The Journal Gazette
Tuesday, March 15, 2016 8:53 pm

Raw fruit can mimic pollen allergy

Suzanne Allard Levingston | Washington Post

My mouth sometimes itches when I eat raw apples, peaches or cherries. It is so annoying that I often avoid those fruits. Strangely, cherry pie never gives me a problem.

I now understand the tasty mystery of the cherry pie. I suffer from hay fever and, like many others, I have developed what is known as oral allergy syndrome (sometimes called pollen food allergy syndrome).

A usually harmless allergy, it occurs because I’m sensitive to pollen and I also react to raw fruits and vegetables that have proteins similar to those in pollen. The result: itchiness in the mouth and throat. Luckily, cooking the produce makes the problem go away, so cherry pie doesn’t set off symptoms.

Pollen in trees, grass and weeds contains proteins that cause the itchy, drippy, sneezy symptoms of hay fever or seasonal allergic rhinitis that affect about 24 million adults and children in the United States, according to data for 2012 from the Centers for Disease Control and Prevention.

If your immune system reacts to birch pollen, for example, you may be sensitive to related foods such as apples, cherries, carrots and celery.

Oral allergy symptoms develop within a few minutes of eating: The mouth or lips can itch or tingle, and there can be burning or swelling or even tightening of the throat. Usually, oral allergy syndrome causes only a short-term allergic reaction in the mouth and throat, lasting a few minutes or a few hours.

Once swallowed, the proteins in the food are broken down by digestive enzymes and acids and do not travel beyond the stomach.

There are few definitive studies, but roughly 30 percent to 75 percent of people with hay fever may have oral allergy syndrome, according to Anna Nowak-Wegrzyn, who is an allergist-immunologist and an associate professor at the Icahn School of Medicine at Mount Sinai in New York.

Many don’t even know there is a name for that fleeting itch. Miriam Keltz Pomeranz, an associate professor of dermatology at the NYU Langone Medical Center, didn’t realize she had oral allergy syndrome until she had kids.

An allergist looking into her child’s peanut reaction asked whether she had food allergies. Pomeranz said, "No, no, I don’t have anything real except for this weird thing that when I eat fresh fruit, it makes my mouth itch." The allergist told her she had oral allergy syndrome.

Allergic inclinations persist throughout the year, but oral allergy syndrome can worsen during and right after pollen season, Nowak-Wegrzyn says.

For those with ragweed allergy, which peaks around Labor Day, people with the syndrome may now be experiencing more discomfort than usual from eating ragweed-related foods such as bananas, melons and zucchini. Those allergic to birch pollen, which hits in the spring, experience the highest rates of oral allergy.

Some people may experience oral allergy syndrome from peanuts and tree nuts, but, given these foods’ potential for serious reactions, a doctor should be consulted to determine whether the problem is a minor annoyance or a serious health challenge.

"If you get this reaction to nuts, you should not assume it’s oral allergy syndrome," Pomeranz said. The oral itching with nut allergies can be the same symptom that you’d get initially from a true food allergy.

"And then you could get really sick the second time you tried it," she said.

The easiest way to avoid oral allergy syndrome is to shun those fruits and vegetables that give you trouble. But oral allergy syndrome can usually be avoided by cooking.

Just as they break down in the stomach, the proteins break down very easily with heat: Raw apples might bring on an itch, but apple pie, applesauce or pasteurized apple juice won’t cause problems. Microwaving raw food for 20 seconds sometimes helps, Nowak-Wegrzyn said.Overall, she said, "For the vast majority of the people who have oral allergy syndrome, this is a mild condition."

Bring on the cherry pie.

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