Orange allergy

[Snifflesandsneezes]

Ten years ago I started having problems with allergies I'd never had before. Environmental and food allergies. It was really surprising. When I had the skin test I tested positive for oranges. I never remembered getting hives or anything from oranges before. The nurse told me that if I had't had any reactions I could still eat them even if the test showed positive. I didn't do that. I stayed away from oranges. Period.

About a week ago I was out and got a mango smoothie. It had an orange slice on the cup and it had a straw. I figured no big deal I just wouldn't eat the orange. As I drank the smoothie I became aware that the whipped cream on top tasted very much like a dreamsicle with orange and cream. I drank 80%  of the smoothie. My stomach started to burn. I was uncomfortable and had to stop drinking it. Within I'd say an hour or two my nose became very congested. I didn't make any connections. I got a splitting headache and I noticed much of it was sinus.

I went to bed with the headache and when I woke up it was 80% gone. As the day wore on it started to hurt more again. I noticed that the burning sensation in my stomach kept bothering me off and on for days. Today my stomach has been burning again. I started thinking when did my stomach first start burning anyway? And then I remembered. I thought about the orange slice and taste in my drink a week ago. I got curious about the reactions for an allergy to oranges so, I looked up the symptoms. The first site I found listed stomach pain, congestion and headache. Among other things like hives as well. I don't have any hives. So, it would appear that for the past week I've been having an allergic reaction to oranges? My question is this.. does anyone else have this allergy and if so, how long does the reaction usually last? Any input would be appreciated .

[CMdeux]

Honestly, it is possible that the symptoms were allergic in nature....

it seems just as probable (if not more-so, given how long this lasted) that you had some kind of virus that was giving you those symptoms.
The symptoms seem MORE likely to be illness-related than allergic-- they are pretty non-specific.  Your stomach hurt, you were nasally congested and you had a headache, which improved with rest. 

   Lots of viruses with those exact symptoms running around this time of year, KWIM? The fact that the symptoms improved and came back on their own and with rest strikes me as more 'illness' than allergy.  I know when I've got something allergic happening precisely because those things DO NOT help.  ONLY antihistamines or other allergy-specific meds do. 


If you aren't taking special care to avoid orange, you're probably ingesting small amounts all the time without even realizing it.  Cross-contamination is a HUGE problem with any kind of juice or prepared fruit, truly.  Restaurants often flavor water with citrus, and it's EVERYWHERE in bars.  It's also present in things like marinades, sauces, salad dressings, baked goods, etc.

How certain are you that you are NOT allergic to mango?  That one is actually slightly more common as allergens go.

If your doctor feels that you "might" be allergic, then s/he needs to clarify whether or not it is okay for you to eat this food.  If there is some question about whether or not it is okay for you to eat the food, then s/he needs to arrange for you to have an in office food challenge to find out the answer. 

Were you diagnosed by an allergist?

[Janelle205]

If you aren't taking special care to avoid orange, you're probably ingesting small amounts all the time without even realizing it.  Cross-contamination is a HUGE problem with any kind of juice or prepared fruit, truly.  Restaurants often flavor water with citrus, and it's EVERYWHERE in bars.  It's also present in things like marinades, sauces, salad dressings, baked goods, etc.

Agreed - I was avoiding orange for a while, and it was very difficult - it is in tons of places that you wouldn't expect, like CM said, so you're probably eating more orange than you think. 

I would lean towards a virus, or maybe acid reflux?  I know that when my reflux acts up, I can end up getting really congested and mucousy as well.

[Snifflesandsneezes]

Honestly, it is possible that the symptoms were allergic in nature....

it seems just as probable (if not more-so, given how long this lasted) that you had some kind of virus that was giving you those symptoms.
The symptoms seem MORE likely to be illness-related than allergic-- they are pretty non-specific.  Your stomach hurt, you were nasally congested and you had a headache, which improved with rest. 

   Lots of viruses with those exact symptoms running around this time of year, KWIM? The fact that the symptoms improved and came back on their own and with rest strikes me as more 'illness' than allergy.  I know when I've got something allergic happening precisely because those things DO NOT help.  ONLY antihistamines or other allergy-specific meds do. 


