‘Why Does My Mouth Tingle When I Eat?’ Oral Allergy Syndrome Explained

Have you ever experienced a tingling or itchy mouth after eating fruit or vegetables? This can be a sign of oral allergy syndrome. Also known as pollen-food allergy syndrome, oral allergy syndrome is the most common type of food allergy in adults. Let’s take a closer look at its symptoms and causes.

What is oral allergy syndrome?

Oral allergy syndrome is a type of mild food allergy. It causes an allergic reaction in your mouth after eating a raw fruit or vegetable. This reaction happens when you already have an allergy to pollen. 

Pollen allergies can lead to oral allergy syndrome because pollen, fruits, and vegetables all come from plants. When you have a pollen allergy, your body can be sensitive to plant proteins. There are plant proteins in pollen, and in raw fruits and vegetables. So when you take a bite of certain foods, your body can think there’s pollen in your mouth. This leads to an oral allergic reaction, causing itching and tingling. This reaction can happen with just one specific fruit or vegetable, or it can happen with multiple different foods. 

Who gets oral allergy syndrome?

Just like seasonal allergies, the number of people with oral allergy syndrome also seems to be on the rise. 

Anybody who has seasonal allergies or hay fever can have oral allergy syndrome. This is why it is more common in older children and young adults. Pollen allergies develop over time. So, it may take a few years — and a few springs and summers — before a child develops this condition. 

What are common oral allergy syndrome symptoms?

The symptoms of oral allergy syndrome are generally mild, and mostly experienced near the mouth without affecting the rest of the body. Here are some classic oral allergy syndrome symptoms: 

• Itchy or tingling mouth, lips, or tongue

• Irritation in the throat, which may feel like scratchiness or tightness

• Mild swelling of the lips, mouth, or tongue

• Itchy ears

• A rash around the lips that may look like small bumps or hives

About 1 out of every 10 people may also experience mild stomach problems like nausea. Very rarely — less than 5% of the time — oral allergy syndrome symptoms can be more severe. 

More severe oral allergy syndrome symptoms include:

• Hives all over the body

• Breathing problems

• Vomiting

Oral allergy syndrome symptoms usually start right after eating the allergen, and resolve within 30 minutes. Symptoms tend to be worse if you eat more of the food. You may also notice a seasonal variation in your symptoms. For example, your symptoms may be worse when pollen counts are higher. 

It’s easy to confuse oral allergy syndrome with other types of food allergies. One way to tell them apart is that oral allergy syndrome should only occur with eating raw foods from plants. For example, raw fruits, vegetables, or nuts. Oral allergy syndrome shouldn’t be caused by seafood, meat, eggs, or milk products. Oral allergy syndrome also shouldn’t occur when eating any type of cooked food. 

Which foods can cause oral allergy syndrome?

Certain raw fruits and vegetables are more likely to cause oral allergy syndrome. And there are some patterns among the common culprits.

If you have an allergy to birch tree pollen, you’re more likely to have symptoms with:

• Pitted fruits like peaches

• Carrots

• Peanuts, almonds, hazelnuts (though nut reactions could be a more serious food allergy)

If you have an allergy to grass pollens, you’re more likely to have symptoms with:

• Peaches

• Celery

• Tomatoes

• Oranges

• Melons

If you have an allergy to ragweed pollens, you’re more likely to have symptoms with:

• Bananas

• Cucumbers

• Zucchinis

• Melons

These are several of the more common cross-reactions — but there can be many others.

Can you treat oral allergy syndrome?

If you have oral allergy syndrome symptoms, you may already know some tips and tricks to prevent them:

• Avoid the food: This is the simplest and safest option.

• Heat the food: Cooking the food should break down the protein and prevent the reaction. Microwaving your food for just 10 seconds may make a difference.

• Peel the food: The food’s peel often contains most of the protein that causes the allergy.

If you experience symptoms, you can try taking an over-the-counter antihistamine like cetirizine or loratadine. Taking an antihistamine before you eat the raw food can sometimes be helpful too. But avoiding it is generally safest. 

If your seasonal allergies also bother you a lot, you could try looking into allergy shots. This treatment is not approved for oral allergy syndrome, but it is effective for pollen allergies. And decreasing your pollen allergies may help decrease your oral allergy syndrome symptoms. 

When to seek medical attention

Oral allergy syndrome is usually a mild condition that doesn’t require a visit to your primary care provider. But look out for symptoms that can be a sign of a different or more severe allergy. You should see a healthcare professional if your oral allergy syndrome symptoms:

• Don’t resolve within 1 hour 

• Become more severe or last longer every time you eat that food

• Occur after eating cooked foods

• Are caused by nuts

Call 911 and go to the nearest emergency room if you have any of these symptoms:

• Hives all over your body

• Difficulty breathing

• Coughing or wheezing

• Chest tightness

• Vomiting

• Significant lip, tongue, or throat swelling 

Why trust our experts?

Written by:

Fonda Jiang, MD

Dr. Fonda Jiang is a practicing allergist in Long Beach, California. At her current practice, Dr. Jiang is committed to working as a team with her adult and pediatric patients to diagnose and treat a wide range of allergic conditions.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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