Adding citrus fruits boosts vitamin C along with numerous antioxidants and essential minerals that enhance the immune system during the season of infectious and respiratory diseases.
What is Citrus Allergy?
Citrus fruit allergies are rare but do occur. Citrus fruits include oranges, lemons, grapefruits, tangerines, etc. You may be allergic to citrus fruits when consuming them directly or to their juices, even the peels. Below is the information you need to know about citrus allergies as well as how to cope and live with this health issue.
1. Symptoms of Citrus Allergy
Individuals allergic to citrus fruits may experience a variety of symptoms, ranging from mild to severe (anaphylaxis). These symptoms are often localized, meaning you may feel the allergy at the site of contact with citrus fruits, such as your hands, oral mucosa, or throughout your body.
Citrus allergy symptoms often begin with oral allergy syndrome (OAS) which includes: intense tingling, itching of the lips, tongue, throat; swelling of the lips, swollen gums, etc. Individuals with oral allergy syndrome related to citrus fruits may consume them when cooked, delaying the onset of symptoms.
Citrus allergy symptoms often start with oral allergy signs. (Image: ST)
Those allergic to the peels of citrus fruits may experience contact dermatitis symptoms upon contact with the peels, which include: redness, burning sensation, tingling, dry skin, peeling, and raised hives, etc.
In rare cases, a citrus allergy can lead to a systemic allergic reaction known as anaphylaxis. Anaphylaxis is a severe allergic reaction that can be life-threatening. Symptoms of anaphylaxis appear suddenly and progress rapidly, including:
- Severe swelling of the mouth and throat leading to difficulty breathing, swallowing, and speaking
- Severe coughing
- Swelling of other body parts
- Pale face or skin
- A asthma attack
- Nausea, vomiting, diarrhea
- Low blood pressure, causing weakness, weak pulse, rapid heartbeat
- Red skin
- Confusion
- Loss of consciousness
If anaphylaxis occurs, you should seek emergency help immediately.
2. Causes of Citrus Fruit Allergy
Pollen Allergy/Cross-Reactivity Syndrome
Similar to allergies to other fruits, there are various causes for citrus fruit allergies, and many people allergic to citrus may also be allergic to pollen.
Individuals allergic to citrus fruits may experience cross-reactivity with grass pollen (having an immune response to certain proteins) with symptoms similar to allergic rhinitis. In other words, some proteins in pollen are similar to proteins in citrus fruits, which is why many people may experience cross-allergy.
According to Medical News Today, a 2013 study showed that when conducting skin prick tests for allergens, 39% of participants allergic to pollen had similar reactions to citrus fruits. However, a person may test positive on a skin prick test without necessarily being allergic to food when consuming citrus or vice versa. Generally, this group should still exercise caution when consuming.
Many pollen allergy sufferers are also allergic to citrus fruits. (Image: ST).
Citric Acid Allergy
Citric acid, found naturally in citrus fruit juices, can irritate the skin, stomach, and oral mucosa. However, this compound does not trigger an immune response and therefore does not cause an allergic reaction.
According to Healthline, some individuals may be allergic to citric acid when it is added as an additive to processed foods or beverages, so those allergic to citric acid need to be careful when reading product labels.
Phytophotodermatitis
An allergic-like reaction to citrus is known as phytophotodermatitis. This condition can arise if citrus juice comes into contact with your skin and then is exposed to sunlight. The UV rays cause the compounds in the juice to irritate your skin.
Limonene Allergy
Individuals allergic to the peels of citrus fruits are often allergic to limonene—a compound abundant in citrus fruits. Simply touching the outer peel can cause contact dermatitis symptoms, although these individuals may still consume fresh juice.
Citrus Allergy in Infants
Food allergies are more common in children and infants. About 5% of children under the age of 5 are affected by food allergies, and children with a history of eczema are more likely to have food allergies, according to VeryWell Health. However, in children, over 90% of food allergy cases are caused by 8 common foods: eggs, milk, wheat, soy, nuts, peanuts, fish, and shellfish.
To diagnose an individual for a citrus fruit allergy, a doctor may recommend a blood test or skin prick test. However, false positives can occur in both skin prick and blood tests, and allergy testing is only recommended when there is a relevant clinical history of food allergies.
3. Management
Food allergies cannot be cured, but those allergic to citrus fruits can take several precautions to avoid consuming or coming into contact with allergens, including carefully reading food labels and ingredient lists when dining out.
Medications
Antihistamines can be used to treat mild allergic reactions. Antihistamines work by blocking the effects of histamine in the body—the substance responsible for allergic reaction symptoms.
Individuals with severe allergies should always carry an Epipen auto-injector in case of anaphylaxis.
Foods to Avoid
Those allergic to foods like citrus should avoid consuming citrus fruits and any food, drink, or products that may contain them, such as fruit juices, ice cream, flavored yogurt, jelly, herbal tea, sauces, grilled seafood dishes, alcoholic or non-alcoholic cocktails, vitamin C and bioflavonoid supplements, candies, cakes, etc.
Citrus ingredients can also be found in personal care products such as toothpaste, cosmetics, and perfumes (often containing limonene).
Alternative Foods
Some individuals allergic to citrus fruits may choose to consume them in cooked forms to neutralize proteins that could trigger allergic reactions.
If you cannot tolerate citrus fruits but want to add this flavor to your dishes, you may use herbs such as lemon verbena, vinegar, or white wine as substitutes.
If you wish to supplement vitamin C from citrus fruits, you can replace them with other vitamin C-rich foods like bell peppers, broccoli, cauliflower, kiwi, mango, papaya, strawberries, etc.
4. When to See a Doctor for Citrus Allergy?
If you suspect you have a citrus fruit allergy with the above symptoms, consider consulting a doctor, especially if this occurs frequently. A doctor will help diagnose you through allergy tests and provide advice tailored to your condition.
Moreover, if anaphylaxis occurs, call emergency services immediately for timely intervention. Unmanaged anaphylaxis can be life-threatening.
