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What is a fruit allergy?

A fruit allergy is a type of food allergy. Food allergy occurs 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.

Allergic reactions to fruit are often part of pollen food syndrome but there are other types of allergy to fruit too.

You can also read about allergy to vegetables

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Fruits that can trigger allergies

Any fruit has the potential to cause an allergic reaction. The following are some of the fruits people react to more commonly, but it is not a complete list.

Apple

Avocado

Banana

Cherry

Citrus fruit

Kiwifruit

Mango

Melon

Nectarine

Peach

Pear

Pineapple

Strawberry

Plum

Tomato

Jackfruit

Pollen food syndrome

Pollen food syndrome usually occurs in people with hay fever who are allergic to pollens. It can cause allergic reactions when you eat certain fruits or vegetables. This is because the proteins in pollen are similar to the proteins in the fruits and vegetables.

Symptoms are usually mild and may respond to antihistamines, but speak to your doctor to make sure this is the right treatment for you.  Symptoms usually include:

  • Redness, mild swelling or itching of the lips, tongue, inside of the mouth and ears.
  • Itching and mild swelling of the throat.
  • Occasionally, symptoms involve the oesophagus (food pipe) or stomach, such as abdominal (tummy) pain, feeling sick and vomiting.
  • Sneezing, runny nose, or symptoms affecting the eyes.
  • Very rarely, more serious symptoms known as anaphylaxis, can occur. In such cases, immediate medical help is needed.

Other types of allergy to fruit

Less commonly, you may have a different type of allergy to fruit.

  • You may also be allergic to latex. This is known as latex food syndrome.
  • You may have an allergy to a type of plant protein called lipid-transfer protein (LTP).
  • You may have an allergy to a fruit or fruits independently of any other allergic syndromes.

What are the symptoms of other types of allergy to fruit?

Mild to moderate symptoms may include:

  • a red raised rash (known as hives or urticaria) anywhere on the body
  • a tingling or itchy feeling in the mouth
  • swelling of lips, face or eyes
  • stomach pain or vomiting.

More serious symptoms

The term for this more serious reaction is anaphylaxis (ana-fil-ax-is).

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 unconsciousness and, on rare occasions, can be fatal.

Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves the ABC symptoms.

Serious symptoms are unusual because the proteins that cause the allergy are unstable and are destroyed with heat or once they reach the stomach. Most people with pollen food syndrome have allergic reactions if they eat the raw fruit, but are able to eat the cooked fruit without any problem.

More serious symptoms are often referred to as the ABC symptoms and can include:
  • right_arrow_orange_icon AIRWAY – swelling in the throat, tongue or upper airways (tightening of the throat, hoarse voice, difficulty swallowing).
  • right_arrow_orange_icon BREATHING – sudden onset wheezing, breathing difficulty, noisy breathing.
  • right_arrow_orange_icon CIRCULATION – dizziness, feeling faint, sudden sleepiness, tiredness, confusion, pale clammy skin, loss of consciousness.
Read more about anaphylaxis

Fruit and soya allergy

Many people with pollen food syndrome who react to fruit also react to raw soya products such as soya drinks, soya yoghurt and raw tofu. The first sip or mouthful of a soya product doesn’t tend to cause symptoms quickly so people eat or drink the whole portion. Reactions can then be severe due to the amount consumed and, in rare cases, can lead to anaphylaxis.

Not everyone with pollen food syndrome will be allergic to soya, but if you have pollen food syndrome, be careful about eating or drinking large quantities of soya for the first time. For example, avoid drinking a whole soya milk shake in one go if you haven’t tried it before. A serious reaction is unlikely but if you develop any of the ABC symptoms, treat it as anaphylaxis. Read more about what to do in an emergency.

Food intolerance

Some people who have symptoms when they eat a food have a food intolerance rather than an allergy. A food allergy is a reaction of the immune system, whereas food intolerance may have a different cause.

Intolerance to fruits could be part of a wider intolerance to foods caused by a sensitivity to chemicals that are present naturally in the fruits, or an inability to digest the sugars found in them.

A food intolerance can have a much wider range of symptoms, including:

  • migraine
  • fatigue
  • tummy (abdominal) pain
  • bloating and frequent diarrhoea
  • muscle and joint pains
  • blocked or runny nose.

 

If you are allergic to one or more fruits, this does not necessarily mean you will react to any others, but with some fruits there is a possibility that you will. If you have had an allergic reaction to any fruit, visit your doctor for advice.

Getting a diagnosis

If you think you may be allergic to a fruit, 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.

Read more about allergy testing

Some clues that you might be at higher risk

 

  • you have already had a serious reaction, with any of the ‘ABC’ symptoms
  • you have asthma, especially if it is not well controlled
  • you have reacted to a tiny amount of the food.

Treating symptoms

If you have mild allergic symptoms you may be prescribed antihistamine medicine that you take by mouth. If you are at risk of anaphylaxis, you may be prescribed adrenaline to use in an emergency.

Adrenaline comes in pre-loaded adrenaline auto-injectors (AAIs) that are designed to be easy to use. Make sure you know how and when to use them. Ask your healthcare professional to show you, and find help on the manufacturer’s website.

The adrenaline auto-injectors prescribed in the UK are:

 

You must carry two with you at all times, as you may need to use a second one five minutes after the first if your symptoms don’t improve or get worse.

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 prescribed medicines.

Read more about what to do in an emergency.

Key messages

  • If you have symptoms after eating fruit, visit your GP.
  • If you are prescribed AAIs, carry them with you at all times.
  • Always be guided by your allergy specialist as to which foods you should avoid.
  • Ensure that asthma is well managed. See your GP about this.

Download our allergy to fruit factsheet

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Useful Links

Pollen Food Syndrome

Lipid Transfer Protein Allergy

Latex Allergy

Allergy to Vegetables

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