Spring is just around the corner! Trees, plants, and flowers are beginning to grow and bloom. Fruits and vegetables are light, fresh, and crisp just like the spring air. However, that fresh spring air may carry more than just excitement for the season and oral allergy syndrome may give cause for concern.

Oral Allergy Syndrome

If you have seasonal allergies, spring may be associated with discomfort. Unfortunately, many people with seasonal allergies also suffer from oral allergy syndrome, sometimes called pollen food allergy syndrome. This syndrome occurs when there is a cross-reaction between the similar proteins found within certain types of foods. These foods, such as fruits, vegetables, and some nuts, can have similar allergy-causing proteins on the surface of the pollen grain.

Cross Reactivity

During the spring season, cross reactivity with tree pollen causes oral allergy syndrome. Birch pollen is the most common allergen trigger. According to the American Academy of Allergy, Asthma, and Immunology (AAAAI), oral allergy syndrome can occur in up to 50% – 75% of adults with a birch tree pollen allergy. Symptoms can occur when consuming a wide variety of foods, including those listed below:

  • almond
  • hazelnut
  • carrot
  • kiwi
  • soybean
  • peanut
  • celery
  • potato
  • apples
  • apricots
  • peaches
  • pears
  • plums
  • nectarines

Similarly, another common tree pollen, cedar, can also trigger oral allergy syndrome. Cedar allergy sufferers may have symptoms with several fruits and vegetables, including:

  • apples
  • cherries
  • bell peppers
  • kiwi
  • tomatoes

Symptoms and Treatment

Typically, if you have an oral allergy syndrome reaction you may experience itching in the mouth and throat. Symptoms tend to be more severe when the food is eaten raw or in the purest form. Peeling, cooking, canning, or baking the food can be helpful in reducing or completely avoiding the symptoms in some individuals.

In most cases, symptoms of oral allergy syndrome are localized to the mouth and are uncomfortable or annoying. However, up to 9% of people have reactions that affect a part of their body beyond their mouth. About 1.7% can suffer a life-threatening allergic reaction or anaphylaxis. For this reason, it is crucial for people to determine the cause of their symptoms. Allergy testing and food journals along with medical advice from your healthcare provider are recommended. It is usually best to avoid eating the offending food, especially in that food’s peak allergy season. Another consideration would be to treat the underlying pollen allergy with immunotherapy.



Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and immunology. 

United Allergy Services is also on FacebookLinkedIn, or Twitter.