Apple allergy is a common form of oral allergy syndrome (OAS). If you experience tingling, itching or swelling of the lips, tongue and throat after eating raw apples (and you have pollen allergies) you may have OAS.
The proteins found in raw apples are similar to those found in birch pollen and mugwort pollen (a type of weed). Between 50 and 80 percent of people with birch pollen allergies react to raw apples.
The proteins in apples break down when cooked, so you may be able to tolerate applesauce or baked apples but not raw apples.
OAS symptoms tend to be worse during pollen season, when your body is already coping with reactions to the pollen. Some people are able to eat raw apples at other times of year, but not when the pollen count is high.
SymptomsSymptoms of OAS are usually confined to a local reaction of the mouth or lips. Occasionally, some people have more severe reactions that may include rashes, delayed gastrointestinal symptoms such as abdominal cramps and diarrhea, or, very rarely, anaphylaxis.
If more severe symptoms develop, such as wheezing or difficulty breathing, seek emergency medical care. Know the symptoms of anaphylaxis and be prepared to treat it.
Localized symptoms like itching or swelling of the mouth or lips can be treated with an over-the-counter antihistamine such as Benadryl. After taking an antihistamine, a person with OAS should be monitored for the next few hours to make sure that more serious allergic symptoms do not develop.
Immunotherapy for birch pollen may help some people with sensitivities to apples. If you think you have an allergy to apples, talk to your doctor or allergist. The type and severity of your symptoms may determine if you are eligible for immunotherapy, or if you need a prescription for an epinephrine auto-injector (commonly referred to by the brand name EpiPen.)
Because there is no cure for food allergies, you will need to manage your apple allergy by avoiding raw apples and being prepared for future reactions.
Cross-ReactionsPeople with birch pollen allergies may also react to: hazelnuts, nectarines, peaches, kiwi fruit, carrots, apricots, cherries, pears, plums, celery and soybeans. People with mugwort allergies may also react to celery, carrots, melons, hazelnuts and chestnuts.
If you do not have allergic reactions to the other foods just mentioned, you don't need to avoid them right now. However, you may be more likely to develop an allergy to those foods in the future.
Apple Cider and VinegarSome people are sensitive to apple cider or apple cider vinegar but not to raw apples. Both products are produced through a fermentation process. A sensitivity to apple cider, vinegar or alcoholic (hard) cider may be due to an allergy to brewer’s yeast.
Consumption of large amounts of apple cider vinegar may cause damage to the stomach or esophagus even in people with no allergies, causing abdominal pain.
NIAID-Sponsored Expert Panel. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel. The Journal of Allergy and Clinical Immunology. Volume 126, Issue 6, Supplement , Pages S1-S58, December 2010
Webber, Christopher and Ronald W. England. Oral allergy syndrome: a clinical, diagnostic, and therapeutic challenge. Ann Allergy Asthma Immunol. 2010;104:101–108