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Citrus allergy
Last reviewed: 04.07.2025
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Citrus allergy is a typical example of idiosyncrasy, that is, intolerance to certain foods and drugs.
This type of allergic manifestation is called pseudoallergy or false allergy, in which the body's allergic response to the invasion of a trigger (provoking allergen) occurs without the participation of specific antibodies - immunoglobulins.
[ Causes of Citrus Allergy
Citrus allergy is not a specific, separate disease. Monoreaction only to oranges or tangerines is almost never encountered, more often such manifestations are associated with cross pseudo-allergy. The main substances that provoke false allergy include salicylates, benzoates and amines. Pseudo-allergy is also caused by products that contain the amino acid histidine, from which histamine is synthesized.
Citrus fruits contain both tyramine (amine) and salicylates, especially in tangerines, oranges, lemons and grapefruits are less dangerous in this sense. In addition, many allergists believe that intolerance to some food components, including citrus fruits, is associated with dysbacteriosis or latent liver diseases.
How does citrus allergy develop?
Pseudoallergy is usually provoked by eating food that contains a trigger ingredient. Any idiosyncrasy, including citrus allergy, begins to develop when a large amount of provoking substances enters the body. The key phrase is a large amount. The intensity of the reaction is directly related to how much citrus a person has eaten: the more, the stronger the allergy. Oranges, lemons, tangerines, etc. contain special components that can cause a strong release of histamine without involving immunoglobulins in this process. Accordingly, the visual symptoms will be extremely similar to the signs of a true allergy, but the disease has a different nature. When conducting allergy tests, antibodies are not detected, this is evidence that the rash, swelling and itching are provoked by an idiosyncrasy to a food product.
Excessive histamine production is caused by so-called liberators (from the word liberation – release) – food components contained in almost all products. But especially provocative in this sense are considered hard cheeses due to tyramine, all types of citrus fruits due to phenolic compounds (salicylates), as well as products that contain chemical dyes, stabilizers, preservatives, thickeners, etc. During the digestion process, the liberator and histamine interact, ending in favor of the latter. In addition, the allergy-provoking substance significantly disrupts the metabolism of arachidonic acid, which is an important component of cell membranes.
Symptoms of Citrus Allergy
The release of histamine causes a vascular and autonomic reaction in the form of redness, itching, rashes, a feeling of heat, and shortness of breath. Quite often, an allergic reaction manifests itself as urticaria, accompanied by a severe headache and dyspepsia. Oranges are considered the most provocative, and to a lesser extent, tangerines, the abuse of which can cause a strong autonomic-vascular reaction in the form of a hypotonic or hypertensive crisis. All other signs by which an allergy to citrus fruits is diagnosed are quite typical of a true, classic allergy. A characteristic feature that can help distinguish a false allergic reaction from signs of a real allergy is the slow development of symptoms.
How to treat citrus allergy?
If oranges and tangerines cause an allergic reaction, of course, you need to give them up, exclude them from your diet, and for a long time. You should also give up all products containing citrus essential oils, including perfumes and hygiene products. However, this does not mean a lifelong refusal to eat such beloved oranges in principle. The elimination diet can last from one month to six months, then careful "experiments" are possible, implying the intake of minimal portions of your favorite fruits. It should be remembered that in the development of a false allergy, an important provoking factor is precisely the amount of food consumed, therefore, small portions should not cause an allergic reaction. If, after a forced break, even a slice of tangerine or a piece of orange provokes a rash, swelling or shortness of breath, then the allergy is caused by a completely different, hidden reason, which can be determined by an allergist.
Primary symptoms - itching, hives, can be relieved with over-the-counter antihistamines. If an allergy to citrus fruits manifests itself with threatening signs in the form of bronchospasm, suffocation, you should call a doctor or an ambulance.