LTP allergy is a type of food allergy. Food allergy happens when the body’s immune system wrongly identifies a food as a threat. When this happens, the body releases chemicals such as histamine in response. It is the release of these chemicals that causes the allergic symptoms.
Most LTPs are in the peel and pips of plant foods. Whilst fresh or raw foods can cause a reaction, the following foods are likely to contain higher levels of LTPs as they contain the peel and pips.
If you are diagnosed with LTP allergy, you only need to avoid the foods which cause your symptoms. Not all LTP-containing foods will cause an allergic reaction for you and it’s important not to cut them out of your diet if you don’t need to. You may be able to tolerate certain foods if they are peeled or the pips have been removed. Discuss this with your allergy specialist and follow their advice.
Unfortunately, the amount of LTP in foods may vary so it can be hard to predict when a reaction may happen. Common foods involved in LTP allergy in the UK include:
Reactions to LTPs can happen after eating raw, cooked or processed foods. The symptoms are not usually immediate but typically appear within 30 minutes of eating.
Mild to moderate symptoms may include:
The term for this more serious reaction is anaphylaxis (pronounced ana-fil-ax-is).
Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves difficulty breathing or affects the heart rhythm or blood pressure. Any one or more of the ABC symptoms above may be present.
In extreme cases there could be a dramatic fall in blood pressure. The person may become weak and floppy and may have a sense of something terrible happening. Any of the ABC symptoms may lead to collapse and loss of consciousness and, on rare occasions, can be fatal.
AIRWAY - swelling in the throat, tongue or upper airways, hoarse voice, difficulty swallowing
BREATHING - sudden onset wheezing, breathing difficulty, noisy breathing, persistent cough
CIRCULATION - dizziness, feeling faint, sudden sleepiness, confusion, pale clammy skin, loss of consciousness or collapse
If you have LTP allergy you may find that you only have a reaction, or the reaction is more serious, if you eat the food around the same time as doing exercise, drinking alcohol, or taking a non-steroidal anti-inflammatory painkiller (such as aspirin and ibuprofen). Stress may also make a reaction worse. These are known as ‘co-factors’.
While LTP allergy symptoms usually happen within 30 minutes of eating the food, they can sometimes be delayed by up to one or two hours depending on whether a co-factor is involved.
If you think you may have LTP allergy, see your GP who can refer you to a specialist allergy clinic if needed. They can find a clinic in your area from the British Society for Allergy and Clinical Immunology (BSACI)
It’s important to get a referral even if your symptoms were mild because it can be hard to tell if future allergic reactions could be more serious.
Once you get a referral, the consultant will discuss your medical history and symptoms with you. They might suggest skin prick, blood tests, and food challenge tests to help diagnose the allergy and work out how serious it may be.
Some clues that you might be at higher risk of more serious reactions are:
If you have asthma, and it is not well controlled, this could make an allergic reaction worse. Make sure you discuss this with your GP or allergy specialist and take any medicines you’re prescribed.
If you have mild allergic symptoms, you may be prescribed antihistamine medicine that you take by mouth. But if you are at risk of a serious allergic reaction (anaphylaxis), you may be prescribed adrenaline – the emergency medicine used to treat anaphylaxis. It is also known as epinephrine.
Because anaphylaxis can happen very quickly, adrenaline is available in different forms that are designed to be easy to use. It’s important to know exactly how and when to use your prescribed adrenaline. Healthcare professionals can show you how to use it, and there are also resources such as practice devices and videos on manufacturer websites.
Options currently available on prescription in the UK include:
You must carry two in-date forms of prescribed adrenaline at all times as a second dose may be needed if symptoms do not improve after five minutes or get worse.
The uncertainty about which foods might cause a reaction, and what might make a reaction worse, can make managing your LTP allergy particularly difficult. Always carry your prescribed medicine and make a clear allergy action plan with your allergy specialist.
Provide your email address to receive our printable guide outlining emergency symptoms and actions.
Additionally, enjoy our monthly Allergy Outlook email, delivering the latest news, updates, and resources directly to your inbox.
