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Oral Allergy Syndrome

 

Since it is National Allergy Awareness Week, I thought I would bring to a light a less commonly talked about or even known about allergy, one that I have suffered with my entire life only in recent years understanding what the heck was actually wrong with me.

oral allergy syndrome

As a little girl, I often felt like my teeth would itch when I ate peaches, sometimes carrots and always apples (especially Red and Golden Delicious).

And the apples would not only make my teeth itch but my lips and mouth would feel weird leading down into my throat with a heavy feeling in my chest.

I couldn’t even cut up an apple for my son because somehow I would touch my face without washing my hands first and my eyes would swell up requiring Benedryl. Who thinks to wash their hands after slicing an apple?

The interesting part was that if the apples were cooked in a pie, if the peaches were canned in light syrup, I had no issue eating them.

It made no sense and when I tried to explain these little facts to my family, doctors and friends, people just thought I was insane and left it at that.

A few years ago I learned about Oral Allergy Syndrome and my life suddenly made sense.

Oral allergy syndrome or OAS is a type of food allergy classified by a cluster of allergic reactions in the mouth in response to eating certain (usually fresh) fruits, nuts and vegetables that typically develops in adult hay fever sufferers.

Welcome to my reality! I am allergic to tree pollen, specifically Birch and Alder so finally, my raw fruit and vegetable allergies made sense.

OAS is perhaps the most common food-related allergy in adults. OAS is not a separate food allergy, but rather represents cross-reactivity between distant remnants of tree or weed pollen still found in certain fruits and vegetables.

Because the allergenic proteins associated with OAS are usually destroyed by cooking, most reactions are caused by eating raw foods. The main exceptions to this are celery and nuts, which may cause reactions even after being cooked.

The most common reaction to uncooked fruits and vegetables (and some nuts) is an itching or burning sensation in the lips, mouth, ear canal, and/or pharynx.

Sometimes other reactions can be triggered in the eyes, nose, and skin. Swelling of the lips, tongue, and a sensation of tightness in the throat may be observed.

It can seldom result in anaphylaxis.

Allergies to a specific pollen are usually associated with OAS reactions to other certain foods:

Alder Pollen: almonds, apples, celery, cherries, hazel nuts, peaches, pears, parsley, strawberry, raspberry

Birch Pollen: almonds, apples, apricots, avocados, bananas, carrots, celery, cherries, chicory, coriander, fennel, fig, hazel nuts, kiwifruit, nectarines, parsley, parsnips, peaches, pears, peppers, plums, potatoes, prunes, soy, strawberries, wheat – potential: walnuts

Grass Pollen: fig, melons, tomatoes, oranges

Mugwort Pollen: carrots, celery, coriander, fennel, parsley, peppers, sunflower

Ragweed Pollen: banana, cantaloupe, cucumber, green pepper, paprika, sunflower seeds/oil, honeydew, watermelon, zucchini, Echinacea, artichoke, dandelions, honey, hibiscus or chamomile tea

Possible cross-reactions to any of the above: berries (strawberries, blueberries, raspberries etc.), citrus (oranges, lemons etc.), grapes, mango, figs, peanut, pineapple, pomegranates, watermelon

 

As I have gotten older, I have developed more sensitivities on the oral allergy spectrum.

Or, it is quite possible that since I am no longer a picky eater, I am learning what I can and cannot eat.

Most birch pollen fruits such as peaches, pears, plums, grapes, sometimes cherries…As for vegetables, celery can bother me, carrots only on occasion, raw peapods in a vegetable tray and even edamame if it isn’t super super cooked.

Nuts are interesting. I have learned to avoid raw walnuts and almonds. In fact, I can’t even eat raw peanuts.

Thank goodness I can consume peanut butter. I don’t know what I would do if I couldn’t.

Candied or roasted walnuts are pretty much safe and symptom free for me but over time I am figuring out to avoid almonds at all costs.

I can eat cookies and things that have almond paste involved but actual pieces of nuts or anything with almonds as the first or second ingredient gives me that heavy feeling in my throat which I really don’t enjoy and to be honest, sometimes scares me.

