OAS – When Raw Fruit is Forbidden
Diagnosing OAS
Since it occurs mainly in people with allergies to birch, grass or ragweed pollen, “the key to diagnosis is the history of hay fever and positive skin tests to relevant pollens,” says Mazer.
“As well, a history of eating the food with typical mouth and throat symptoms without other symptoms, plus the ability to eat the cooked variety of the fruit or vegetable makes the diagnosis fairly certain.”
However – I don’t react to any vegetables sharing allergenic proteins with birch tree pollen, only to fruits. Keith explains that this could be due to a lower level of offending proteins in some of the cross-reacting foods. As well, freshness makes a big difference to the potency.
“The peel also tends to have more protein than the fruit itself,” he says. “So if you peeled an apple and ate it, you might not react as if you ate one with the peel on.”
Like any food allergy, both Mazer and Keith espouse avoidance as the primary means of coping. Mazer also mentions microwaving raw fruit before eating, but agrees the suggestion is not the most appetizing solution. Sprinkling the cut-up fruit with lemon juice and letting it sit for a few minutes may also work.
Given the unpredictability of “true” food allergy, even I have to be on the lookout. “If someone gets hives or worse with the fruit, vegetable or nut; or gets symptoms with both fresh and cooked varieties; or has prolonged symptoms (hours instead of minutes), this may be the sign of a true food allergy,” says Mazer.
In those cases, he emphasizes the importance of seeing an allergist for diagnosis and testing, and then to “strictly avoid the substance and carry self-injectable adrenaline.”
Seeds of Control
If the problem is genuinely OAS, “the key is to manage the hay fever,” Keith says. He suggests using an intranasal steroid two weeks before the season and throughout, to stave off a seasonal rise in the allergic IgE antibodies.
“We want to turn off your nose’s production of IgE locally to the pollen, so when you eat a protein that is very similar, you won’t get the symptoms,” he says. Immunotherapy or allergy shots has not proved particularly helpful for this syndrome, though it can be effective for the hay fever itself.
Some natural therapies may provide some relief. Keith finds that nasal rinsing with a saline spray can be effective in reducing inflammation, while wearing glasses lessens pollen exposure in eyes. He also recommends keeping windows closed, especially in the bedroom and the car, during the specific allergy season.
Keith and his colleagues have recently completed a novel study on a mint tea high in rosmarinic acid, which is believed to have anti-allergic properties. Trials were conducted with sufferers of severe chronic rhinitis.
The results, which Keith allows “are interesting” were to be released at the American Academy of Allergy, Asthma & Immunology annual meeting in March. He thinks it’s important to undertake proper studies “to see if natural therapies do have a benefit.”
Given that a third of Canadians suffer from hay fever, the experts actually find it surprising that so few people experience OAS. “A major question is not why people get this problem, but why more people don’t – since the pollen-protein link is always there,” says Mazer. It tends to be those who have more severe hay fever who get OAS.
“If you get OAS symptoms, see your doctor,” says Keith. “What you’re experiencing is really a side effect of your hay fever not being controlled.” So it’s off to the specialist for me to make sense of my hay fever symptoms. There may be a chance yet for my love affair with peaches. One can only hope.
First published in Allergic Living magazine, Spring 2009.
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jmneiderer
Thank you for this. I was dx with OAS a few months ago and no one has every heard of it, although the doctor said it was very common! Glad that info is getting out there! I was given a ‘script for an epi pen and told to avoid all the foods I was reacting to (so far only Almonds, even when baked as flour), I think it’s important to mention that they can become life threatening and if you’re reacting to a certain food to the point where things are swelling it’s probably a good idea to avoid them!
wessexcathedral
People need to know this, so I am putting a previous comment I made on this article too: I have suffered from OAS my entire life, since I was a baby. I never knew what it was but always ate the offending fruits/vegetables. Most if not all, I had a reaction to–my mouth would break out in hives, swell up, tingle at first and then itch. Then my ears would begin to itch. Not much later I would have diarrhea, followed by break-outs all over my body in little patches of eczema. Once an adult and in my twenties, I started to get sick all the time. A friend, whose husband has the same condition advised me to stop eating raw food. Once I stopped, I was never sick again. It has been ten years since then. My hay fever is very bad, so I started eating raw, natural but LOCAL honey, about one to two teaspoons daily. Ever since (it has been two years of doing this) I have been able to eat raw fruits and veggies without a single reaction. My hay fever is gone. When ingesting the actual pollen in the honey, my body can build a resistance. I recommend people with OAS to eat local honey. It works wonders and is natural. It is the first time in my life where I am able to eat things like a normal human being.
Gwen Smith
WC, I find local honey fascinating, too. But unfortunately, when Allergic Living has looked into it, we’ve found conflicting studies. Because bees pick up local pollen, it seems some people, like you, report improvement in symptoms, a sort of desensitizing effect no doubt. However, some reports show people with hay fever or OAS who eat local honey get worse symptoms – they’re not getting that same effect and instead just being exposed to that allergen. Glad it’s working for you. But drat it, doesn’t appear to be a panacea for all.
canteatraw
I have OAS very bad. It started about 15 years ago and has been getting worse to the point now where I likely go into anaphylatic shock if I consume a raw fruit OR a raw vegetable. I am so devastated over all of this. About 18 months ago I went gluten-free too because I had symptoms of Celiac disease. Now I think I have GERD and just want to be fed via an IV! I am sick of food, what I can have what I can’t. I’ve forced my children and my husband to be mostly GF in the house but they are resisting. I used to be sick of servers in restaurants giving me attitude when I ask for things not to be on my meal, I’ve stopped being able to go out for a meal anyway. I feel like I am the only one on the planet with allergies this severe. My next step is allergy shots. I have been wanting to try local raw honey but I am allergic to honey!! I am also allergic to bee stings too…. and get SEVERE hay fever in the Spring.
If anyone has other things that worked for them or are in the same position as me, I’d love to hear from you as its lonely and I feel really badly about all of these restrictions. And its not really all that healthy either since I don’t get a lot of nutrients since I have to cook every raw veggie or raw fruit to death. These allergies have also made me anemic too so I have to take iron supplements.