If you've ever felt an itchy tongue or throat after eating strawberries, you may actually be allergic to them.
It's true: You can be allergic to strawberries. And if you are, you may have an allergic reaction to some other similar fruits as well.
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Here, learn about the symptoms of a strawberry allergy, how to manage it and how it's diagnosed.
What Is a Strawberry Allergy?
A strawberry allergy is considered an oral allergy, according to the University of Manchester. Oral allergy syndrome — sometimes called pollen-food allergy syndrome — affects some people who are allergic to pollen, per the American College of Allergy, Asthma and Immunology (ACAAI). These people may also have an allergic reaction to certain nuts, spices and fresh fruits and vegetables like strawberries.
This is because the foods contain similar proteins to pollen, according to the Mayo Clinic, so your body mistakes the food for something harmful.
Symptoms of oral allergy syndrome may include, per the ACAAI:
- Itchy mouth
- Scratchy throat
- Swelling of the lips, mouth, tongue and throat
- Itchy ears
- Hives around the mouth
Strawberry Allergy Symptoms
Symptoms of a strawberry allergy may include the following, according to the ACAAI and Stanford Health Care:
- Itchy mouth
- Scratchy throat
- Itchy ears
- Tingling, itching or burning lips
- Swelling of the lips, mouth, tongue and throat
- Sensation of tightness in the throat
- Hives or a rash around the mouth
Symptoms will occur almost immediately after you've eaten or come into contact with strawberries, and last for about 30 minutes once you stop eating them (as most oral allergies do), per the Cleveland Clinic.
Strawberry Allergy Rash
A strawberry allergy rash will often present as hives (raised, red welts) around the mouth. These hives will likely be itchy and confined to just the mouth area, according to the ACAAI. A strawberry allergy usually does not cause a rash on other areas of the body.
Strawberry Allergy vs. Intolerance
While a strawberry allergy mainly affects the mouth and throat, a food intolerance often only affects the digestive system and causes less serious symptoms, such as bloating, gas and diarrhea, per the Cleveland Clinic.
If you have a strawberry intolerance, it's often a result of an enzyme deficiency, meaning your digestive system can't properly break down certain ingredients in the food. This is what causes the digestive upset, per the Cleveland Clinic.
Unlike a food allergy, which can sometimes be life-threatening, an intolerance produces relatively mild, short-term side effects that resolve on their own with time.
Food intolerances are more common than allergies, but a strawberry intolerance is not among the more common intolerances — those include lactose, gluten, eggs and nuts.
Risk Factors for Strawberry Allergy
You are generally at a higher risk of developing a strawberry allergy if you're already allergic to some cross-reacting allergens, like trees, grass and other pollens like birch pollen, per the Cleveland Clinic.
You're also at a higher risk of strawberry allergy if you're allergic to other fruits in the Rosaceae family — like cherries, per the American Academy of Allergy, Asthma & Immunology. (More on this below.)
Additionally, those with eczema — or a family history of eczema — are more prone to developing food allergies, per a February 2019 report from the National Institutes of Health.
Foods to Avoid With a Strawberry Allergy
As mentioned above, strawberries are members of the Rosaceae family. You may be unable to eat other raw fruits in this family if you're allergic to strawberries.
According to a February 2017 article in Molecular Biology and Evolution, other fruits in the Rosaceae family include:
Most fruits in the Rosaceae family are also linked to birch allergic rhinitis (or hay fever) per the study above.
While rare, you could develop oral allergic reactions to the following foods as well, per the AAAAI:
- Peanuts, almonds or hazelnuts
Note: Reactions to these foods are less likely, but visit your allergist if you develop any concerning symptoms after eating them. You may have an initial allergy to birch pollen, ragweed or other grasses that contain the same allergens as some of these foods, per the AAAAI.
What About Strawberry Jam, Dried Strawberry or Strawberry Candy?
People with oral allergy syndrome can usually eat the fruits or vegetables to which they are allergic in cooked form because their proteins are altered during the heating process, per the Mayo Clinic. The body doesn't react in the same way to cooked food — for example, you may be allergic to apples but can safely eat applesauce.
This means you may be able to eat foods with cooked-down strawberries — like strawberry jam, dehydrated strawberries or strawberry candy.
Always talk to your doctor if you are allergic to a food and are unsure what form (if any) is safe to eat.
How to Manage a Strawberry Allergy
The best way to manage a strawberry allergy and prevent symptoms is to avoid eating raw or uncooked strawberries.