You see me eat apples quite often and must be wondering what gives.

granny smith apples

Here’s the situation – when it comes to Granny Smith apples or even Pink Lady, as long as I eat them on a regular basis, I can tolerate them without issue. It’s like a desensitizing of some sort.

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On rare occasion, they will bother me but for the most part, I am good especially if I warm the apples first which we know I love.

Lately I am noticing more fruits being added to the I really shouldn’t consume this list. Pineapple, watermelon and maybe even strawberries; I really don’t wish to talk about it.

A few years ago I discovered that I could eat apples and other raw fruits like a normal person (meaning no itching in mouth or heaviness in throat) while I was taking Zyrtec for hay fever.

It makes sense actually since Zyrtec treats your symptoms associated with seasonal allergies which is the same pollen the body reacts to in the  raw fruits and vegetables.

I don’t advise taking allergy medication just to be able to eat things even though I have been known to do it. It doesn’t remove the problem, it just treats the symptoms. Your body is still reacting, you just don’t notice.

As a fruit and vegetable lover and especially a vegetarian, this is not the allergy to have.

Even though OAS seldom causes anaphylaxis, you just never know which time the triggering food  will affect you worse than just irritating your mouth, especially the nuts.

It isn’t easy to see everyone else giving up dairy milk in favor of almond milk, using almond meal in their baking recipes and adding walnuts and almonds to their snacks for the healthy fats because I can’t.

However, this just gives another example of how different we all are and how we must customize and tailor our lifestyles according to our own bodies.

And really, I am just grateful to be able to eat peanut butter.

Click here for more information about Oral Allergy Syndrome.

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Anyone else have this allergy?!?!?

What are you allergic to?

Do you eat things that sometimes you know you shouldn’t?

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  • jill conyers May 13, 2014, 6:26 am

    Interesting. I’ve never heard of OAS.
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  • Tina Muir May 13, 2014, 7:26 am

    Wow! How interesting! I had no idea that even was an allergy, but that doesnt sound like too much fun. Itchiness is the worst…..I remember a few years ago my feet got really cold one winter, and I got chilblains, the itchiness at night made me want to rip the skin off my toes. It drove me crazy. I cannot even imagine how annoying it would be to have an itchy mouth or teeth!

    I have allergies around this time of year, but not too bad really. I consider myself pretty lucky 🙂
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  • Shashi @ RunninSrilankan(dot)com May 13, 2014, 7:53 am

    I wasn’t familiar with OAS – but am now!
    Other than being lactose intolerant, I am not allergic to any foods – so glad you can at least eat PB!!!

  • Susie @ SuzLyfe May 13, 2014, 8:17 am

    That is crazy! I actually didn’t know much about this, so thank you for sharing! I have environmental allergies, and I break out in a lacy rash from sulfa products. I have had allergic reactions to things from time to time over the years, but never like this! I’m very lucky in that regard.
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  • Amanda @ .running with spoons. May 13, 2014, 9:11 am

    You learn to get by without peanuts… just saying 😛 I don’t -think- I suffer from OAS, but then again I seem to be developing more sensitivities as I get older, especially surrounding fruits… which is annoying since they’re basically my favourite thing ever! Sometimes I wish I could just ask my body what the heck it doesn’t like instead of trying to figure it out on my own. It’s way too much of a guessing game.
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  • Davida @ The Healthy Maven May 13, 2014, 10:52 am

    This was actually fascinating especially because you should made my reaction to strawberries and almonds SO CLEAR! I am highly allergic to alder (my arm swelled up from that prick). Fortunately I haven’t noticed a reaction to anything else and it’s more that my throat feels tight and my gums swell so it’s tolerable. Plus I take prescription allergy meds from my heat allergy (I know, WTF) so Im usually good to go as long as I remember to take them 🙂
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    • The Cookie ChRUNicles May 13, 2014, 3:06 pm

      Isn’t Oral Allergy Syndrome fascinating? I loved learning the connection between the foods and pollens…And I love that taking allergy medication really can minimize the symptoms for the most part, except for the almond thing for me. No almonds.

