonds. Similarly, those with allergies to grass may have a reaction to peaches, celery, tomatoes, melons and oranges. Even individuals with latex rubber allergies may experience cross reactivity with food items such as bananas, avocados, kiwi, chestnut and papaya, whose proteins the body’s immune system may recognizes as similar to latex. Generally, if individuals with allergies experience any symptoms of OAS, they should avoid eating these foods, especially during the allergy season. One way to reduce the reactions of oral allergy syndrome is to cook, bake or microwave the food. Eating canned food may also limit the reaction, as well as peeling the food, as the offending ingredient is often in the skin. Questions patients with possible oral allergy syndrome should ask
themselves include:
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