How to Stay Safe with a Strawberry Allergy

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Strawberries are a delicious and nutritious fruit that many people enjoy. However, for some individuals, consuming strawberries can lead to an allergic reaction.

A strawberry allergy is a type of food allergy that affects both children and adults.

In this blog post, we will discuss strawberry allergies. Keep reading to learn more about how to stay safe and make informed choices.

We will also talk about other reasons some people have to avoid strawberries. These include food sensitivities and other adverse reactions.

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Strawberry Allergy

Strawberry allergies are a type of food allergy that occurs when the immune system reacts to strawberries. The body mistakenly identifies proteins in strawberries as harmful.

The immune system then produces an antibody called immunoglobulin E (IgE) in response to the perceived threat. When the individual consumes strawberries again, the IgE antibodies release histamine and other chemicals, causing allergic symptoms.

How Common is Strawberry Allergy?

Strawberry allergy is not one of the Top 8 Food Allergens. However, it is commonly reported as a somewhat common allergy for children.

Exact rates of strawberry allergy are not available. There are differences in prevalence in geographic regions as well as differences between children and adults.

Additionally, some people do not tolerate strawberries but may not have an IgE-mediated allergy to strawberries.

Can You Develop a Strawberry Allergy Later in Life?

While we often associate food allergies with children. However, developing allergies later in life does occur. Adults may develop adult-onset food allergies as well as sensitivities and intolerances.

Some people may experience adverse reactions to strawberries, even if they have never eaten them before. Likewise, those who eat strawberries regularly can also develop such reactions.

Causes of Strawberry Allergy

Risk factors for strawberry allergies include a personal or family history of environmental allergies, food allergies, eczema, and asthma.

Food allergies may develop even without these risk factors.

Delayed introduction of allergenic foods to babies may increase the risk of developing allergic reactions. If you are worried about introducing new foods to your baby, it is advisable to speak to your pediatrician about it. They can advise you on the potential risks of food allergies.

Strawberry Food Family

Strawberries belong to the Rosaceae food family.

People with a strawberry allergy may need to avoid other fruits from this family, which is broken down into groups:

Amygdaleae

●    Almond

●    Apricot

●    Cherry

●    Peach

●    Plumb

Maleae

●    Apple

●    Pear

Rosoideae

●    Blackberry

●    Strawberry

●    Strawberry

Strawberry Allergy Symptoms

The symptoms of a strawberry allergy can range from mild to severe and can include the following:

●    Abdominal pain

●    Atopic Dermatitis

●    Diarrhea

●    Difficulty swallowing

●    Dizziness

●    Eczema

●    Fainting

●    Hives

●    Itching

●    Itching in the mouth

●    Lightheadedness

●    Nausea

●    Nasal congestion

●    Swelling of any body part

●    Swelling of the face

●    Swelling of the lips

●    Swelling of the tongue and throat

●    Tingling in the mouth

●    Trouble breathing

●    Vomiting

●    Wheezing   

Reactions may include one or many symptoms. Severity may vary based on factors such as the amount eaten and other factors.

Call your doctor immediately if you or your child have symptoms of an allergic reaction. Call 911 for difficulty breathing, swallowing, or other life-threatening symptoms.

Anaphylaxis

Anaphylaxis is a life-threatening allergic reaction. A food allergy or other allergens can cause anaphylaxis. Reactions may be more severe if more than one body part is affected.

Signs and Symptoms of Anaphylaxis include:

●    Angioedema

●    Cardiovascular symptoms

●    Constriction of the airway

●    Difficulty breathing

●    Dizziness

●    Fast pulse

●    Lightheadedness

●    Loss of consciousness

●    Sensation of a lump in the throat

●    Drop in blood pressure

●    Shock, including a drastic drop in blood pressure

●    Swollen throat

●    Tightening of the airway

These reactions require immediate medical attention.

What about White Strawberries?

Strawberries are made up of twelve species. Most commercially available strawberries are crosses of two species. Strawberries contain several proteins that may cause allergic reactions.

Research suggests white strawberries may not contain the same proteins that cause allergies. Therefore, they may be safe for those with strawberry allergies.

However, if you have a known allergy to strawberries, we highly recommend consulting an allergist before trying a white strawberry. It is possible that the characteristics of white strawberries may vary, and they might not all be hypoallergenic.

Diagnosis

For an accurate diagnosis of strawberry allergy, we recommend working with an allergist.

We recommend working with an Allergist, Registered Dietitian, Certified Nutrition Specialist, or Certified Leap Therapist to identify which foods are safest for you and which foods you should avoid.

These providers can also help determine if you are having adverse symptoms due to hypersensitivity or intolerance. (Keep reading for more information on these reactions.)

A blood test and skin test may be beneficial.

Strawberry Sensitivity

Some people have food sensitivities to strawberries. Strawberries trigger these reactions and involve the immune system. However, IgE does not play a significant role.

These reactions are also known as non-IgE hypersensitivity reactions.