If you aren't taking special care to avoid orange, you're probably ingesting small amounts all the time without even realizing it.  Cross-contamination is a HUGE problem with any kind of juice or prepared fruit, truly.  Restaurants often flavor water with citrus, and it's EVERYWHERE in bars.  It's also present in things like marinades, sauces, salad dressings, baked goods, etc.

How certain are you that you are NOT allergic to mango?  That one is actually slightly more common as allergens go.

If your doctor feels that you "might" be allergic, then s/he needs to clarify whether or not it is okay for you to eat this food.  If there is some question about whether or not it is okay for you to eat the food, then s/he needs to arrange for you to have an in office food challenge to find out the answer. 

Were you diagnosed by an allergist?

I'm pretty sure I don't have a virus.  I don't feel sick with body aches or fevers or anything. Initially I thought it was indigestion. The nasal congestion was almost gone by bedtime and was totally gone when I got up in the morning. The headache took two days to go completely away. The only thing left now is the acidy burning feeling in my stomach that seems to come and go and is more pronounced if my stomach is empty.

I'm sure I'm not allergic to mangoes. I eat them often and have never had any reactions or positive test results on any of the allergy tests I've had.

I was diagnosed with several allergies by an allergist. My allergist didn't say that I might have an allergy to oranges. She said that I am allergic to them. The skin test that she gave me was positive for an allergy to oranges as well as a few other foods and some environmental allergies.

What was curious to me was being diagnosed with the allergy and not remembering having any hives and sneezing from them prior to the diagnosis. When I started with these symptoms presently it made me curious as to what the symptoms for orange allergy are so, I looked them up. My thought was IF it was actually, a reaction to oranges maybe I was experiencing this type of reaction in my past and never recognized it because I thought of the more typical hives and sneezing kind of reaction.

I am very careful about avoiding oranges and the other foods I'm allergic to because, I'm allergic to all nuts as well. I almost never eat any baked goods and rarely eat store bought marinades. I don't eat bars or drink juices or flavored waters. I drink water, coffee or green tea. Very seldom do I drink anything else.

[Snifflesandsneezes]

If you aren't taking special care to avoid orange, you're probably ingesting small amounts all the time without even realizing it.  Cross-contamination is a HUGE problem with any kind of juice or prepared fruit, truly.  Restaurants often flavor water with citrus, and it's EVERYWHERE in bars.  It's also present in things like marinades, sauces, salad dressings, baked goods, etc.

Agreed - I was avoiding orange for a while, and it was very difficult - it is in tons of places that you wouldn't expect, like CM said, so you're probably eating more orange than you think. 

I would lean towards a virus, or maybe acid reflux?  I know that when my reflux acts up, I can end up getting really congested and mucousy as well.

My thought is if not a reaction then probably some kind of acid reflux kind of thing. But, it was very interesting to see some of the symptoms listed be the same ones that I experienced. Oh well, I guess if I'm still feeling burning tomorrow I'll try an antacid.. and then an allergy pill some time later. If neither work then I guess it's just one of those things lol.

[CMdeux]

Keep in mind that I'm not saying that you are not allergic, because: 1) I'm not a medical professional, just another person with a lot of experience with allergies and atopic conditions in general, and b) if you do really have an allergy, then what you did (knowingly eating something cross-contaminated) was potentially pretty DANGEROUS...

It was really surprising. When I had the skin test I tested positive for oranges. I never remembered getting hives or anything from oranges before. The nurse told me that if I had't had any reactions I could still eat them even if the test showed positive.

This is not the same thing as being diagnosed with a food allergy.  If this is the kind of guidance you got from your allergist and/or his/her staffers, this is NOT good care with respect to food allergy.  The reason is that it isn't clear whether or not you had history to support being skin tested in the first place-- er, or maybe it is, actually, since you said that the result was astonishing.  That indicates that this is probably something that shouldn't have been tested to begin with.  The reason?  Skin testing is NOTORIOUS for producing false positive results.  At least 50% of positive SPTs for foods are false positives, in the absense of reaction history to support a diagnosis. 

I was diagnosed with several allergies by an allergist. My allergist didn't say that I might have an allergy to oranges. She said that I am allergic to them. The skin test that she gave me was positive for an allergy to oranges as well as a few other foods and some environmental allergies.