  • Helen May 18, 2014, 9:18 am

    I also have OAS. Like you, I am allergic to alder and birch. Worst for me are Hazelnuts, peaches, and nectarines (Which i can’t eat at all without intense itching), but more recently also cherries (soo sad about those), plums, kiwis and apples. Kiwis and certain kinds of apples are ok though, and I eat them all the time. As for you, fruit are ok, as long as they are cooked.

    • The Cookie ChRUNicles May 18, 2014, 11:32 am

      Isn’t it funny how some apples are OK and some are totally off limits? I won’t touch a Red or Golden Delicious and during the fall apple season, most of them are complete no-no’s even my granny smith’s sometimes will cause an issue. I do find that Zyrtec totally helps me to eat without symptoms but I don’t advise it since some reactions can really be severe….Cherries can bother me too, usually if it is the first I have had for the season. The frozen cherries are fine though!

  • Adrienne May 18, 2014, 9:20 am

    My daughter (16) was just diagnosed with this two years ago! And like you-she can tolerate peanut butter but only on sandwich a day. No more.
    She did stop breathing after two bites to a pear. We had no idea what was going on. It was scary.
    It is hard to explain to people when they see her eating my homemade applesauce. But-we have tried to leave it chunky but it caused a reaction. It has to be cooked right down. It has been hard to balance her diet but she seems to be doing well.

    • The Cookie ChRUNicles May 18, 2014, 11:37 am

      Wow. That is scary. That’s the thing with this – you just never know which apple or pear will be more pollenated and more potent than the last one you ate just fine. I should avoid more of the fruits than I do but I get stubborn. Taking Zyrtec has really helped me but I don’t advise it for other people because reactions can be serious and you just never know. I do avoid the raw walnuts and almonds though because they give me the most reaction in terms of the breathing.

    • The Cookie ChRUNicles May 18, 2014, 11:37 am

      Wow. That is scary. That’s the thing with this – you just never know which apple or pear will be more pollenated and more potent than the last one you ate just fine. I should avoid more of the fruits than I do but I get stubborn. Taking Zyrtec has really helped me but I don’t advise it for other people because reactions can be serious and you just never know. I do avoid the raw walnuts and almonds though because they give me the most reaction in terms of the breathing.

  • Nikki May 18, 2014, 2:19 pm

    Hi! I came across your blog as I was trolling/exploring bloglovin. I saw runningwithspoons had a link party or link up (not sure which) and listed your post. It totally drew my attention because I have OAS and EOE. I am allergic to almost anything airborne. In regards to food my main culprits are soy, eggs, chicken, oats, peanuts, tree nuts, garlic, onion, and then a laundry list of foods I should only consume in very limited amounts. I am glad you still get to enjoy peanut butter! I can’t unfortunately, even when foods are cooked I still have issues.

    Potatoes are my favorite veggie – love all forms of potatoes! Although I react quickly to potatoes and it aggravates my EOE I still savor them when I can. I just try to be more vigilant with everything else to avoid trips to the ER!

    Do you share allergy-free recipes? I am always looking for ideas. It’s hard having to avoid soy and eggs and gluten.

    Thanks for the post! I didn’t realize last week was allergy week…but I always enjoy connecting (even virtually) with someone who can relate to awful allergies!

    Nikki

  • Nikki May 18, 2014, 2:25 pm

    Anddddd…..as I click on your homepage I see yes, you do in fact share recipes. 🙂 Scratch that q!
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    • The Cookie ChRUNicles May 18, 2014, 3:57 pm

      I cannot even imagine what it is like for you to have OAS plus the severe airborne allergies to most foods. So rough, I am so sorry. I can still eat my peanut butter but I can’t do anything almond which is an issue in blog land lol. I don’t focus so much on allergy friendly recipes since my son has no allergies and I only have to avoid the raw fruits but for the most part, I don’t cook or share recipes with nuts. Nothing I make involves almonds and since I am vegetarian, I do a lot of things without eggs so I will totally consider some recipes going forward with allergy needs in mind.

  • Sarah May 18, 2014, 6:07 pm

    For the past several or so years I’ve said I am allergic to avocados because when I eat them it makes me throat tighten up. I think I read into OAS sometime ago but forgot it.