Food sensitivities may play a role in many conditions, such as:

●    ADD/ADHD

●    Atopic Dermatitis

●    Autism Spectrum Disorders

●    Chronic Fatigue Syndrome

●    Crohn’s Disease

●    Colitis

●    Cyclic Vomiting Syndrome

●    Depression

●    Diarrhea

●    Epilepsy

●    Fibromyalgia

●    GERD

●    Inflammatory Arthritis

●    Insomnia

●    Interstitial Cystitis

●    Irritable Bowel Syndrome

●    Migraine

●    Polycystic Ovarian Syndrome

●    Psoriasis

●    Restless Leg Syndrome

●    Urticaria (Hives)

Suspect you have a sensitivity to strawberries or other foods? We recommend working with a Certified Leap Therapist. They may recommend Mediator Release Testing.

Food sensitivities can change based on changes in health status, changes in diet, and other factors.

Intolerance

Food intolerances are generally defined as adverse food reactions that are not due to allergic or immune-mediated changes in the body.

Symptomatically, strawberry allergies and intolerances or sensitivities are sometimes challenging to tell apart. However, the biological mechanisms triggering the reaction are very different.

Allergies are immune system responses that release histamines and IgE antibodies. Strawberry intolerance, on the other hand, does not release IgE proteins.

Individuals may sometimes experience symptoms after consuming strawberries unrelated to an allergy. This is known as strawberry intolerance and can cause gastrointestinal symptoms, such as bloating and diarrhea.

Strawberry intolerance symptoms can take from a few hours to a few days to develop, unlike allergies which can come about in a matter of minutes. Some of the most common symptoms of strawberry intolerance include:

●    Abdominal pain

●    Bloating

●    Cramping

●    Gas

●    Diarrhea

●    Flatulence

●    Headache

●    Loose Stools

●    Skin Rash and Inflammation

These intolerance symptoms will vary from person to person.

Vitamin C

These symptoms may be due to the presence of Vitamin C. Strawberries are naturally high in Vitamin C. This can contribute to rashes on the skin and face, especially in babies and toddlers.

Young children may also experience gastrointestinal symptoms after eating strawberries if they consume more Vitamin C than their bodies need at that time. High doses of Vitamin C can have a laxative effect.

Cross Reactivity

People with a strawberry allergy may also react to:

●    apricots

●    banana

●    birch pollen

●    carrots

●    celery

●    latex

●    melon

●    nuts, such as hazelnuts

As mentioned earlier, individuals with a strawberry allergy may also be allergic to other fruits in the Rosaceae family. This is due to cross-reactivity, which occurs when the proteins in one fruit are similar to those in another fruit, leading to a mistaken immune response.

Birch Pollen Allergy

Both strawberries and birch pollen contain a Bet v 1 like protein. People who react to strawberries may also react to birch pollen and other fruits.

Panallergens

Panallergens are proteins that are responsible for a wide range of IgE cross-reactivity between related and unrelated pollen sources, plant foods, and other foods. These reactions may be due to profilins, polcalcins, non-specific lipid transfer proteins, and PR-10 proteins.

Profilins

Strawberries and many other foods contain profilins. These may cause unpleasant symptoms.

Lipid transfer protein syndrome

Lipid transfer proteins are found in plants and plant foods. People who are sensitized to LTP’s may have negative results when tested for food allergies despite having severe reactions. Strawberries have been associated with Lipid Transfer Protein Syndrome, as have many other foods.

Celery-Mugwort Spice Syndrome

Strawberry allergy is associated with Celery-Mugwort-Spice Syndrome. The common protein is a profilin protein.

Latex Food Syndrome

Some people who are sensitive to latex may also be sensitive to strawberries. This is due to a protein that is present in latex as well as strawberries. These allergens are also found in many other foods.

People who are allergic to strawberries may also experience cross-reactive symptoms with these plant foods:

●    Apricot

●    Banana

●    Bell pepper

●    Celery

●    Chestnut

●    Fig

●    Kiwi

●    Mango

●    Papaya

●    Peach

●    Pineapple

●    Potato

●    Tomato

People who are sensitive or allergic to latex may also have to avoid products containing latex.

Oral Allergy Syndrome

Some people who can not eat strawberries have Oral Allergy Syndrome (OAS). This condition may be more common in people who have seasonal or environmental allergies. Symptoms tend to be worse when eating fresh fruits and vegetables. Cooked versions of the same food may be tolerated.

OSA reactions are usually not life-threatening. These reactions typically involve the lips and mouth.

OAS is also known as Pollen-Food Allergy Syndrome.

Pseudoanaphylaxis

Pseudoanaphylaxis occurs when histamine is released from the cells into the body. This can happen when a person eats a food that is a histamine liberator. Strawberries have been identified as histamine liberators. This type of adverse food reaction can be severe.

Cross Contamination

Cross-contamination is a risk for people with food allergies. Cross-contamination can occur on farms, in processing, in manufacturing, as well as in homes, restaurants, and food service settings like hospitals and schools.