Sn+Sn, I promise I'm not picking on YOU-- though I might be picking on your doc a bit...

This really doesn't sound valid as a means of diagnosing you with food allergies.  Had you-- ever-- had more specific food allergy symptoms prior to testing?  Is your allergist someone who specializes in environmental allergies, by any chance?  Lots of those people will make diagnoses of food allergy on the basis of positive test results alone, most never realizing that they aren't following best practices for food allergy in particular.

Orange is an odd food allergy, also.  Not very many people are truly allergic to oranges.  I am and have been since I was about five years old.  I can count on one hand the other people I've known with orange allergy, and that's after over a decade being a FA advocate for my duaghter with MLTFA. 

Might be time to ask some questions of your doc.  Living with a food allergy you DO have is hard enough-- living with one you do NOT have is just unecessary and cruel of your medical practitioners.  "Avoidance" is a very different ballgame when you do it because of suspected intolerance or aversion than when you do it because a trace of the food might kill you.

I'm glad you are feeling better!

[CMdeux]

For reference (and since Sn+Sn asked about experience with orange allergy):

the last time I was exposed to uncooked citrus was in a glass of (plain) water in a restaurant.
I did NOT know that the water contained lemon slices, since the server filled my glass with ice cubes and then water-- at a station, away from our table.  Each 'pitcher' of water at the station contained a couple of thin lemon slices.   

I took ONE SIP, and I could immediately feel my lips burning.  My nose started to run.  My eyes watered, itched, and my lips swelled slightly.  My entire mouth felt like it was on fire.  That single sip of water very definitely burned as it went down, and I had a few hives around my mouth (according to my DH, who was sitting across the table from me).  I started feeling nauseous and took a benadryl strip.  Within about ten minutes, the symptoms started to subside.

I knew that it was the water, and I didn't know what was in it (until I asked the server), but I knew that it was citrus.
I had a similar reaction about two years ago to a breakfast plate (in a different restaurant) that had been garnished with an orange wedge.  Sometimes I get away with that, and sometimes I don't-- it really depends on whether or not the food itself is absorbing enough of the juice from the citrus, and on how freshly cut the slice is, and how much of it is in direct contact with my food. 

   My citrus allergy is more like really bad OAS than like an anaphylactic food allergy; I can tolerate small amounts of citrus if it is well-cooked. I would NEVER treat shellfish this way, because traces of shellfish can and have caused me life-threatening reactions.

   On the other hand, this illustrates several things about allergic responses to food: a) immediacy (this was pretty much instantaneous... the vast majority of food reactions begin within twenty minutes), b) responds to antihistamines (at least in part-- I also carry epinephrine for my LTFA in case antihistamines are NOT enough), and c) mostly tend to be proportional both in time and intensity to the level of exposure...

in other words, the kind of protracted, non-specific symptoms you experienced would be unusual from a single exposure to an allergen that you don't have anaphylaxis history with.

I mention that only because your INITIAL symptoms weren't severe, nor was what you describe like a biphasic anaphylaxis episode.  For an anaphylactic reaction, on the other hand, gradually subsiding symptoms are entirely in keeping with how these things seem to work. I've had anaphylaxis last a few days, and it's not pleasant, by any means... but those kinds of reactions are hard to ignore since they tend to be extremely scary/debilitating and most often include something fairly specifically "allergic" in nature (like breathing problems, hives, swelling, etc.). 

  Definitely to have low-level symptoms that last and last points more to an on-going exposure to an allergen or to another cause (like illness).

 
Some people who are not allergic to citrus fruits have trouble with the acidity re: reflux, especially during periods of stress or other illness.  I know that I do have that problem with tomato-based foods when I'm under stress or if I'm coming down with something.  It's different from my allergic responses to food, though.   

[Snifflesandsneezes]

Keep in mind that I'm not saying that you are not allergic, because: 1) I'm not a medical professional, just another person with a lot of experience with allergies and atopic conditions in general, and b) if you do really have an allergy, then what you did (knowingly eating something cross-contaminated) was potentially pretty DANGEROUS...

It was really surprising. When I had the skin test I tested positive for oranges. I never remembered getting hives or anything from oranges before. The nurse told me that if I had't had any reactions I could still eat them even if the test showed positive.

