Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentWhat to AvoidFood AlternativesWhen to See a Healthcare ProviderFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
What to Avoid
Food Alternatives
When to See a Healthcare Provider
Frequently Asked Questions
Citrus allergies are uncommon but possible. Allergies have been reported to grapefruit and oranges.
This article discusses the symptoms, causes, diagnosis, treatment, and alternatives of citrus allergy.
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Those who have an allergy tocitrus fruitmay experience a wide variety of symptoms. They can range from mild symptoms toanaphylaxis.
Possible symptoms include:
How Can Citric Acid Affect Your Health?
Complications
In some cases, more serious symptoms can occur as a result of a citrus allergy.
These can include:
Those with a severe allergy may also experience anaphylaxis.
Anaphylaxis is a severe allergic reaction that can be life-threatening. Being able to identify symptoms of anaphylaxis is essential.
Symptoms of anaphylaxis may come on suddenly and rapidly worsen.
They may include:
If you or someone near you has an anaphylactic reaction, administer the epinephrine auto-injector (EpiPen) immediately and call 911.
As with other allergies to fruit, a citrus allergy has many possible causes. Many people with an allergy to citrus may also have an allergy to pollen.
Pollen-Food Syndrome
Those with an allergy to citrus fruits may be experiencing a cross-reactivity with grass pollen (having an immune reaction to certain proteins).
People with pollen-food syndrome often already have a pollen allergy and may have hay fever symptoms. These people will also experience allergy symptoms when eating certain fruits and vegetables.
Citrus fruits are one of the fruits that may cause this reaction.This is because the proteins in pollen are similar to the proteins in some fruits and vegetables, like citrus.
Heated or processed versions of the food do not usually cause symptoms (including pasteurized orange juice). Anaphylaxis from pollen-food syndrome is rare, so having an injectable epinephrine device is not necessary. Taking an antihistamine (tablet or syrup form) can relieve the symptoms faster if needed.
Other Causes
Those with an immediate family member who has an allergic condition likeeczema,asthma, or a food allergy may have a slightly increased risk of also developing a food allergy. The food they are allergic to will not necessarily be the same as that of their family member.
Citrus Allergy In Infants
Food allergies are more common in children and infants. About 5% of children under the age of 5 have a food allergy.
Children who have eczema when they are very young are more likely to develop a food allergy.
Although possible, a citrus allergy is uncommon.
An allergist will typically make a diagnosis of food allergy after conducting tests.
These are outlined below.
Skin Prick Test
During a skin prick test, an allergist will place a small drop of liquid that contains a food allergen on the skin on either the back or arm. If testing a fruit like citrus, fresh fruit may be used.
The allergist then pricks or scratches the skin using a needle or plastic probe to break the skin and allow a small amount of the allergen to enter the area below the skin’s surface.
The person having the test is then observed. If positive, the skin where the test was given will often have a raised bump and a circle of red and itchy skin.
In addition to testing the suspected food allergens, allergists need to perform a negative control test (no allergen included) to be sure that the skin is not overly sensitive to the prick itself and to achieve a positive control test using histamine to be sure that the skin is responsive to histamine release (what causes the red bump to form in an allergic reaction).
Blood Test
In some cases of possible food allergy, a blood test may be preferred.
An IgE (immunoglobulin E) blood test measures the number of specific antibodies in the blood. If there are high levels, the body may overreact if exposed to those allergens.
However, false positives can occur in both skin and blood tests, and food allergy testing is only recommended in cases where clinical history is concerning for food allergy.
The Difference Between Blood Tests and Skin Tests for Allergies
A food allergy can’t be cured, but people with an allergy to citrus should do all they can to avoid consuming or coming into contact with that allergen.
This means reading food labels thoroughly when buying food or asking questions about food when dining out.
Medications
Antihistamines are available over the counter at the pharmacy.
Those with a severe allergy should always carry their EpiPen with them to be prepared in the case of anaphylaxis.
People with an allergy to food like citrus should avoid consuming citrus fruits and any food, beverage, or product that may contain them.
Reading labels is essential for managing food allergies, as sometimes what you’re allergic to may be an unexpected ingredient.
If a person with a citrus allergy also has a pollen allergy, they may also be advised to avoid certain other vegetables and fruits. A healthcare provider will be able to advise what should and shouldn’t be consumed.
Citrus fruits contain a high level of vitamin C, which is typically healthy for you, but people with an allergy should still avoid eating citrus fruits.
Alternative foods that are also high in vitamin C include:
If you suspect you have an allergy to food like citrus, consider making an appointment with your healthcare provider.
If you or someone you know is experiencing symptoms of anaphylaxis, call 911 immediately.
Summary
A citrus allergy is rare but has been reported to some citrus fruits like grapefruit and oranges. Symptoms may include a rash, swelling, itching, nausea, and vomiting, among other symptoms. A citrus allergy is not the same as an allergy to citric acid.
There is no treatment or cure for food allergies, but management strategies like reading labels and carrying an EpiPen are helpful. Those who can’t have citrus fruits usually can eat other foods high in vitamin C like strawberries or broccoli.
A Word From Verywell
A citrus allergy is rare, but if you are experiencing symptoms after consuming citrus, consider making an appointment with a healthcare provider for help. They may advise you to get tested to determine if you have allergies to citrus or other foods.