If you have a strawberry allergy, be cautious of foods that are prepared near strawberries. Some examples may include salad bars, dessert bars, ice cream shops, smoothie bars, and bakeries. Practicing good food hygiene may help prevent the risk of cross-contamination.

Treatment

For those with a strawberry allergy, it is essential to take precautions to avoid allergic reactions. This includes reading food labels carefully, avoiding foods that contain strawberries, and carrying an epinephrine auto-injector in case of a severe allergic reaction.

Safety – Eating Out – School & Social Settings

If you avoid strawberries or any specific foods, it is good to have a safety plan. The following strategies may be helpful:

●    Always check ingredient lists and read all food labels.

●    Be aware of common ways the trigger food is used.

●    Be aware of possible hidden sources of the trigger food.

●    Ask your doctor if you should carry an EpiPen or other medication in case of accidental ingestion.

●    Have a support system such as friends, family members, school nurse, teachers, coworkers, and health care providers.

●    Ask questions about how food is prepared and handled.

●    When in doubt, choose safety first.

Other Reasons to Avoid Strawberries

Strawberries are generally included in most lifestyle and therapeutic diets, including diabetic, keto, and Low FODMAP diets.

Mucosal Irritation

Strawberry has been implicated in various adverse reactions, including uncomfortable mucosal irritation due to acidic pH. The strawberry can also cause itching of the skin when touched, which is a form of allergic contact dermatitis.

Salicylates

Strawberries contain salicylates which have the potential to cause gastrointestinal symptoms in people who are sensitive to salicylates.

Common Forms of Strawberry

Strawberries can be consumed in many forms, including:

●    Fresh

●    Frozen

●    Cooked in various recipes, such as smoothies, jams, and pies.

●    Dehydrated

●    Dried

They can also be found in many processed foods, such as yogurt, ice cream, and candy.

Hidden Sources of Strawberry

If you are allergic to strawberries, it is crucial to identify and avoid foods that contain strawberries or strawberry derivatives.

These include jam, jelly, ice cream, cakes, smoothies, milkshakes, and other treats. Additionally, strawberries may be hidden in food items such as candy, cereal, granola, trail mix, and other processed foods. Examples include salad dressings, marinades, condiments, fruit-flavored teas, and beverages.

It is also important to read food labels carefully when shopping to ensure that the food item you purchase does not contain strawberries or any of its derivatives.

The Latin name for strawberry is Fragaria vesca. This wording may be used on food and product labels.

Furthermore, when dining out, it is important to ask questions about the ingredients used to make a dish to ensure that it does not contain strawberries.

Strawberry Leaves

Strawberry leaves are sometimes eaten raw and cooked. They can also be used to make tea.

Valentine’s Day and Romantic Gestures

Due to their beautiful red color, sweetness, and heart shape, strawberries are popular as romantic gestures. They are often served with champagne, breakfast in bed, and as chocolate-covered strawberries. 

Strawberries as part of a fruit cup served with coffee and breakfast next to a hotel bed for an image about breakfast in bed and strawberry allergy.

Strawberry Substitutes

For those with a strawberry allergy, there are several potential substitutes that can be used in recipes or consumed as snacks. These include:

●    Raspberries, blackberries, blueberries, and other berries

●    Mango, papaya, and other tropical fruits

●    Peaches, plums, apricots, and nectarines

●    Pomegranates, cherries, and grapes

For those who are allergic to strawberries, other fruits such as blueberries, raspberries, and blackberries can be used as substitutes. Additionally, there are many strawberry-flavored products made with artificial flavors and colors that those with a strawberry allergy can enjoy.

However, before choosing a strawberry alternative, it is important to assess for cross-reactive foods and eliminate any that may also cause an adverse reaction.

Infographic with title Strawberry Alternatives with text and photos of berries, pomegranate, cherries, grapes, plums for Single Ingredient Groceries.

Alternatives for Valentine’s Day & Special Occasions

To replace the beautiful red color of strawberries, consider using red raspberries or chocolates wrapped in red foil.

Heart-shaped cookies and pancakes can add some festive flair to special occasion breakfasts.

To replace chocolate-covered strawberries, consider one of the following: chocolate-covered espresso beans, chocolate-covered cherries, chocolate-covered nuts, or chocolate-covered frozen bananas.

Final Thoughts

Choosing groceries when you have food allergies can be challenging. This is why we recommend selecting groceries made with a single ingredient and focusing on what you CAN eat, not just what you have to avoid.

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Author

  • Dr. Lisa Hugh DHA MSHS RD LDN CLT

    Dr. Lisa Hugh is a Registered Dietitian and Certified Leap Therapist. She is a Doctor of Healthcare Administration and has a Master's of Science in Healthcare Administration. As a Food Sensitivity Expert, her passion is helping people with complex medical and nutrition needs find food and groceries that are safe and enjoyable. Lisa enjoys helping clients in her private practice.

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