From there, if you happen to eat strawberries accidentally or prior to realizing you're allergic, there are a number of treatment courses you can choose. These include, per the Cleveland Clinic:
- Over-the-counter antihistamines: These medications work by blocking chemicals in your body that cause allergic reactions (i.e., histamines). Common brands are Benadryl ($13.20 for 100 tablets, Amazon), Claritin ($19.82 for 30 tablets, Walmart.com) and Allegra ($15.49 for 12 tablets, CVS.com).
- Epinephrine: If you've had a severe allergic reaction, your doctor may prescribe an injectable medication called epinephrine, which reduces swelling and helps you breathe. This comes in the form of an EpiPen. If you have a severe allergy or a reaction that causes difficulty breathing, you should use your EpiPen after exposure and call 911 immediately.
- Avoiding allergens at certain times of year: If you have seasonal allergies, you may want to avoid strawberries or other trigger foods depending on when they're in season, like spring.
- Allergy shots (immunotherapy): Allergy shots expose you to what you're allergic to in increasing doses, in hopes that your body builds a tolerance.
Other tips to manage a strawberry allergy include:
- Pay attention to what you're eating and drinking, particularly when you are not at home, and make a habit out of checking food labels.
- Be careful at restaurants and ask questions about the food served. Mention your strawberry allergy to the server.
- Wear a medical alert bracelet or necklace that lets others know about your condition. This may help in case you experience a severe allergic reaction and are unable to communicate.
How Is a Strawberry Allergy Diagnosed?
If your doctor suspects you have a strawberry allergy, they may refer you to an allergist who can perform a variety of tests to determine your allergy. These include, per the ACAAI:
1. A Skin Test
For this test, an allergist pricks skin on your arm or back with a tiny, sterile probe that contains a small amount of the food allergen (or in this case, strawberries). If you're positive for a certain allergen, your skin will have developed a bump resembling a mosquito bite at the site of the skin prick. Test results usually take about 15 to 30 minutes.
These tests are not painful, but may create an itching sensation at the site of whatever food you're allergic to.
2. A Blood Test
Blood tests measure the amount of the IgE antibody your body has built up against the foods being tested. This indicates that your body is having an allergic response to whatever the allergen is. Blood tests are less sensitive than skin prick tests, and results are usually available within one to two weeks after testing.
3. Oral Food Challenge
If your allergist is looking to confirm inconclusive test results, they may recommend an oral food challenge. With this method, you are fed gradually increasing amounts of the suspected allergy-causing food over a period of time under a doctor's supervision. Unfortunately, though, this test can be costly, time-consuming and potentially dangerous to patients.
Of course, emergency equipment and medicine would be on hand during the challenge.
4. Elimination Diet
While this method is not as specific and refined as the tests above, an elimination diet can be a great starting point for you and your allergist to narrow down triggering foods.
Begin by eliminating one or two foods that you suspect are causing symptoms for one to two weeks. If symptoms decrease and then flare up when you reintroduce the food, it's likely you have an allergy.
When to See a Doctor
If you suspect that you are allergic to strawberries or any fruits in the Rosaceae family, seek advice from a doctor, who can offer options for diagnosis and treatment.
Symptoms like itching, swelling and burning of the mouth, throat and tongue are common indicators that an allergic reaction is occurring. Call 911 if you are having trouble breathing, as this could be a sign of a severe, life-threatening allergic reaction.
Keep in mind that some people with oral allergy syndrome don't experience symptoms immediately. You may even feel symptoms from a particular food hours after eating. This is why it's important to take note of what you're eating, and treat symptoms as they arise.
- American College of Allergy, Asthma and Immunology: "Oral Allergy Syndrome"
- Mayo Clinic: "Food Allergy"
- Molecular Biology and Evolution: "Evolution of Rosaceae Fruit Types Based on Nuclear Phylogeny in the Context of Geological Times and Genome Duplication"
- Stanford Health Care: "Oral Allergy Syndrome"
- AAAAI: "Oral Allergy Syndrome"
- Cleveland Clinic: "Oral Allergy Syndrome"
- Seattle Children's Hospital: "Hives"
- AAAAI: "Anaphylactic reactions to cherries, strawberries, and grapes"
- National Institutes of Health: "Scientists identify unique subtype of eczema linked to food allergy"
- ACAAI: "Food Allergy Testing and Diagnosis"
- The University of Manchester: "Strawberry-allergy information"
- Cleveland Clinic: "Food Allergy vs. Intolerance"
- Cleveland Clinic: "Antihistamines"
- ACAAI: "Oral Allergy Syndrome"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.