Frequently Asked QuestionsAllergies to grapefruit, orange, and mandarin have been reported. However, a citrus allergy is considered rare.Although food allergies are more common in children, they can develop at any time in life.Those who had eczema in their early years are more likely to develop a food allergy.While it is possible to be allergic to citrus fruits, an allergy to citric acid is unlikely.There have been reports of a delayed inflammatory response from manufactured citric acid. However, this is not the same as an allergy.Having an allergy to citrus does not mean the same thing as having an allergy to citric acid.There is limited information on allergies to citric acid, and there is no evidence to suggest citric acid can cause an immune response like an allergic reaction.
Allergies to grapefruit, orange, and mandarin have been reported. However, a citrus allergy is considered rare.
Although food allergies are more common in children, they can develop at any time in life.Those who had eczema in their early years are more likely to develop a food allergy.
Although food allergies are more common in children, they can develop at any time in life.
Those who had eczema in their early years are more likely to develop a food allergy.
While it is possible to be allergic to citrus fruits, an allergy to citric acid is unlikely.There have been reports of a delayed inflammatory response from manufactured citric acid. However, this is not the same as an allergy.
While it is possible to be allergic to citrus fruits, an allergy to citric acid is unlikely.
There have been reports of a delayed inflammatory response from manufactured citric acid. However, this is not the same as an allergy.
Having an allergy to citrus does not mean the same thing as having an allergy to citric acid.There is limited information on allergies to citric acid, and there is no evidence to suggest citric acid can cause an immune response like an allergic reaction.
Having an allergy to citrus does not mean the same thing as having an allergy to citric acid.
There is limited information on allergies to citric acid, and there is no evidence to suggest citric acid can cause an immune response like an allergic reaction.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Allergy Asthma and Immunology.Citric acid and citrus allergy.Bourrier, T., Pereira, C.Allergy to citrus juice.Clin Transl Allergy3, P153 (2013). doi:10.1186/2045-7022-3-S3-P153Anaphylaxis Campaign.Fruit.NHS.Overview - Anaphylaxis.Iorio RA, Del Duca S, Calamelli E, et al.Citrus allergy from pollen to clinical symptoms.PLoS One. 2013;8(1):e53680. doi:10.1371/journal.pone.0053680American College of Allergy, Asthma, and Immunology.Pollen food allergy syndrome.NHS.Causes - food allergy.Johns Hopkins Medicine.Food allergies in children.American Academy of Allergy, Asthma and Immunology.Food allergy.FARE.Skin prick tests.Nemours Kids Health.Blood test: allergen-specific immunoglobulin E (IgE).NHS.Treatment - food allergy.NHS.Vitamin C - vitamins and minerals.Seattle Children’s.Food allergy.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Allergy Asthma and Immunology.Citric acid and citrus allergy.Bourrier, T., Pereira, C.Allergy to citrus juice.Clin Transl Allergy3, P153 (2013). doi:10.1186/2045-7022-3-S3-P153Anaphylaxis Campaign.Fruit.NHS.Overview - Anaphylaxis.Iorio RA, Del Duca S, Calamelli E, et al.Citrus allergy from pollen to clinical symptoms.PLoS One. 2013;8(1):e53680. doi:10.1371/journal.pone.0053680American College of Allergy, Asthma, and Immunology.Pollen food allergy syndrome.NHS.Causes - food allergy.Johns Hopkins Medicine.Food allergies in children.American Academy of Allergy, Asthma and Immunology.Food allergy.FARE.Skin prick tests.Nemours Kids Health.Blood test: allergen-specific immunoglobulin E (IgE).NHS.Treatment - food allergy.NHS.Vitamin C - vitamins and minerals.Seattle Children’s.Food allergy.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Allergy Asthma and Immunology.Citric acid and citrus allergy.Bourrier, T., Pereira, C.Allergy to citrus juice.Clin Transl Allergy3, P153 (2013). doi:10.1186/2045-7022-3-S3-P153Anaphylaxis Campaign.Fruit.NHS.Overview - Anaphylaxis.Iorio RA, Del Duca S, Calamelli E, et al.Citrus allergy from pollen to clinical symptoms.PLoS One. 2013;8(1):e53680. doi:10.1371/journal.pone.0053680American College of Allergy, Asthma, and Immunology.Pollen food allergy syndrome.NHS.Causes - food allergy.Johns Hopkins Medicine.Food allergies in children.American Academy of Allergy, Asthma and Immunology.Food allergy.FARE.Skin prick tests.Nemours Kids Health.Blood test: allergen-specific immunoglobulin E (IgE).NHS.Treatment - food allergy.NHS.Vitamin C - vitamins and minerals.Seattle Children’s.Food allergy.
American Academy of Allergy Asthma and Immunology.Citric acid and citrus allergy.
Bourrier, T., Pereira, C.Allergy to citrus juice.Clin Transl Allergy3, P153 (2013). doi:10.1186/2045-7022-3-S3-P153
Anaphylaxis Campaign.Fruit.
Iorio RA, Del Duca S, Calamelli E, et al.Citrus allergy from pollen to clinical symptoms.PLoS One. 2013;8(1):e53680. doi:10.1371/journal.pone.0053680
American College of Allergy, Asthma, and Immunology.Pollen food allergy syndrome.
NHS.Causes - food allergy.
Johns Hopkins Medicine.Food allergies in children.
American Academy of Allergy, Asthma and Immunology.Food allergy.
FARE.Skin prick tests.
Nemours Kids Health.Blood test: allergen-specific immunoglobulin E (IgE).
NHS.Treatment - food allergy.
NHS.Vitamin C - vitamins and minerals.
Seattle Children’s.Food allergy.
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