David L. Katz, MD
Photo: Mackenzie Stroh
Q: I have oral allergy syndrome, and most raw fruits and vegetables set it off. Any advice—beyond cooking all my produce?
— Amy Kratochvil, Wind Lake, Wisconsin

A: Though not many people have heard of oral allergy syndrome (OAS), it affects up to 70 percent of those with pollen allergies. The reaction is a crossover: The body confuses proteins in fruits and vegetables with those in pollen. If you're allergic to ragweed, for example, then bananas, melons, or cucumbers may trigger OAS.

The condition tends to be more severe during allergy seasons—usually spring and fall. For most people, symptoms are mild: transient tingling, itching, or other irritation on the lips or tongue or in the throat. Swelling may occur as well, but it typically subsides within a few minutes.

However, a small percentage of people with OAS may experience more severe reactions, such as hives; some may even be vulnerable to a life-threatening allergy attack known as anaphylaxis.

Although avoiding the irritating fruits and vegetables is the best way to stay out of trouble, many people find relief by peeling or—as you mention—cooking the food. Heat "denatures" offending molecules, and they no longer resemble those in the precipitating pollen.

If peeling or cooking doesn't do the job, you can try taking allergy medication such as antihistamines before eating a problem food. If your symptoms are severe, allergy shots can help reduce reaction to the original pollen sensitivity.

Or you could try another approach, known as sublingual immunotherapy: A doctor places extracts of allergens under the tongue and achieves results similar to those of allergy shots but with fewer adverse reactions. This method is not yet approved by the FDA, but it is offered by many allergists. And there is even hope of using the problem food itself as the cure. In a recent study at Duke University, children with peanut allergies received tiny doses of peanuts by mouth to desensitize them. With one of these options, you may yet, along with T.S. Eliot, dare to eat a peach.

David L. Katz, MD, is director of the Yale-Griffin Prevention Research Center and president of the nonprofit Turn the Tide Foundation.

As a reminder, always consult your doctor for medical advice and treatment before starting any program.

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