This is not the same thing as being diagnosed with a food allergy.  If this is the kind of guidance you got from your allergist and/or his/her staffers, this is NOT good care with respect to food allergy.  The reason is that it isn't clear whether or not you had history to support being skin tested in the first place-- er, or maybe it is, actually, since you said that the result was astonishing.  That indicates that this is probably something that shouldn't have been tested to begin with.  The reason?  Skin testing is NOTORIOUS for producing false positive results.  At least 50% of positive SPTs for foods are false positives, in the absense of reaction history to support a diagnosis. 

I was diagnosed with several allergies by an allergist. My allergist didn't say that I might have an allergy to oranges. She said that I am allergic to them. The skin test that she gave me was positive for an allergy to oranges as well as a few other foods and some environmental allergies.

Sn+Sn, I promise I'm not picking on YOU-- though I might be picking on your doc a bit...

This really doesn't sound valid as a means of diagnosing you with food allergies.  Had you-- ever-- had more specific food allergy symptoms prior to testing?  Is your allergist someone who specializes in environmental allergies, by any chance?  Lots of those people will make diagnoses of food allergy on the basis of positive test results alone, most never realizing that they aren't following best practices for food allergy in particular.

Orange is an odd food allergy, also.  Not very many people are truly allergic to oranges.  I am and have been since I was about five years old.  I can count on one hand the other people I've known with orange allergy, and that's after over a decade being a FA advocate for my duaghter with MLTFA. 

Might be time to ask some questions of your doc.  Living with a food allergy you DO have is hard enough-- living with one you do NOT have is just unecessary and cruel of your medical practitioners.  "Avoidance" is a very different ballgame when you do it because of suspected intolerance or aversion than when you do it because a trace of the food might kill you.

I'm glad you are feeling better!

I appreciate your input. Although you've said you're not picking on me but, I'm beginning to feel a bit picked on by some of your responses.

I'm not really interested in describing or defending my allergic reactions. I have had numerous allergic reactions. My allergic reactions to nuts, medication and environmental triggers is what prompted my primary care doctor to refer me to an allergist who also specializes in asthma which I also have. My allergist tested me for a great deal of foods and orange just happened to be one on the panel. I did not walk into her office and claim a stuffy nose and therefore thought I was allergic to an orange.

I've had allergic reactions in front of family, friends and doctors alike. And none of the doctors diagnosed me with allergies based on my words alone. I was having reactions in their office. I've even had an anaphylactic reaction where I needed to be intubated.

The only reason I continued to drink the smoothie last week was because, after avoiding oranges and anything containing oranges and orange juice for 10 years when I tasted it in the drink I remembered what the nurse said when she told me that if I hadn't had any reactions to oranges then I didn't have to avoid them. I avoided them anyway.

My original question wasn't me asking if I was allergic to oranges. It was if any of the symptoms that I was experiencing sounded like any reactions anyone allergic to oranges had ever experienced themselves. And how long did it last if so. I know that a headache and stuffy nose can sound very much like a cold. And I've had many colds in my life and I can tell when I have one and when I don't. The burning in my stomach was near to when I'd had an ulcer years and years ago. Yet my initial thought was that the acid was simply causing the burning.

My thought was that if it was in fact some kind of allergic reaction that was common with oranges then maybe I'd had the reaction in my past ..before getting diagnosed and that I just didn't recognize the symptoms as being an allergic reaction.

You're right that having food allergies and avoidance diets are stressful. That's why I came to this message board. To talk with people who experience things that I do as well. I didn't come to defend my reactions or my tests and results or why any of my doctors ordered the tests that they did.

I have a very close family friend who has anaphylactic reactions to peanuts every single time she comes in even airborne contact with any peanut products ever since she was a little girl. She has been hospitalized in the ICU for some very extreme anaphylactic reactions. So, I am very well aware that even trace amounts can be life threatening.

[YouKnowWho]

I know it seems like she is attacking you, she is not though.  I want to work through a few of my thoughts and I hope it doesn't come in a attacking sense - we really do want to help.

