This article is written to help people who are allergic to bananas to understand and manage their allergy.
Allergic reactions to banana vary widely and can include itching of the mouth and throat, an itchy rash (known as hives or urticaria) and swelling of the skin (known as angioedema). In rare cases there can be narrowing of the throat, wheezing and even collapse. In most cases, symptoms begin within seconds or minutes of eating the fruit.
Symptoms
Mild symptoms
Banana allergy most commonly occurs in conjunction with allergy to other foods, presenting as one of two types of oral allergy syndrome (affecting the mouth or throat).
The two types are:
Pollen food syndrome – this occurs in some people with hay fever who are allergic to certain pollens, either from grass or weeds. In these cases, proteins in the pollen are so similar in structure to those present in certain plant foods that allergy symptoms occur when the food is eaten. This is due to a process known as cross-reactivity. The foods involved are certain fresh fruits and vegetables. Banana can be one of those foods.
Latex food syndrome – this occurs in some people who are allergic to natural rubber latex. In these cases, there is a similarity between the proteins in latex and those in banana.
With both conditions, severe symptoms are unlikely because the proteins causing the allergy are unstable and become destroyed when the food (in this case, banana) reaches the stomach. Also, most of the allergen is in the fruit’s skin or pips, so peeling the banana and removing the black seeds in the middle may reduce or eliminate symptoms. Symptoms are usually confined to the lips, mouth, tongue, throat or gullet. In most cases, people with either of these types of oral allergy are advised that they do not need to carry adrenaline auto-injectors.
Severe symptoms
Banana allergy is also known to occur in people who are not allergic to pollen or to natural rubber latex. This form of banana allergy is rare, but those affected are at much greater risk of a severe allergic reaction. The symptoms may affect not only the mouth and skin, but there may also be breathing difficulty and/or a drop in blood pressure which may lead to loss of consciousness. These are the symptoms of anaphylaxis, a serious life-threatening allergic reaction. People who are at risk of anaphylaxis are usually prescribed adrenaline auto-injector devices, which must always be available and should be used as soon as a serious reaction is suspected.
We strongly advise anyone who suspects they or their child has a banana allergy to see their GP and request a referral to an NHS allergy clinic.
Diagnosis
Specialised allergy tests, which are more accurate than the earlier tests, have recently become available. They can often tell the specialist not only whether an allergy is likely to be present but can also identify the culprit protein, and even indicate which protein family it belongs to. Such tests can help the specialist determine the likelihood of a severe reaction and whether a prescription for an adrenaline auto-injector is advisable.
Managing banana allergy
In all cases of banana allergy, avoiding bananas is advisable, but it is especially important in the severe form of banana allergy described above.
Be careful of fruit salads, fruit drinks and anything else which might have banana as an ingredient. If you are prescribed a medicine by your doctor, check that banana flavouring hasn’t been added. One medical journal reports on an eight-year-old girl who suffered an allergic reaction within one hour of taking an oral dose of penicillin containing banana essence as a flavouring additive. Also be careful of personal care products and toiletries, such as shampoos and body lotions. Always read the ingredient lists.
In milder cases (where banana allergy is related to pollen food syndrome or latex food syndrome) avoiding bananas is still important. If a reaction does occur, stop eating the food and wash your mouth out with water. Although a severe reaction is unlikely, you may wish to take an antihistamine tablet. This may help, but symptoms usually disappear quickly on their own (usually in less than two hours), so antihistamine tablets are likely to have little impact.
Our expert medical reviewer tells us that most people with a fruit allergy related to pollen food syndrome or latex food syndrome can tolerate their culprit fruits once cooked. This is because the protein that causes the reaction is likely to be deactivated by heat.
What else could I react to?
If you are allergic to bananas, cross-reactivity with latex may mean you also react to avocado, kiwi or chestnut. People with a banana allergy sometimes also experience oral reactions to other fruits such as peach, olive and tomato, and raw vegetables such as bell pepper and carrot.
Two key messages
- If you know or suspect you have a banana allergy, getting expert medical advice is vital. See your GP in the first instance.
- If your allergy is diagnosed as potentially severe and you are prescribed adrenaline auto-injectors, make sure you carry them with you at all times and know how to use them.
Further information
More information can be found on our Factsheets webpage. If your banana allergy is diagnosed as potentially severe, you may wish to read our factsheets on Anaphylaxis and Adrenaline in the General advice and information about anaphylaxis section.
See the factsheet on Pollen food syndrome in the Food allergens factsheets section.
See the factsheet on Latex allergy: the facts in the Non-food allergens factsheets section.
Sources
All the information we produce is evidence-based or follows expert opinion and is checked by our clinical and research reviewers. If you wish to know the sources we used in producing any of our information products, please contact info@anaphylaxis.org.uk and we will gladly supply details.
Reviewer
The content of this article has been peer-reviewed by Dr Isabel Skypala, Clinical Lead for Food Allergy, Royal Brompton and Harefield NHS Foundation Trust, London.
Disclosures
We are not aware of any conflicts of interest in relation to the review of this article.
Disclaimer
The information provided in this article is given in good faith. Every effort is taken to ensure accuracy. All patients are different, and specific cases need specific advice. There is no substitute for good medical advice provided by a medical professional.
Publication Date: April 2022
Review Date: April 2025
