When you have oral allergy syndrome, certain fresh fruits, nuts, and vegetables can trigger an allergic reaction in the mouth and throat because of proteins with a similar structure to pollen.
In other words, your body confuses a fruit protein with a pollen protein. Specific immunoglobin E antibodies in your immune system cause allergic reactions.
For this reason, the condition is sometimes called pollen-fruit allergy syndrome. The symptoms tend to be worse during times of the year when pollen levels are high.
Different people are triggered by different foods. However, OAS only happens as the result of cross-reactivity between pollen and similarly structured proteins in certain fruits.
Some common triggers of OAS include:
- bell peppers
- sunflower seeds
- fresh herbs, such as parsley or cilantro
If you have OAS, tree nuts, such as hazelnuts and almonds, can trigger your symptoms. Oral allergy syndrome is usually milder than more systemic nut allergies that can be fatal.
People with oral allergy syndrome generally won’t have a severe allergic reaction. The reaction is usually limited to the area of the mouth and throat, but it can progress to systemic symptoms in up to 9 percent of people. True anaphylaxis is even rarer, but it can occur in almost 2 percent of people.
OAS symptoms can vary, but they tend to be concentrated in the area of the mouth and throat. They rarely affect other areas of the body. When your OAS is triggered, you may have these symptoms:
- an itching or tingling on your tongue or the roof of your mouth
- swollen or numb lips
- a scratchy throat
- sneezing and nasal congestion
The best treatment for OAS is straightforward: Avoid your trigger foods.
Some other easy ways to reduce OAS symptoms include these tips:
- Cook or heat your food. Preparing food with heat changes the protein composition of the food. Many times, it eliminates the allergic trigger.
- Buy canned vegetables or fruits.
- Peel vegetables or fruits. The OAS-causing protein is often found in the skin of the produce.
Over-the-counter (OTC) treatments
Diphenhydramine (Benadryl) and fexofenadine (Allegra) can be used to relieve the itching, watery eyes, and scratchy throat that come along with high pollen days when you have allergies. They can sometimes suppress OAS reactions as well.
Pre-medicating with antihistamines before eating these foods
People who were treated with immunotherapy for OAS have had mixed results. In a 2004 clinical study, participants could tolerate small amounts of the birch pollen triggers after immunotherapy. However, they couldn’t overcome OAS symptoms completely.
People who have allergies to birch pollen, grass pollen, and ragweed pollen are most likely to have OAS, according to the American College of Allergy, Asthma, and Immunology.
Young children aren’t usually affected by oral allergy syndrome. Often, young adults will have symptoms of OAS for the first time after having eaten trigger foods for years without a problem.
The tree and grass pollination season — between April and June — tends to be the peak time for OAS. September and October may bring on symptoms again as weeds undergo pollination.
In 9 percent of people with oral allergy syndrome, symptoms can become more severe and require medical assistance. If you have a reaction to a pollen-based food that extends beyond the area of the mouth, you should seek medical attention.
In some very rare cases, OAS can trigger anaphylaxis. In other cases, people may confuse their serious nut or legume allergies with oral allergy syndrome.
Make sure you speak to your doctor about the intensity and severity of your symptoms. You might need to be referred to an allergist to be certain that your symptoms are caused by OAS.