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Food allergy is a very common problem for both children and adults. The most common food allergies are to cow’s milk, egg, peanut, tree nuts/seeds, wheat, fish and shellfish. It is possible to be allergic to any food.
What is Pollen-Food Allergy Syndrome?
Pollen-Food Allergy Syndrome (PFAS), also known as Oral Allergy Syndrome (OAS), is a type of food allergy that causes allergic reactions typically in the mouth and throat. It occurs when certain proteins in fresh/raw fruits, vegetables, and nuts cause a reaction in people who are allergic to pollen. This happens because the proteins in these foods are similar to the proteins found in pollen.
Typical symptoms of PFAS:
- Itch or tingle of the lips, mouth, tongue, and/or throat
These symptoms typically appear within a few minutes of eating the offending food and usually resolve within an hour. Severe reactions are rare but can occur, including life-threatening allergic reactions. In some cases epinephrine (e.g. EpiPen), may be used to treat serious allergic reactions.
Common Pollen and Cross-Reactive Foods (examples, not comprehensive):
- POLLEN TYPE: Birch
CROSS-REACTIVE FOODS: Apples, Carrots, Celery, Cherries, Hazelnuts, Kiwi, Peaches, Pears, Plums - TYPE: Ragweed
FOODS: Bananas, Cucumbers, Melons (watermelon, cantaloupe, honeydew), Zucchini - TYPE: Grass
FOODS: Celery, Melons (watermelon, cantaloupe, honeydew), Oranges, Peaches, Tomatoes - TYPE: Mugwort
FOODS: Carrots, Celery, Coriander, Fennel, Parsley, Peppers, Sunflower seeds
* Of note being reactive to one of these foods, does not mean you will necessarily react to others in the same column.
Managing PFAS:
- Avoidance: The best way to manage PFAS is to avoid the foods that trigger symptoms.
- Cooking or Processing: Cooking the food can break down the proteins that cause the reaction. Canned, baked, or microwaved fruits and vegetables may be safe to eat.
- Immunotherapy (Allergy Shots): Treating the underlying allergy to pollen can often treat the corresponding food allergy.
Conclusion:
Pollen-Food Allergy Syndrome can be managed with careful avoidance and preparation of foods. Understanding which foods may cross-react with your pollen allergies is key to preventing uncomfortable symptoms. If you have any questions or concerns about PFAS, please speak with your healthcare provider.
Note: This page is for informational purposes only and should not replace professional medical advice. Always consult your doctor for personalized guidance and treatment.
Food Allergies: Frequently Asked Questions
Symptoms vary on a case by case basis. Classic symptoms include skin reactions such as hives, itching, flushing/redness of the skin and swelling, as well as the possibility of nausea/vomiting and diarrhea. You can also have respiratory symptoms such as shortness of breath, chest tightness, or wheeze. Some patients experience a decrease of blood pressure, which may result in dizziness or loss of consciousness.
There are two ways to test for food allergy. Usually the first step to test for food allergy is by performing skin testing. Alternatively one could perform a blood test. To perform skin testing, we gently scratch the skin with a plastic tip that deposits protein from whatever foods are being tested. Then we wait……15 minutes later, we read the results, and have a discussion with our patients. You can get the results the same day of testing.
Oral Food Challenge: What To Expect
***Please notify your allergist of all medications and/or supplements you are currently taking. Some medications, such as antihistamines, will need to be held for one week prior to allergy testing.
The test involves ingesting a small amount of allergen to watch for signs and symptoms of reaction. If no adverse symptoms arise, you will be given increasing amounts of the allergen and observed for a set amount of time.
- OFC: What To Bring
- Please bring in the food item being tested as well as a vehicle to mix it in
and/or aid in its consumption, such as pudding, yogurt, or applesauce. - Plan to be in the office for at least 3 hours. We recommend you bring something to occupy your time, e.g. quiet activities such as books, coloring, puzzles, etc.
- Please bring in the food item being tested as well as a vehicle to mix it in
Resources & Information
American Academy of Allergy, Asthma and Immunology
611 East Wells Street
Milwaukee, WI 53202
1-800-822-2762
Allergy and Asthma Foundation of America
Washington, DC 20036
1-800-7ASTHMA
Allergy and Asthma Network / Mothers of Asthmatics, Inc.
2751 Prosperity Avenue, Suite 150
Fairfax, VA 22031
1-800-878-4403
American College of Allergy, Asthma and Immunology
85 West Algonquin Road, Suite 550
Arlington Heights, IL 60005
1-800-842-7777
The Food Allergy Network
10400 Eaton Place, Suite 107
Fairfax, VA 22030
1-703-691-3179
National Institute of Allergy and Infectious Diseases
31 Center Drive, MSC 2520
Bethesda, MD 20892
1-301-496-5717
The Complete Peanut Allergy Handbook
Author: Scott H. Sicherer and Terry Malloy
Understanding and Managing Your Child’s Food Allergies
Author: Scott Sicherer
The Peanut Allergy Answer Book: 2nd Edition
Author: Michael C. Young
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