Add my son to the list of people falsely diagnosed based on testing alone - SPT and RAST.  If it was up to two previous allergists we would still be avoiding corn, rice, oats, milk, soy, peanuts and tree nuts.  All foods he was eating with no issues.  The reality is that his only allergies are to wheat, rye, barley and egg.  It took nearly 5 years for us to finally found an allergist who understood food allergies and the importance of in office food challenges.

Keep in mind that all allergists are not created equally.  Yes your allergist deals with asthma and that is awesome.  But are they specialized in asthma because they see it in patients who have environmental allergies?  The understanding of food allergies in the last ten years has changed dramatically, even the testing protocol has changed.  Allergists should not be doing blanket testing without strong clues to indicate specific foods.  So many environmental allergists are parading as allergists who have a clue about food allergies without proper knowledge.  Blanket testing is easy for allergists to do but hard on the person has to avoid all of those foods, especially if they are false positives.

So you are wondering if orange could cause the symptoms you experienced.  One of the things you may need to do is to have an in office food challenge to see if oranges are truly an allergen for you.  I am making the assumption that smoothie was made commercially?  Do you get those on occassion?  The reason I ask is because the likelihood of cross contamination is likely.  Was it in the mall where perfumes are in higher concentration?  Headaches lean more toward environmental and not food reactions.  Runny noses can go either way.

Believe me when I say that I know how hard it is to figure out mystery reactions.  I am going through that right now with my other son whose lips swelled while eating a dinner we normally have to fight to get him to eat, post steroids (where he was having odd reactions such as all over body itching with no hives and purple patches on his face) and while on Amox.  Not sure we will ever have a clear answer because there is also a chance it could have been viral. 

[rebekahc]

I'm sorry you're feeling attacked.    I know CM is trying to help answer your question while also keeping in mind the many other people (especially those who are new to food allergies) who read and take advice here without ever posting.  It's important that we (as a board and the allergic community) emphasize current best practices in food allergy diagnosis/treatment/management, the accuracy (or not) of testing, and which types of reactions are likely to NOT be IgE mediated immune responses.

Now, as to your question - does your reaction sound typical of reactions experienced by those with orange allergy?  Probably not.  There aren't allergic reaction symptoms specific to a certain food.  You can't say people who are allergic to milk tend to get hives and vomit or people allergic to peanuts tend to wheeze and get swollen lips.  Any food allergy can cause any number or combination of symptoms.  The symptoms are not food specific or even the same each time a person reacts.

Could you be having an adverse reaction to the orange?  Maybe.  But your symptoms, if caused by the orange, would more likely be due to some type of intolerance rather than a true allergy.  For one, your symptoms aren't typical for those of an IgE mediated allergic response.  Also, if others experience the same symptoms to the food, that would tend to be more typical of an intolerance (ie lactose intolerance causes gas and bloating). 

Regardless of intolerance or true allergy, I'd think your reaction was more likely to be caused by the orange if the stomach burning hadn't lasted so long.  I would think that once it was out of your system that symptom would have gone away.

I hope your stomach is feeling better soon!

[Snifflesandsneezes]

I know it seems like she is attacking you, she is not though.  I want to work through a few of my thoughts and I hope it doesn't come in a attacking sense - we really do want to help.

Add my son to the list of people falsely diagnosed based on testing alone - SPT and RAST.  If it was up to two previous allergists we would still be avoiding corn, rice, oats, milk, soy, peanuts and tree nuts.  All foods he was eating with no issues.  The reality is that his only allergies are to wheat, rye, barley and egg.  It took nearly 5 years for us to finally found an allergist who understood food allergies and the importance of in office food challenges.

Keep in mind that all allergists are not created equally.  Yes your allergist deals with asthma and that is awesome.  But are they specialized in asthma because they see it in patients who have environmental allergies? The understanding of food allergies in the last ten years has changed dramatically, even the testing protocol has changed. Allergists should not be doing blanket testing without strong clues to indicate specific foods.  So many environmental allergists are parading as allergists who have a clue about food allergies without proper knowledge.  Blanket testing is easy for allergists to do but hard on the person has to avoid all of those foods, especially if they are false positives.

