A man in a crowded restaurant shouts, “Waiter! Waiter! Was there shellfish in this?!” Bluefaced and swollen, his wife tumbles out of her chair gasping for breath. Somebody calls 911, while the husband frantically fishes an EpiPen out of his wife’s purse.
A quick shot to her leg, and a few minutes of labored breathing later, it seems like she’s going to be okay. Alarmed, but relieved, fellow diners at the tables surrounding the spectacle whisper to one another, “She must have had a food allergy.”
We’ve all seen the scene play out in movies and television enough times for us to script it all out, line by line with relative ease. But in actuality, most food allergy afflictions don’t quite play out this way, thankfully.
For every flight attendant asking over the intercom whether there is a doctor aboard the plane, or parent rushing to a child’s birthday party with medicine in hand, there are thousands and thousands of instances in which a woman’s tongue just gets a little itchy or a man’s lips tingle and swell just a bit.
An EpiPen treats severe allergic reactions — Photo courtesy of iStock / CarrieCaptured
People may not even be able to see the subtle reactions, owing to the fact that they’re so slight. But the person in mild distress or discomfort can certainly feel the change.
Throat-clenching anaphylactic shock gets top billing when it comes to food allergies, but Oral Allergy Syndrome (OAS) is the real face of the movement. Though OAS is the clinical terminology used by medical professionals today, the more casual names for the ailment better hints at what’s going on here: Pollen-Food Allergy Syndrome, or Pollen Fruit Syndrome (PFS).
OAS symptoms can include tingling, swelling and itching around your tongue, lips, gums, throat or even ears. Prolonged exposure to OAS triggers can result in hives, nasal congestion, diarrhea, vomiting or even dizziness.
The throat-tightening and shortness of breath associated with anaphylaxis – the medical term for an acute allergic reaction to an antigen in which the body becomes hypersensitive and hyperreactive – could very well develop if exposure to the problematic food is sustained for long enough. But OAS sufferers will more than likely drop their fork long before it comes to that.
The foods that trigger OAS symptoms hail almost exclusively from the fruit, vegetable and nut families. And here’s some more bad news for allergy sufferers: the insult of OAS is most frequently added to the injury of hay fever and pollen allergies.
Fruits, vegetables and nuts can all cause allergic reactions — Photo courtesy of E+ / fcafotodigital
That means that if beautiful, blushing cherry blossom season is really your own private nightmare, marked by watery, bloodshot eyes and constant nose-blowing, you’re also more likely to be hit with instances of OAS. That’s because OAS isn’t itself an allergy to individual foods in the way that, well, food allergies are.
Instead, OAS causes a small cluster of allergic reactions in the mouth by cross-reactive trace elements of ancient tree and weed pollens still present in the genetic makeup of a handful of nuts, fruits and vegetables today. In fact, 60% of all food allergies are actually cross-reactions from foods that your body mistakes for inhalative allergens.
Because we know which antigens cause some human bodies to react in the ways that they do, scientists and doctors have been able to hone in on lists of the most common OAS offenders respective to each antigen false flag. An allergy to the individual offending antigen can likely cause an OAS response to any of the foods in each group, unlike the way we imagine that true individual food allergies work.
Grass pollen allergies: melons, tomatoes, oranges, figs
Ragweed pollen allergies: bananas, melons, cucumber, zucchini, artichokes, hibiscus
Birch pollen allergies: almonds, apples, avocados, apricots, bananas, carrots, celery, cherries, coriander, fennel, hazelnuts, kiwi, parsley, parsnips, pears, peppers, plums, potatoes, prunes, soy, strawberries, wheat
Other OAS allergen groups center around the mugwort and alder pollens. And for those genetically pre-dispositioned, an allergen to any of these five pollens whatsoever can trigger reactions from any of the dozens of foods that fall within the respective umbrellas.
A garden salad with veggies and nuts — Photo courtesy of iStock / FatCamera
In this manner, OAS triggers can be difficult to zero in on. Imagine, for example, a generic garden salad. You may have tomato, cucumber, green pepper, carrots or even strawberries or almonds artfully decorating your bowl. With just those five or six ingredients present, all five OAS pollen groups are represented. A pair of tingly lips after polishing off your lunch can be quite difficult to narrow down to a single offending culprit.
Luckily, OAS symptoms are rarely severe enough to be life-threatening. But it bears saying anyway: if you are experiencing an allergic reaction – no matter how seemingly minor – while eating something, you really ought to put down your fork.
Our bodies’ responses to antigens can churn and develop over the course of an hour. So a tingle right now could become something much more dramatic in 45 minutes’ time. If you are experiencing OAS symptoms regularly – or more likely, seasonally – speaking with your doctor or allergist is a great idea. Because these reactions are often mild, they can sometimes be easily addressed or even corrected.