Fruit and vegetablesf49

Apple allergy

Apple allergy is one of the most common cross-reactions in people with birch allergy. It usually causes an itchy mouth from raw fruit, and cooked apple is usually fine.

Allergen
Apple Malus domestica
Allergen code
f49
Key allergens
Mal d 1, Mal d 3
Included in
1 test
Contents
  1. What is apple allergy?
  2. Symptoms
  3. Cooked apple and different varieties
  4. Cross-reactivity
  5. How to get tested
  6. Frequently asked questions

What is apple allergy?

In northern and central Europe, the most common form of apple allergy is linked to birch allergy. The protein Mal d 1 in apple resembles Bet v 1 in birch pollen, and the immune system confuses the two. This causes oral allergy syndrome: itching, tingling or slight swelling in the mouth and throat shortly after eating raw apple.

In southern Europe, another form is more common. It is caused by the protein Mal d 3, which is found in the peel, withstands heat and can cause stronger reactions.

Symptoms

  • Itching and tingling in the mouth, lips and throat
  • Slight swelling of the lips or tongue
  • Less often, hives, stomach problems or breathing difficulties

Symptoms appear within a few minutes and usually pass on their own. They can be worse during the birch pollen season.

Cooked apple and different varieties

Mal d 1 is destroyed by heat. That is why most people tolerate apple sauce, apple pie and pasteurised apple juice. The amount of allergen also differs between apple varieties, and some people tolerate certain varieties better than others.

Cross-reactivity

The same type of protein is found in pear, cherry, plum, peach, hazelnut and carrot. People who react to apple therefore often react to some of these as well.

How to get tested

Apple (allergen code f49) is included in our Fruit allergy test, together with peach and kiwi. The test shows whether you have IgE antibodies to apple. It is a good idea to test for birch at the same time, for example with our Pollen allergy test, as this makes the link clearer.

Frequently asked questions

Why does apple make my mouth itch but apple pie does not?

The allergen that causes the itching is destroyed when the apple is heated. That is why baked and cooked apples are usually fine.

Can apple allergy be dangerous?

The birch-related form is almost always mild. If you get swelling in the throat, breathing difficulties or hives all over your body, seek medical help.

Often cross-reacts with

This text is general information and does not replace an assessment by a healthcare professional. In an emergency, call 112. If you have questions about your health, contact your doctor.

Tests for apple allergy

You take the sample yourself at home. The tests measure IgE antibodies in a capillary blood sample.

Fruit and vegetables

An itchy mouth from raw fruit and vegetables is usually due to cross-reactivity with pollen. Heating often destroys the sensitive proteins, but not all of them.

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