Tricking Your Immune System When Fresh Fruit Turns On The Itch

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Oral allergy syndrome can keep you from eating the fresh fruit you love. Grapes, apples, pears, peaches--any fruit with edible skin--can cause an itchy, swollen face. Rarely does it cause anaphylaxis, a condition that can quickly cause death. So how can you enjoy your favorite fruit when your immune system attacks at the first bite?

What triggers the allergic response might not be the fruit--directly.

The culprit that triggers oral allergy syndrome is usually hay fever. People allergic to birch trees, grass or ragweed pollen often find that certain fruit, vegetables, and nuts have similar proteins. Your immune system gets confused. You get symptomatic. An itchy tongue, mouth, and ears are common. Your lips might swell. Your throat might feel like it is closing up.

It's called cross-reacting. Oral allergy syndrome is also called pollen-food syndrome. Did you know that pollen contains protein? Pollen settles on the skin of fruit and can be absorbed with the fruit as it grows. So if you have hay fever in the fall and in the spring, your symptoms might be worse. You eat a raw apple during the spring or fall. Your immune system thinks the pollen and food proteins are attacking you. It sets out to defend your body against those attackers.

In OAS, an apple is not just an apple.

Apples are associated with the birch tree family of proteins. Peaches are associated with grass, and bananas with ragweed. The associations are what leads your immune system to react to the fresh fruit proteins. If the reaction affects more than one of your body's systems, you will likely need to carry epinephrine to counter the harsher reaction. Most of the time, OAS symptoms go away fairly quickly without escalating into anaphylaxis. So the question remains. Can you eat apples and peaches again without getting all red and itchy?

You can by tricking your immune system.

At least, usually you can. Peel and cook your fruit. Peeling removes pollen on the skin of raw fruit. By cooking the fruit, you change the structure of offending proteins. Most people suffering from OAS can eat apple pie or peach cobbler with little or no issues.

The final word on OAS: don't self-diagnose.

If fresh fruit is causing you oral allergy symptoms, get checked by an allergist. Only your allergist can tell you if you have OAS. Avoid eating raw or cooked fruit until your allergist says that it is safe to eat it. The reaction could have been a one time reaction or you could have a true food allergy. Once you know for sure, you can trick your immune system all you want with tasty pies and cobblers.

For more information, contact a professional like Mark Montgomery MD FACS with any questions you have.

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