So you are wondering if orange could cause the symptoms you experienced.  One of the things you may need to do is to have an in office food challenge to see if oranges are truly an allergen for you.  I am making the assumption that smoothie was made commercially?  Do you get those on occassion? The reason I ask is because the likelihood of cross contamination is likely.  Was it in the mall where perfumes are in higher concentration?  Headaches lean more toward environmental and not food reactions.  Runny noses can go either way.

Believe me when I say that I know how hard it is to figure out mystery reactions.  I am going through that right now with my other son whose lips swelled while eating a dinner we normally have to fight to get him to eat, post steroids (where he was having odd reactions such as all over body itching with no hives and purple patches on his face) and while on Amox.  Not sure we will ever have a clear answer because there is also a chance it could have been viral.

Thank you for giving some input also. I do appreciate it. Just to clear a few things up I'm going to respond to some of your questions individually.

I do realize that allergists aren't always the same. My allergist does specialize in food and environmental allergies.

She did blanket testing of different foods because, I was having allergic reactions and breaking out in hives every single day for some time before I went to see her. I seemed to be reacting to different foods. My primary care doctor advised me to be aware of what I was eating so that I could let the allergist know. When I let the allergist know what I was eating and how often I was having allergic reactions she said it would be best to do a blanket test of foods as well as the environmental triggers to see what exactly I was reacting so badly to.

The smoothie was one my cousin made for me that was non alcoholic at the bar where she works. She had no idea that I've tested positive for and have been avoiding oranges for 10 years. I almost never get smoothies or shakes or slurpees or anything of the like because, I've been avoiding oranges for so long and I didn't want to cross contaminate.

It was just odd. I had noticed part way through drinking the smoothie that my stomach was burning. The stuffy nose was almost immediate and was gone by bedtime. The headache came on pretty shortly after having the smoothie. My first thought hadn't been that I was having an allergic reaction. I chalked them all up to be completely unrelated. It was days later when my stomach was periodically still burning when I asked myself "ok when did this actually start?" and that's when I remembered the orange in my smoothie. At that point is when I decided just for the heck of it I'd look to see if that could have been any kind of reaction to the orange. I then thought maybe it had happened in my past with oranges and I'd dismissed it if in fact it was a reaction. When I started reading that the symptoms were some of the symptoms that can occur light bulbs went off in my head and I decided to look online for people I could ask. If it wasn't an allegic reaction then it wasn't. No big deal. It was just a question I had.

The other thing regarding allergists. I was diagnosed 10 years ago yes. But, that wasn't the last time I've seen an allergist. And surely wasn't the only one. The other I saw wasn't even in the same practice or office. So, yes I've been to more than one allergist both specialized in food and environmental allergies from two different practices altogether.

I'm sorry you're having a hard time with your son's allergies. I know how frustrating it can be. I ran into the weirdest allergic reaction I've had in years this past summer when I reacted to chocolate. That was probably a case of cross contaminated chocolate but, the reaction ..the hives.. were out of this world. And with my allergy to all nuts I've had my share of hives and facial swelling so, it really floored me when I got these enormous hives all over me.

[Snifflesandsneezes]

I'm sorry you're feeling attacked.    I know CM is trying to help answer your question while also keeping in mind the many other people (especially those who are new to food allergies) who read and take advice here without ever posting.  It's important that we (as a board and the allergic community) emphasize current best practices in food allergy diagnosis/treatment/management, the accuracy (or not) of testing, and which types of reactions are likely to NOT be IgE mediated immune responses.

Now, as to your question - does your reaction sound typical of reactions experienced by those with orange allergy?  Probably not.  There aren't allergic reaction symptoms specific to a certain food.  You can't say people who are allergic to milk tend to get hives and vomit or people allergic to peanuts tend to wheeze and get swollen lips.  Any food allergy can cause any number or combination of symptoms.  The symptoms are not food specific or even the same each time a person reacts.

Could you be having an adverse reaction to the orange?  Maybe.  But your symptoms, if caused by the orange, would more likely be due to some type of intolerance rather than a true allergy.  For one, your symptoms aren't typical for those of an IgE mediated allergic response.  Also, if others experience the same symptoms to the food, that would tend to be more typical of an intolerance (ie lactose intolerance causes gas and bloating). 

Regardless of intolerance or true allergy, I'd think your reaction was more likely to be caused by the orange if the stomach burning hadn't lasted so long.  I would think that once it was out of your system that symptom would have gone away.

