Advanced Allergy & Asthma Family Care

Oral Allergy Syndrome


Oral Allergy Syndrome (

Oral Allergy Syndrome is a term used to describe itchy or scratchy mouth symptoms caused by raw fruits or vegetables in people who also have hay fever. Symptoms are typically limited to the mouth. This reaction is caused by an allergic response to the pollen that crosses over to similar proteins in the foods. Most people affected by oral allergy syndrome can eat cooked fruits or vegetables because the proteins are sensitive to heating. The condition is also known as pollen-food syndrome.


Older children, teens, or young adults; typically patients have been eating the implicated foods without problems for many years.

Relation to hay fever

Hay fever is usually present before oral symptoms (seasonal allergy to pollens) to foods begin.


Limited to itchy mouth and throat with occasional itchy ears and swelling of the lips; never generalized!

Difference between raw and cooked foods

Symptoms are caused by raw fruits or vegetables; cooked or canned foods and juices are tolerated.


Symptoms resolve usually within minutes after the food is swallowed or removed from mouth, and treatment typically is not necessary.

Common pollen-food associations*

  • Birch: apple, carrot, peach, plum, cherry, pear, almond, hazelnut
  • Grasses: tomato
  • Ragweed: melons, zucchini, cucumber, kiwi, banana

* These are potential associations. Not every patient allergic to pollen develops symptoms with cross-reacting fruits or vegetables. Patients may react to a few but not all of the above.

Alder pollen: almonds, apples, celery, cherries, hazel nuts, peaches, pears, parsley

Birch pollen: almonds, apples, apricots, avocados, bananas,[10] carrots, celery, cherries, chicory,[11] coriander, fennel, fig,[12] hazelnuts, kiwifruit, nectarines, parsley, parsnips, peaches, pears, peppers, plums, potatoes, prunes, soy, strawberries, wheat; Potential: walnuts

Grass pollen: fig,[12] melons, tomatoes, oranges

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

Ragweed pollen : banana, cantaloupe, cucumber, honeydew, watermelon, zucchini, echinacea, artichoke, dandelions, 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

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