    It makes sense! But the only food listed above that gives me that trouble is avocados. How weird!

  • Jan May 25, 2014, 11:54 am

    I have always thought I had actual allergies to some of the foods you list; bananas, cantaloupe and watermelons. When I was a kid I would get that itchiness in my ears when I ate them and then I would get a stomachache. I also had tremendous airborne allergies and was finally tested and ragweed was my big offender. I cannot remember about the trees you mention. But considering almost everything they tested me for was positive in varying degrees I suspect they were on the list as well.

    I found your blog as I was googling around for info on a rash that got me a few days ago and will not abate (on my chest and neck). It started the morning after I drank a bunch of Lemon Zinger tea the evening before. I notice that the first ingredient in the list is hibiscus. It never occurred to me it could possibly be the tea. I have drunk it the last 3 days. I am taking Benadryl and Zyrtec ( take Zyrtec every single day to keep my airborne allergies in check) plus Benadryl cream on it. Nothing seems to help.

    Any suggestions on how to calm it? And does anyone think it could be the tea?
    Thanks! – Jan

    • The Cookie ChRUNicles May 25, 2014, 12:20 pm

      While I am not a doctor, I wouldn’t be surprised if it was indeed the tea. I know the OAS list mentions chamomile as a possible allergy but I am sure hibiscus could be an issue too. I actually can’t drink any tea all that well without feeling dizzy, especially Green tea. I have never found an exact cause -if it’s an allergy or just a blood pressure issue, regardless, I just don’t drink it anymore…I am dealing with a faint rash on my back (no itching) at the moment (actually for quite some time) that does not itch but is definitely from something I am eating, most likely a fruit which I can’t pinpoint. I have learned that it takes a good 10 days for something you ate to leave your system so it is possible your rash will not fade until then. You may want to stop drinking that tea to see if it makes a difference. Have you eaten anything else different?

      • Jan May 25, 2014, 12:37 pm

        Thanks for the quick reply, Cookie! I am definitely not drinking any more of this tea! No food changes that I can think of. The only herbal tea I avoid is chamomile as I know it is in the same family as ragweed. Although I must say, any black tea variety will give me stomach distress if I drink more than one cup.

  • Kate Logan November 21, 2014, 2:55 pm

    I have a nut allergy so too bad for I can’t have peanut butter. Allergy Easy

  • Shawna March 11, 2015, 7:21 am

    I really really feel for you with the OAS. I just came across your blog from the recipes over to this, and read up on it for the first time.
    I can relate on to the extent of food allergies or intolerances… But due to other health reactions. It is extremely frustrating to be unable to have basic things and hard to explain to people (sometimes I say that I “don’t like” the item rather than trying to explain a reaction and being /feeling judged / misunderstood). Does that happen to you – especially with someone you just met or don’t know on a personal level? I find it awkward or embarrassing at times (esp if someone offers smacks, beverage, or cooks dinner!). How do you deal with this?
    I have a long list, and can’t remember all of them at once, but here are a few that come up frequently: green tea, caffeine, spicy food (have not identified which spice/s), red wine, chocolate in most forms (I can tolerate a little bit, and I may be able to get away with eating small candy from Cadbury, but NO American chocolate brands, and VERY sadly, NO cocoa powder at all – which is challenging with smoothies!!), orange juice (but I can eat one fresh cut orange), NO daily MIXED vitamins But some individual vitamins are okay with sensitivities/reactions to many vitamins and supplements, tomatoes cooked (but can have a little if raw), anything with potassium or vitamin C added, and others (sorry to write so much).
    While some of these are just challenging in and of themselves, (such as cocoa powder because I crave chocolate sometimes but don’t know how else to get it into a healthy smoothie), the social issue of varied severe “allergies” or severe reactions to certain unrelated foods is not something people understand, and sometimes I wonder if they believe me! Or judge me?! Would love to know how others deal with explaining or avoiding on various social settings… (for example, not really a good thing to mention on a first date… Or second, third..?).

