Symptoms, causes, foods to avoid, etc.

If you have ever bitten into an apple and experienced itching, prickling, prickling, or swelling in your lips and mouth, you may have a condition known as oral allergy syndrome (OAS). ), also known as pollen food allergy syndrome.

OAS is the result of an allergic reaction to a protein in apples that is similar to a type of pollen found in birch trees. Therefore, if you are allergic to birch pollen, you may also be allergic to apples.

There are also allergies to apples linked to allergies to peaches and other foods due to similar proteins.

This article will explore the different types of apple allergies, common symptoms, treatments, and when to see a doctor.

Alright / Jiaqi Zhou

What is an apple allergy?

An apple allergy occurs when your immune system overreacts to apples and causes a reaction.

The severity of the reaction after eating an apple or foods containing apples can vary greatly from person to person. Symptoms can range from mild irritation or itching to a life-threatening emergency.

Some people with OAS only react to raw apples while others, especially those with apple allergies linked to peach allergies, may also react to all forms of cooked apples.

What Causes Apple Allergies

An apple allergy is caused by proteins in apples that disrupt the immune system.

It may be a direct response to apple protein or a shared allergic reaction in which the immune system mistakes apple protein for pollen.

All plants have pollen, that’s how they reproduce. Every pollen you encounter is different; it has a unique set of proteins. If you are allergic to a particular protein in birch pollen, you may have an allergic reaction to apples. This shared allergic reaction is called cross-reactivity.

In all types of apple allergies, the immune system reacts as if the proteins in apples are a threat.

Oral allergy syndrome

Oral Allergy Syndrome (OAS) is usually not a true allergy, but rather the body’s response to apple protein which it mistakenly believes to be pollen.

These shared reactions may also be linked to other fruit and nut allergies.

Very few people with OAS have a true allergy to the fruits or vegetables they eat.

Up to 50% to 75% of people allergic to birch pollen will react to raw apples or celery.

Apple allergy and other fruit and nut allergies

In addition to apples, other fruits, vegetables, spices, and nuts have similar cross-reactivity issues involving types of pollens, such as:

  • Birch: Apple, almond, carrot, celery, cherry, garlic, hazelnut, kiwi, peach, pear, plum
  • Ambrosia: Banana, cucumber, melon, sunflower seeds, zucchini
  • Mugwort: Celery, melons, oranges, peaches, tomato

If you bite into one, you may also have an allergic reaction (although milder and shorter than pollen allergy).

Another type of allergic reaction to apples is a true allergy to a protein in apples that is also closely related to a protein found in peaches.

These allergies tend to lead to more serious symptoms, such as hives, or even life-threatening emergencies, such as difficulty breathing.

Proteins for this type of allergy and OAS are also similar to other fruits and nuts, such as almonds or walnuts.

to sum up

Apple allergies are commonly linked to birch pollen allergies and other food allergies due to similar proteins that disrupt the immune system. People with a severe peach allergy may also have a severe apple allergy.

Symptoms of Apple Allergy

Symptoms of OAS are usually mild and limited to the mouth, lips, or tongue.

Symptoms of OAS often include:

  • Itchy, irritated mouth, tongue or throat
  • Red, slightly swollen lips, tongue or throat

Symptoms of OAS tend to be more startling than irritating and only last a few seconds or minutes until enzymes in saliva break down proteins.

People with OAS often have more severe symptoms during allergy seasons when their bodies are already struggling with airborne pollens.

For this reason, if you can otherwise tolerate raw fruits and vegetables and suddenly have a reaction, it may be because the pollen count is high.

People with a peach allergy are more likely to experience more pronounced apple allergy symptoms, such as:

  • Nausea or stomach pain
  • Abdominal cramps
  • Diarrhea
  • Eruption
  • Urticaria

Although these symptoms can also sometimes occur in people with VS. For example, nausea or stomach pain occurs in about 10% of people with OAS.

In severe cases, anaphylaxis, a life-threatening allergic reaction, can occur in people with an apple allergy. It is a medical emergency that requires urgent care.

If left untreated, anaphylaxis can lead to respiratory asphyxia (lack of oxygen), shock, coma, and even death.

When to call 911

Call 911 or seek emergency medical care if you develop any of these symptoms of anaphylaxis, a life-threatening allergic reaction:

  • Swelling of the face, tongue or throat
  • Wheezing
  • Shortness of breath
  • Vomiting
  • rapid heartbeat
  • Difficulty swallowing
  • Speech disorders


In many cases of OAS, medications are not needed since the symptoms of OAS usually resolve within minutes.

