Unusual Food Allergies

Q: I cannot eat cold or room-temperature fruits or vegetables with seeds. If I do, my throat swells, my tongue swells, my ears severely itch and it is almost impossible to breathe. I developed these food allergies three years ago when I was seven months pregnant. Were these allergies caused by my pregnancy? I can’t eat these healthy foods and I’ve gained 30 pounds since my delivery. What do I do?

A: Your symptoms suggest a reaction known as the oral allergy syndrome. It is not caused by pregnancy, but by an allergy to certain proteins contained in those room-temperature fruits and vegetables. While symptoms are usually limited to the face and mouth, the allergic response has the potential to be more widespread and severe. Given the difficulty in breathing that you have experienced, I would highly encourage a prompt visit to an allergy and asthma specialist. In the meantime, if those symptoms reoccur, please go to an emergency room right away.

The majority of people with oral allergy syndrome to uncooked fruits and vegetables experience symptoms within minutes of contact with their lips, mouth or throat. Reactions vary and range from very mild to potentially severe. These include:

• Mild tingling in the lips or mouth.
• Burning, itching and redness of the tongue, mouth and lips.
• Itchy rash that may blister inside the mouth, on the lips or tongue.
• Sneezing, runny nose, itchy eyes and face.
• Swelling of the lips, tongue, mouth and throat (basically anywhere the fruit or vegetable touched).
• Difficulty swallowing.
• Wheezing and breathing difficulties.
• On rare occasions, the allergic reaction may progress to anaphylaxis. This is potentially life-threatening.

You may also have seasonal pollen allergies. The majority of those with oral allergies limited to fruits and vegetables also have an allergy to any one, or combination of pollens (ragweed, grass, others). This is known as the food-pollen syndrome and results from an allergic “cross-reaction” between allergy antibodies against pollen proteins with similar proteins found in some fruits and vegetables. Although a number of pollen allergies are connected to this condition, I will list the top four, as well as the fruits, vegetables, spices and seeds that may cause the crossover allergic reaction.

If you have:

• Ragweed allergies: Symptoms may be triggered when eating a banana, cucumber, melon (watermelon, honeydew or cantaloupe), zucchini, sunflower seeds, or drinking chamomile tea or taking echinacea.
• Birch tree pollen allergies: Symptoms may trigger if eating a pear, apple, peach, cherry, carrot, plum, pears, apricot, potato, celery, kiwi, hazelnut or almond.
• Mugwort (weed) allergies: Eating celery, apple, carrot or melon, may bring on symptoms, along with the spices anise, fennel, coriander and cumin.
• Grass allergies: Symptoms could appear when eating oranges, melons, tomatoes, potatoes, kiwis or peanuts.

I also need to mention another possibility, the latex-fruit syndrome. While triggering symptoms similar to those of the pollen-food syndrome, the latex-fruit syndrome is an allergic response to specific proteins present in latex. And since similar proteins are also contained in certain fruits, vegetables, nuts and spices, touching or eating them may cause a reaction. These foods or spices include but are not limited to: almonds, apples, bananas, kiwis, raw tomatoes or potatoes, as well as spices such as dill, oregano, ginger or sage.

The fact that only cold or room-temperature fruits and vegetables trigger your symptoms is important because many can eat these very same foods safely if they’re cooked, baked or processed. That’s because those heating methods inactivate proteins that trigger the allergic reaction. However, there’s a caveat here: You have experienced a more significant reaction leading to difficulty breathing. Anybody with this type of severe reaction should get clearance and a full medical evaluation by their physician or allergy/asthma specialist before attempting to eat the foods that caused the allergic response. They may even ask you to carry a medication known as epinephrine just in case your allergic response leads to a more serious reaction.

Consulting with a registered dietician may do wonders for your waistline, as well as improve the nutritional value of the foods you put into your body. For further information on food allergies, please go to the American Academy of Allergy, Asthma and Immunology.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)