    • The Cookie ChRUNicles March 12, 2015, 6:38 am

      Do you have oral allergies? Mine really aren’t that severe so I don’t really have to mention them when out with people. If it comes up, I do say I can’t eat certain apples because they make my mouth feel funny. I just laugh about it because it’s kind of funny and true. My nut allergies are minor – I don’t have to worry if they are in foods when I am out but I avoid raw nuts if possible. I think people should understand since most of society has some sort of allergy these days!

  • Cate July 28, 2015, 7:22 pm

    Really liked your post on this. Just wanted to point out to you and all the readers about why this happens to us. I found it really interesting when I found out and thought I’d share 🙂 Since pollen comes from trees, and so do fruits (and nuts are considered ‘ fruits’ to plants), they share really similar proteins. For example, the birch pollen that I, like you, am extremely allergic to is called Bet v 1. This protein is about 70% similar to the structure of those found in all the allergenic foods that go along with birch; carrots, melons, etc. So our body is not reacting to pollen ON the fruit, but the proteins inside the fruit because our bodies think (since they’re so similar) that you’re basically eating birch pollen when you’re eating that fruit.

    Sorry to go all science nerd on you 🙂 I just find it really interesting.
    Have you ever experimented with using cooked fruit in smoothies? I can’t have any raw fruit at all anymore, and I was thinking of cooking them for a short time maybe in the microwave, and then refreezing them to make a smoothie out of. That’s one thing I miss sooooo much.

    • The Cookie ChRUNicles July 29, 2015, 4:49 pm

      Thank you for this comment. I am actually doing much better, better than ever I suppose, when it comes to my allergies. Becoming a vegetarian eliminated 99.9% of my seasonal allergies to pollen and I no longer need zyrtec or any other medicine. I am able to eat raw fruit without a reaction and the raw vegetables without a reaction almost every time. Walnuts and almonds are still iffy but not bad like it was.

  • Lisa August 7, 2015, 2:04 am

    Hi- I came across this as I was searching for lists of foods that can’t be eaten with allergies to Alder and Birch. I was diagnosed with OAS two days ago. I almost passed out after eating a piece of cake with slivered almonds on it. Growing up, I had hay fever and over the years noticed itchiness with apples, pineapple, nuts, etc… but it was only a problem if they were raw. Now, it seems that even roasted or cooked are a problem. I was given a list of foods to avoid for 5 days, and cucumber was not on it, but tonight, after eating raw cucumber, my ears and throat became itchy. I am afraid to eat anything, b/c I don’t want to pass out again! ( I also have really low blood pressure, so any reaction makes my pressure drop even more) My doctor recommended starting immunology injections. Biweekly shots that are supposed to make my body resistant to the allergens. Have you ever done this? Do you know anyone who this has worked for? You said you became vegetarian, but there are so many vegetables and fruit I react to… I feel like meat and cheese are the only things I can eat! 🙁

    • The Cookie ChRUNicles August 7, 2015, 5:07 am

      Hi! I am so sorry you have to deal with OAS. I never had injections or any kid and don’t know anything about it at all so I can’t really advise on it. I did take zyrtec for years which minimized my food allergies enough to keep me eating my favorite apples every day. Sometimes I noticed allergies even with zyrtec so it is not fool-proof. However, I don’t really suffer anymore. I stopped taking zyrtec a while back and noticed most allergies are nonexistent which coincides with my lack of hay fever as well which I do attribute to becoming a vegetarian and being mostly plant-based. I do not have vegetable allergies (only raw carrots and celery sometimes) so vegetarian works for me. It’s a known thing that animal protein can stress the body and cause allergies but I understand if this isn’t a diet option for you. I have low blood pressure too and I can relate to the almond allergy (although mine thankfully was never severe enough for me to pass out but I have gotten dizzy). I am not really sure how to effectively advise you other than tell you to listen to your doctor and avoid what you can for now. If there are nutrient dense foods you aren’t sensitive to, that aren’t on the birch/alder list, I recommend eating them because I do believe in the power of the antioxidants and health benefits associated with fruits/vegetables/plantbased proteins and how they relieve stress in the body which can help with the allergies.

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