I hope your stomach is feeling better soon!

Thank you for responding.

From my understanding there are some foods that can have specific signature reactions. One of the allergists I've seen told me that specifically pistachios can cause your eyes to swell as a signature allergic reaction ..as well as hives etc. And that as well as hives happened to me any time I was in contact with pistachios. I know of grown adults allergic to fish and not shellfish and it makes them do nothing but vomit.

As per gas and bloating and intolerance. I experienced none of those symptoms. It most likely based on what I'm being told here.. wasn't an allergic reaction. And that's just fine with me. It was just a curiosity. And if I don't have to avoid oranges that actually, makes life a little easier on the avoidance diet I already have to follow.

[CMdeux]

That allergist is simply wrong regarding food allergens producing a particular allergic reaction symptom.

  S/he may be convinced that some allergens produce "typical" symptoms, but research simply doesn't bear that out in population studies of people with allergies.  There are allergic symptoms that are the result of mast cell degranulation triggered by IgE, and there are allergen-specific IgE in an allergic person's bloodstream.  Beyond that, it's a mixed bag mechanistically.  Period.

Some allergens are far more likely to provoke anaphylaxis than others-- for example, fish, shellfish, nuts and seeds-- and among those, there are individual allergens that are more likely to produce spectacular anaphylaxis with vanishingly small traces...  yes.   

But it isn't EVER as simple as saying that "peanut produces breathing difficulty."  Or that "egg produces hives and swelling."  Maybe in one person, it does, at least some (most) of the time.  But in another person, maybe not.  If it were that simple, then doctors would have a much easier time predicting which patients were truly at risk of fatality from food allergy.  Currently, the best they can do is predict who is at elevated risk for anaphylaxis on the basis of the allergen's identity and patient history.  So someone like YKW's son needs epinephrine even though he's allergic to wheat, which is mostly not an anaphylaxis trigger.  In his case, what is true for "most" patients is simply irrelevant because he has anaphylaxis history with the allergen.


  This is why I'm extremely clear about the fact that my own orange allergy is probably OAS and not a primary allergy-- and that I would never take risks like that with shellfish, because that one can produce unpredictably severe reactions from traces, at least in my own individual experience.  For someone else who has an IgE-mediated reaction to oranges, that could well be the case and my method of managing my allergy would be entirely insufficient (and dangerous).

I promise that we're really just trying to help, honest.    I sure love how oranges smell.  <sigh>  I wish I could eat the real thing.  I hope that is true for you-- if so, I sincerely hope that you'd enjoy one for me sometime.   


   
One last note (just in general, and not specific to Sn+Sn);     It is REALLY important, when dealing with possible food allergies, to make certain that the person you are seeing is an M.D. and not an OD or ND.  Also important; do enough research on current best practices at AAAAI (and FAI/FAAN) to know whether or not the person who sees you is offering current advice that tallies with developments over the past 4-6 years.  Much has changed in the thinking regarding testing, diagnosis, and management in that time.  There are also emerging allergens as new seeds/oils begin to be used more widely.  Sunflower, for example, is a much more common allergen than it used to be, and it is-- like other seeds and nuts-- super-potent in that they can cause anaphylaxis in very small quantities.  HTH someone, even if Sn+Sn already knows all of that.   

[rebekahc]

Another thought, you mention you're allergic to pistachio.  Since mango is closely related to pistachio (and cashew), often people are allergic to both.  It may be that you can usually tolerate mango, but if you have other stuff going on with your immune system you might not tolerate it then.  I wonder if that could have been a contributing factor to your reaction?  Also, have you considered that the stuffiness and stomach pain could be unrelated?  Stuffiness from a reaction to the smoothie and stomach something else - virus, indigestion, gall bladder, etc.  Maybe whatever was causing the stomach pain left you vulnerable to a reaction to the mango that you normally would not have?

[CMdeux]

Oh, that is a REALLY good point, Rebekah.

Mango/cashew/pistachio is one of those fairly unusual series of related allergens where cross-reactivity to the entire family is very common.  I'd be concerned about developing cross-reactivity to mango, particularly if your pistachio allergy is anaphylactic and/or adult onset among other food allergies.