Oral Allergy Syndrome


If certain raw fruits and vegetables make your mouth, tongue, throat or inner ears itch, you may have Oral Allergy Syndrome (OAS).  

OAS is what happens when you've got seasonal allergies and your body accidentally confuses the proteins on raw fruit with the pollen proteins its supposed to be allergic to. Basically, its a seasonal allergy masquerading as a food allergy. 


OAS differs from classic food allergies because the majority of people don't react to the fruit when it's been cooked. In other words, raw apples may give your mouth grief, but applesauce often goes down without a hitch.  Same goes for raw stone fruits versus fruit pies, raw carrots versus cooked ones or raw pears versus poached ones. Some lucky folks can even get away with eating their trigger food raw so long as they peel it.

It's rare-- though certainly not impossible-- for OAS to cause anaphylaxis like a more typical food allergy does. Still, pay attention to your symptoms and take action if your reaction spreads beyond an unpleasant itchiness in the mouth or throat. If you can't tolerate even the cooked form of the fruit-- or if nuts trigger an oral reaction-- you should avoid the trigger food(s) and see an allergist for proper food allergy testing.

The food(s) you react to with OAS will depend on what seasonal allergen you're allergic to, and your food reactions will likely be more severe when you're in the midst of allergy season. Certain fruits, veggies and even nuts can "cross react" with pollens whose proteins resemble theirs.

If you're allergic to birch pollen (Spring), you may experience OAS with: apples, pears, stone fruits (peach, plum etc), kiwi, carrots, celery, peanuts, almonds and/or hazelnuts.

If you're allergic to ragweed (Late summer/Fall), you may experience OAS with: melons, cucumber and zucchini

If you're allergic to grasses (Summer), you may experience OAS with: peach, watermelon, orange, tomato, 

If you're allergic to mugwort (Fall), you may experience OAS with: raw veggies, like pepper, broccoli, cabbage, cauliflower, chard, garlic, onion and parsley

IBS 101: The Two Supplements Everyone with IBS Should Know About

Irritable Bowel Syndrome (IBS) affects 10-20% of the U.S. population... and about 80% of my clinical practice's patient population. For the better part of the past decade, I've basically been living and breathing IBS in all of its forms vicariously through my patients. I know all about the incessant morning trips to the bathroom with IBS-D... the days without any activity in the bathroom with IBS-C... and the IBS-M cycles of not being able to go for days, followed by an entire day spent running to the bathroom once the "dam breaks." 

There are many approaches to managing these symptoms of IBS-- from elimination diets to probiotics to other supplements to prescription medications to hypnotherapy.  At one time or another, I've recommended all of these in my practice, tailoring my advice to a patient's individual pattern of symptoms. 


But there are two remedies that have been the most effective for the largest number of my patients over the years: soluble fiber supplements for IBS-D and magnesium supplements for IBS-C. They're cheap, over the counter, sold everywhere, and in my humble opinion, should be the first thing you try before diving deep into the rabbit hole of expensive, extensive treatment protocols.

Citrucel and Benefiber are my soluble fiber products of choice. Taken every evening at the recommended 2g dose, they are often remarkable effective at normalizing the morning routine among people with IBS-D-- consolidating those multiple, urgent trips to the bathroom to just one or two efficient visits and forming those loose and crampy stools into bulky, complete and easy-to-pass alternatives. A full dose of Citrucel is 4 pills or 1 TBSP (orange flavored) powder. A full dose of Benefiber (unflavored) is 2 tsp. Both are equally effective. The most common way my patients describe soluble fiber therapy is "life changing."

For constipation predominant IBS, magnesium supplements at a dose of 400-800mg, also taken in the evening, can be remarkably effective in softening stools and increasing their frequency. Any old form will do, though magnesium oxide is the one you'll encounter most often. I'll usually have my patients start at 400mg and work their way up-- 200mg at a time-- if needed. Take the full dose all at once. Assuming you've got functioning kidneys, the only real side effect you need to worry about at this dose is diarrhea. If that happens, pull back on the dose to find that happy middle ground.