Strawberry allergy
Strawberry allergy.
About strawberry allergy
Strawberry is a soft fruit in the rose family, and reactions to it are common but usually mild. Many are not classic allergy at all but responses to natural chemicals in the fruit, while true allergy is IgE-mediated, with antibodies to strawberry proteins, including a protein related to birch pollen and a lipid transfer protein, triggering histamine release. A red protein in ripe strawberries appears important, as some people tolerate unripe white strawberries better.
Symptoms usually begin within minutes to two hours and often involve an itchy or tingling mouth, hives, swelling around the lips and, in children, flare-ups of eczema or a blotchy rash around the mouth. In people sensitised through birch pollen the symptoms are typically confined to the mouth and short-lived, whereas lipid transfer protein sensitivity, more common in southern Europe, can occasionally cause stronger, systemic reactions.
Diagnosis draws on the history supported by skin-prick or specific-IgE testing, with component testing sometimes helping to judge the likely severity. Management means avoiding strawberry when it causes symptoms and checking desserts, jams, yoghurts and flavoured products. Most reactions are mild and settle on their own, but anyone who experiences throat tightness, breathing difficulty or a widespread reaction should seek urgent medical help and call 999.
Common triggers
- Strawberry and products containing it
Symptoms
- Itching or tingling in the mouth
- Hives, itching or eczema
- Swelling of the lips, face, tongue or throat
- Stomach cramps, nausea, vomiting or diarrhoea
- Wheezing or trouble breathing
- In severe cases, anaphylaxis
Avoidance & management
- Read ingredient labels every time
- Ask about ingredients and cross-contamination when eating out
- Keep the food out of shared cooking areas
- Carry prescribed antihistamines or an adrenaline auto-injector
- Seek emergency help for any severe reaction
Sources & references
Allergy safety: what everyone should know
Mild-to-moderate reaction signs
- Itching, hives or a raised rash
- Swelling of lips, face or eyes
- Tingling mouth, sneezing, runny nose
- Stomach pain, nausea or vomiting
Anaphylaxis — call 999 (UK) or 112 (EU) immediately
- Difficult or noisy breathing, wheeze, persistent cough
- Swelling of the tongue or tightness in the throat
- Dizziness, collapse, pale and floppy (young children)
- Use an adrenaline auto-injector (e.g. EpiPen) at once if prescribed, then call an ambulance even if symptoms improve
Allergy or intolerance? A true allergy involves the immune system and can escalate quickly; an intolerance (e.g. lactose intolerance) is unpleasant but not life-threatening. The symptoms overlap, so self-diagnosis is unreliable.
Getting tested: home-testing kits based on IgG are not diagnostically valid. If you suspect an allergy, ask a GP for referral to an allergy clinic for skin-prick or specific-IgE testing and a supervised food challenge where appropriate.