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What Are the Signs of an Allergic Reaction to Citrus?

By Gregory Hanson
Updated Mar 03, 2024
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The signs of an allergic reaction to citrus run the gamut from symptoms that cause mild discomfort, such as itching, to potentially life-threatening reactions. Citrus allergies are rare, and most people who do have a citrus allergy exhibit only mild symptoms. Individuals who are seriously allergic to citrus may experience anaphylaxis, a very serious condition, which requires immediate medical attention. In some cases, individuals may not digest citric acid or other components of citrus fruit, but this is not a true allergy.

All allergies occur when the human body overreacts to a foreign substance. This overreaction causes the immune system to attack parts of the body itself. In most cases, this is far less serious than it sounds and involves only minor discomfort, such as the sneezing and watering eyes associated with hay fever. Food allergies are among the most common types of allergic reactions, although allergies to citrus fruits are not especially widespread.

Some indications of an allergic reaction to citrus, or to any other food, may be centered in the lips and mouth. Itching or tingling after citrus has been consumed is a common reaction, and is one of the typical signs of an allergic reaction to citrus. The face and throat may also react when citrus is consumed by someone who is allergic. The throat may feel tight or uncomfortable, and the face may itch or turn red.

Hives that appear after eating fruit may also be markers of an allergic reaction to citrus. These raised blotchy red and pink patches appear fairly suddenly. They typically itch ferociously and may appear anywhere on the body, not simply near the mouth. They may appear rapidly after eating or may take some time to manifest. A doctor should be consulted if hives appear, as they may be a symptom of anaphylaxis.

Anaphylaxis may occur as a result of a food allergy. This is an extremely serious type of allergic reaction, which can prove fatal if left untreated, and warrants immediate and urgent medical attention. In this type of reaction, an individual’s entire body is wracked with allergy symptoms. Shortness of breath, dizziness, and difficulty breathing are common, as is anxiety. Serious swelling of the face or the appearance of a blue tint in the skin may also occur.

A much less serious reaction to citrus fruit occurs in some individuals who cannot digest these foods. This type of reaction typically causes intestinal distress, but this distress is not a true allergic reaction to citrus, as the immune system is not involved. Avoiding citrus fruit is still advised for people who experience this sort of distress, but medicines that limit allergic reactions will not be of help.

How Common Is a Citrus Allergy?

It is rare for an individual to be allergic to citrus. Doctors have not diagnosed a specific percentage of the population with citrus allergies because many people have such a minor reaction that they don’t go through allergy testing. Those with severe reactions usually discover symptoms at a young age.

Citrus fruits grow throughout much of the world, and many cultures use different varieties in their cooking. Given that citrus is so popular, the incidences of an allergic reaction are small compared to the number of people who consume these foods without any trouble.

Pollen May Contribute to a Citrus Allergic Reaction

People with a pollen allergy may also have a cross-reaction with citrus, and many people with citrus allergies are also sensitive to grass and other pollens. Citrus fruit molecules are similar to different pollens, and the body does not always differentiate between the two. When allergy-prone individuals consume a bite of citrus fruit, their immune system responds the same way as if they were exposed to grass or other allergens.

What Foods Are Off Limits With a Citrus Allergy?

People with a citrus allergy should avoid eating lemons, limes, grapefruit and oranges. This includes frozen, fresh, juiced and dehydrated forms of these fruits. Citrus is a common flavoring that can be found in:

  • Vitamins
  • Dehydrated fruit rolls
  • Muffins
  • Cakes
  • Fruit punch
  • Skin cream
  • Salad dressing
  • Jams

Some individuals react less to cooked citrus fruits, making baked goods, syrups and sauces tolerable.

What Alternatives Are Available To Add a Tart Taste to Food?

Citrus flavors give foods a tart appeal. When avoiding citrus, cooks can use vinegar, the herb lemon verbena or white wine to give foods a kick. Using pure citric acid is also an option in recipes that call for citrus juice.

Can People With a Citrus Allergy Consume Citric Acid?

Citric acid is a component of citric juice, but it usually doesn’t cause an allergic reaction. Manufacturers use this potent acid in multiple things, including artificial flavors. The acid may cause mouth or stomach irritation, but it does not induce an immune response in most people. People with citrus allergies more typically are allergic to the oils or proteins in the fruits rather than the acid.

How To Get Vitamin C With a Citrus Allergy

Citrus foods are high in vitamin C, which is necessary for a robust immune system. Fortunately, there are other foods and supplements available for those allergic to citrus. Non-citrus foods that are high in vitamin C include:

  • Kale
  • Broccoli
  • Potatoes
  • Snow peas
  • Brussel sprouts
  • Guava
  • Bell peppers
  • Kiwifruit

Some supplement producers sell vitamin C formulated without citrus extracts. These may be safe for individuals who want to enhance their diet with vitamin C.

How To Test for a Citrus Allergy

When someone suspects an allergy to citrus foods, there are three options for confirming this suspicion.

Blood Tests

Tests analyze a person’s blood to measure the amount of immunoglobulin E antibodies. High levels of these antibodies may suggest that the individual is allergic to the food. However, while blood tests are relatively accurate for outdoor and indoor allergies, they are less reliable for food allergies.

Skin Tests

A more precise option than testing blood for food allergies is skin testing. This type of test uses a small pin dipped in an allergen that a doctor then applies to the skin. A person with an allergy to the solution may develop a small, itchy red bump in the location of the allergen. More severe reactions indicate a more substantial allergy to the food.

Elimination Diet

People who prefer to evaluate their allergies themselves can try an elimination diet. To do this, individuals should avoid consuming foods they believe they are allergic to. If they notice an improvement in their allergy symptoms, the eliminated foods may be the culprit. One way to check is to reintroduce those items back into the diet one at a time to see if any allergy symptoms reappear.

What Treatments Help With a Citrus Allergy?

Since citrus is a common additive to many foods, beauty products and household solutions, it may be impossible to avoid it all the time. While allergies might never disappear, medications are available to manage the symptoms. Inhalers, steroid creams and antihistamines can help ease the allergy effects.

Individuals with severe reactions may benefit from allergy shots to lessen their response to an allergen over time. Shots introduce small amounts of the allergen into the patient, which allows their body to learn not to treat that food as a threat.

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