Fruit allergy

A fruit allergy is a type of food allergy. Food allergy occurs when the body’s immune system wrongly identifies a food as a threat. When this happens, the body releases chemicals, such as histamine, in response. It is the release of these chemicals that causes the allergic symptoms.

There are different types of allergy to fruit, including pollen food syndrome, latex food syndrome and an allergy to lipid-transfer protein (LTP).

You can also read about allergy to vegetables.

Pollen food syndrome usually occurs in people with hay fever who are allergic to pollens. It can cause allergic reactions when you eat certain fruits or vegetables. This is because the proteins in pollen are similar to the proteins in the fruits and vegetables.

Symptoms are usually mild and may respond to antihistamines, but speak to your doctor to make sure this is the right treatment for you.

Symptoms of pollen food syndrome usually include:

• redness, mild swelling or itching of the lips, tongue, inside of the mouth, soft palate and ears
• itching and mild swelling of the throat
• occasionally, symptoms involve the oesophagus (food pipe) or stomach, such as abdominal (tunny) pain, nausea and vomiting
• sneezing, runny nose, or symptoms affecting the eyes

More serious symptoms are often referred to as the ABC symptoms and can include:

• AIRWAY – swelling in the throat, tongue or upper airways (tightening of the throat, hoarse voice, difficulty swallowing).
• BREATHING – sudden onset wheezing, breathing difficulty, noisy breathing.
• CIRCULATION – dizziness, feeling faint, sudden sleepiness, tiredness, confusion, pale clammy skin, loss of consciousness.

The term for this more serious reaction is anaphylaxis (anna-fill-axis).

In extreme cases there could be a dramatic fall in blood pressure. The person may become weak and floppy and may have a sense of something terrible happening. This may lead to collapse and unconsciousness and, on rare occasions, can be fatal.

Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves the ABC symptoms. Read more about anaphylaxis.

Serious symptoms are unusual because the proteins that cause the allergy are unstable and are destroyed with heat or once they reach the stomach. Most people with pollen food syndrome have allergic reactions if they eat the raw fruit, but are able to eat the cooked fruit without any problem.

Many people with pollen food syndrome who react to fruit also react to raw soya products such as soya drinks, soya yoghurt and raw tofu. The first sip or mouthful of a soya product doesn’t tend to cause symptoms quickly so people eat or drink the whole portion. Reactions can then be severe due to the amount consumed and, in rare cases, can lead to anaphylaxis.

Not everyone with pollen food syndrome will be allergic to soya, but if you have pollen food syndrome, be careful about eating or drinking large quantities of soya for the first time. For example, avoid drinking a whole soya milk shake in one go if you haven’t tried it before. A serious reaction is unlikely but if you develop any of the ABC symptoms, treat it as anaphylaxis. Read more about what to do in an emergency.

If you think you may be allergic to a fruit, see your GP who can refer you to a specialist allergy clinic if needed. They can find a clinic in your area from the British Society for Allergy and Clinical Immunology (BSACI).

It’s important to get a referral even if your symptoms were mild because it can be hard to tell if future allergic reactions could be more serious.

Once you get a referral, the consultant will discuss your medical history and symptoms with you. They might suggest skin prick, blood tests, and food challenge tests to help diagnose the allergy and work out how serious it may be. Read more about allergy testing.

Some clues that you might be at higher risk are:

• you have already had a serious reaction, with any of the ‘ABC’ symptoms
• you have asthma, especially if it is not well controlled
• you have reacted to a tiny amount of the food.

• If you have symptoms after eating fruit, visit your GP.
• If you are prescribed AAIs, carry them with you at all times.
• Always be guided by your allergy specialist as to which foods you should avoid.
• Ensure that asthma is well managed. See your GP about this.