My Journey to Diagnosis - Oral Allergy Syndrome (also known as pollen food syndrome)

skin prick testing for allergies
Disclaimer - The information provided is for guidance and is not a substitute for medical advice. My source of information: British Society for Allergy & Clinical Immunology. Further reading: Allergy UK - OAS

In March I finally found a GP who listened to me and agreed I needed a referral to an Allergy Consultant. After a five month wait, I had my first appointment this week and I am now officially on a new journey to re-evaluate my allergies, roll on more appointments and testing. I should explain that my initial diagnosis occurred 28 years ago and my online friends in the allergy community have encouraged me to seek out answers to questions that have bugged me for many years.

This week I have under gone a skin prick test and the results confirmed I still have an allergy to grass pollen and I can also add birch pollen to my list. My initial reaction is pictured above. I forgot to take another photo so you will have to take my word for it when I say those lumps got worse as time went on. The urge to scratch was so intense I had to sit on my hand. Not only did I leave the hospital with a new allergy but I gained a diagnosis for Oral Allergy Syndrome. This is the point where you all stare blankly at the screen and mutter to yourself “WTF is Oral Allergy Syndrome?”. Don’t worry I only know about OAS because someone had previously suggested to me I could have the condition. I am now armed with a hospital fact sheet and want to raise awareness. 

The interesting element to Oral Allergy Syndrome is the link with hayfever. According to the information I received, people who have hayfever between *March to the end of July (that’s me!) are probably allergic to both grass and tree pollen (me again!) are more likely to develop Oral Allergy Syndrome but also be allergic to a wider range of foods (hello light bulb moment!).

Oral Allergy Syndrome symptoms are itching and swelling of the mouth, tongue and soft palate after eating raw fruit, vegetables and some nuts but the symptoms do not occur when the food is cooked. I have been avoiding strawberry and orange since childhood and for a considerable number of years I have been complaining of itchy throat and roof of mouth when eating melon, pineapple, kiwi and grapefruit. These fruits have long since been eliminated from my diet and I miss them. I have never been a fussy eater and love fruit and vegetables. When you are dairy and egg free as well, pudding options in restaurants are usually fruit salad, cue my immediate panic! 

Symptoms are caused by a reaction to plant proteins which are similar to pollen. These proteins are usually destroyed when heated so that explains why some people don’t experience symptoms when food is cooked and canned as opposed to raw. 

Which foods may cause Oral Allergy Syndrome? - Apple, Walnut, Peach, peanuts, Pear, Wheat, Nectarine, Hazelnuts, Strawberries, Celery, Melons, Watermelon, Parsley, Tomato, Swiss Chard, Carrot, Cherries, Potato, Plum, Fennel, Honey, Spinach, Almonds, Brazil nuts, Apricots, Spices, Cucumber, Chamomile tea. 

I understand that diagnosis is problematic. The skin prick test for grass and tree pollens is useful but testing for the foods may not work because the allergens could be destroyed in the process of making the testing solution. Skin testing using raw foods may be useful. Unfortunately, there isn't a magic pill to cure Oral Allergy Syndrome you simply have to avoid your trigger food(s) or ensure they are cooked before eating. 

If you are concerned about Oral Allergy Syndrome seek professional medical advice. If your symptoms include wheezing, rash or abdominal pains that could indicate a more severe type of allergy so get yourself checked out.

So there you have it. A positive outcome of sorts but sadly I am not going to be adding any more fruits back into my diet. In case you were wondering, not every allergen can be tested in a skin prick test so I have to wait for blood test results. This is not the end to "My Story" as I await follow up appointments and referrals to other Hospital departments.

Sarah x

*If you have hayfever February to May that usually means a tree pollen allergy and apparently you’re likely to only react to fruits and some nuts.