Allergic reactions limited to the mouth and lips can be treated with an over-the-counter antihistamine, such as Benadryl (diphenhydramine).

Antihistamines block the actions of histamine, a chemical released in response to an allergen that contributes to allergy symptoms.

Antihistamines can be used once the food is consumed. However, it is not recommended that antihistamines be used regularly as premedication for eating these fruits.

People with VS symptoms should opt for cooked or processed foods — which usually don’t cause symptoms — instead of relying on antihistamines.

If you experience an unexpected food allergy, you should be monitored for a few hours in case a more serious reaction follows. This is especially true if it’s the first time you’ve had a reaction.

If you have an apple allergy and severe hypersensitivity, your healthcare provider will likely ask you to carry an EpiPen (epinephrine auto-injector) with you in case of an emergency. An EpiPen can relax the airways and reverse the effects of severe allergic reactions.

to sum up

ODS often causes mild symptoms in the throat and mouth that go away quickly and may not need treatment. Sometimes an antihistamine is recommended.

People with severe apple allergies should always carry an EpiPen in case of accidental ingestion.

Foods to avoid if you are allergic to apples

If you are allergic to apples, you may also have reactions to certain other fruits and nuts and may need to avoid them.

Those that cause reactions can vary from person to person and can include:

  • The Peach
  • Pear
  • Cherry
  • Apricots
  • Plum
  • Strawberry
  • Nectarine
  • Banana
  • Melons
  • Celery
  • Carrots
  • Hazelnut
  • Almonds
  • Nuts
  • Soy

If you have OAS and you cook or process apples by baking, boiling, or drying, the proteins often break down and your body may become unresponsive to them.

The same is true for any other fruits, vegetables, spices or nuts with a slight cross-reactivity. However, it does not matter whether you choose an organic or non-organic product, an allergy will occur anyway.

Dealing with Apple Allergies

Managing an apple allergy may simply require avoiding apples. Sometimes it’s just raw apples and other times it’s apples in a raw, processed, or cooked form.

When to consult a doctor

If you think you have an apple allergy or have an OAS that seems to be getting worse, see your doctor.

They can help you determine next steps and whether to carry medication whenever you accidentally eat apples or other trigger foods.

If you ever experience symptoms of anaphylaxis, seek emergency medical attention.

Outlook and prevention

The best preventative measure to avoid symptoms is to avoid trigger foods.

If your allergy is severe, always carry an EpiPen with you and check that ingredients, such as pastries and snacks, do not contain apples (and peaches, if you are allergic to both).


If you are allergic to apples, your immune system reacts to apple proteins as a threat. Symptoms vary greatly from person to person and can be mild to severe.

Oral allergy syndrome usually causes mild symptoms in the throat and mouth that quickly resolve. If you are allergic to birch pollen, you may experience OAS because your immune system mistakes a protein in raw apples for pollen.

There are also proteins in apples and peaches that your immune system can identify as an allergen. These apple allergies tend to lead to more severe, even life-threatening symptoms after eating any form of raw or cooked apples.

A word from Verywell

If you have experienced oral allergy symptoms, you should know that pollen is not the only allergen linked to OAS. Latex allergies, which affect about 5% of people, are associated with allergies to avocados, bananas, chestnuts, kiwis and papayas.

If you are allergic to apple cider or apple cider vinegar but not the raw apples themselves, you may be allergic to brewer’s yeast, a byproduct of fermentation, as opposed to OAS.

Frequently Asked Questions

  • What fruits are safe to eat with oral allergy syndrome?

    Even if you have oral allergy syndrome, you may be able to eat any fruit you want if you wash it thoroughly, heat it, or remove the skin before eating. The proteins that cause the reaction are usually very concentrated in the skin of the fruit.

  • How common is oral allergy syndrome?

    ODS is very common, with about 1 in 3 people with seasonal allergies experiencing symptoms. The numbers could be even higher as the condition is usually undiagnosed.

  • Why am I suddenly allergic to apples?

    It is possible to develop a food allergy at any time in your life.

  • How common is apple allergy?

    It’s unknown, but some studies estimate that up to 5% of people may have food allergies related to pollen allergies, specifically a cross-reaction between birch pollen and apple.

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