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Strawberry Allergy: Symptoms and How to Manage It

Strawberries are everyone’s favorite fruit—sweet, juicy, and ideal for everything from smoothies to summertime desserts. But for others, they can be more than a stomach cramp or a pucker face. A strawberry allergy, although not as prevalent as peanut or shellfish allergy, is real and can even be dangerous. If you or someone in your life begins to experience odd symptoms after consuming strawberries, it’s time to take notice.

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When a person is allergic to strawberries, their immune system responds to some of the proteins in the fruit, particularly one known as Fra a1. The immune system mistakenly identifies these proteins as a threat and sends out an attack, which includes releasing chemicals such as histamine. This causes all the usual allergy symptoms. According to NY Allergy & Sinus Centers, “Strawberry allergy is an allergic reaction that takes place when the immune system mistakenly identifies the proteins present in strawberries as harmful and mounts an allergic response.”

The symptoms can be quite varied. For others, it’s a scratchy mouth or a couple of red bumps. Others may experience more severe responses such as face, lip, or throat swelling, difficulty breathing, or in some instances, anaphylaxis—a potentially life-threatening allergic reaction. Verywell Health suggests that “rarely, individuals with a strawberry allergy can experience symptoms of anaphylaxis, a potentially life-threatening allergic reaction.” On the mild end, you may see hives, skin rashes, congestion in the nose, or watery eyes. For people with eczema or allergic asthma, strawberries can also sometimes exacerbate their symptoms.

It’s also worth being aware of the difference between a real allergy and a food intolerance. They may appear to be the same thing, but they aren’t. Food intolerance has nothing to do with the immune system—it’s more about how your body processes certain foods. It can cause bloating, gas, or cramps in the stomach, but it won’t trigger severe symptoms like anaphylaxis. As explained by the Australasian Society of Clinical Immunology and Allergy (ASCIA), “Food intolerances are sometimes mistakenly called food allergy but do not result in allergic reactions. Food intolerances affect the gastrointestinal system (gut). Food allergies affect the immune system.” 

So why do some become allergic to strawberries while others do not? A combination of genetics and environment is generally to fault. Kids, particularly those with eczema or a history of allergy in the family, are more likely to be at risk. And individuals with hay fever—particularly those sensitive to birch pollen—can get a condition known as oral allergy syndrome. In this condition, the immune system is confused because the proteins in strawberries are similar to those contained in some pollens. The outcome? A mouth or throat that itches after consuming strawberries.

Another factor to keep in mind is cross-reactivity. If you’re allergic to strawberries, you may react to other foods that belong to the same plant family. That means apples, peaches, cherries, and even almonds. Verywell Health says that “You may have an increased risk of being allergic to one or more other foods closely related to strawberries (foods in the Rosaceae plant family). These include: Almonds, Apples, Apricots, Cherries, Peaches, Pears, Raspberries.”

If you suspect you have an allergy to strawberries, don’t try to solve it yourself. Allergists put together your history, skin tests, and, at times, blood tests to assess how your immune system is reacting. In some situations, they may recommend a short-term elimination diet to determine the issue. But ASCIA cautions that elimination diets must be undertaken in the care of a doctor and for only a limited period, particularly with children, or there is a risk of missing key nutrients.

The key to controlling a strawberry allergy is to stay away from the fruit altogether. That requires reading labels on foods meticulously and being careful when eating out or at social events. If you do react, mild symptoms are usually treated with antihistamines. For serious reactions, you’ll have to administer an epinephrine auto-injector immediately. The NHS recommends, “If you or the person you’re with is having a severe allergic reaction and has an adrenaline auto-injector (like an EpiPen), you should use it at once.” Following the use of an auto-injector, always call emergency medical services, even if you improve rapidly.

Strawberry allergy can be difficult to live with, but it can be managed with proper guidance. Discussing with a health care professional or an allergist will make you aware of the causes, create a safety plan, and give you peace of mind. Proper information and precautions will ensure your safety, and you can live the life you love, just perhaps strawberry-free.

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