Can I consume foods that cause throat itching?

From the Guidelines

You should avoid consuming foods that cause throat itching as this indicates a potential food allergy or sensitivity. If you experience throat itching after eating certain foods, stop consuming them and consult with a healthcare provider for proper evaluation 1. Throat itching can be an early warning sign of a more serious allergic reaction that could progress to throat swelling and difficulty breathing.

Key Considerations

• Food allergies can be mediated by IgE or non-IgE mechanisms, and some diseases like contact urticaria can be mediated by either mechanism 1.
• The diagnosis of IgE-mediated allergy is generally easier to make when tests for sIgE antibodies are positive 1.
• A true allergy is defined as an adverse health event that results from stimulation of a specific immune response that occurs reproducibly on exposure to a given food 1.
• For mild reactions, over-the-counter antihistamines like Benadryl (diphenhydramine) 25-50mg or Zyrtec (cetirizine) 10mg may help relieve symptoms temporarily, but they are not a substitute for avoiding trigger foods.
• If you know you have severe allergic reactions, carry an epinephrine auto-injector (EpiPen or Auvi-Q) as prescribed by your doctor and use it immediately if you experience throat tightness, difficulty breathing, or other severe symptoms, then seek emergency medical attention.

Management and Testing

• An allergist can perform testing to identify your specific food triggers and help develop a management plan that may include strict avoidance or, in some cases, carefully supervised desensitization therapy 1.
• Tests often performed for evaluation include skin prick testing (SPT) and serum specific IgE level determination, which assess for immediate/type I hypersensitivity reactions 1.
• The gold standard test for diagnosing food allergy is a double-blind, placebo-controlled oral food challenge (DBPCFC) 1.

From the Research

Foods that Can Cause Throat Itching

• Certain fruits, vegetables, spices, and nuts can cause throat itching in individuals with oral allergy syndrome (OAS) 2
• Foods that are commonly associated with OAS include:
  • Fruits such as apples, bananas, and melons
  • Vegetables such as celery, carrots, and fennel
  • Nuts such as peanuts, almonds, and walnuts
  • Spices such as cinnamon, nutmeg, and cloves
• In some cases, even small amounts of an allergenic food can cause a reaction, such as throat itching, facial angioedema, and vomiting 3
• Cross-reactions between certain types of pollen and food allergens can also cause throat itching and other oral symptoms 4

Mechanisms of Food-Induced Throat Itching

• Food can induce throat itching through various mechanisms, including:
  • Immunoglobulin E (IgE)-mediated pathways, which can cause acute urticaria and other allergic reactions 5
  • Non-IgE-mediated, mixed, T-cell-mediated, and nonimmune reactions, which can cause a range of symptoms including throat itching and pruritus 5
• The most common type of itch provoked by food is acute urticaria, often through the classical IgE-mediated pathway 5

Diagnosis and Management of Food-Induced Throat Itching

• A thorough history and physical examination are essential for diagnosing food-induced throat itching 2, 6
• Elimination diets and avoidance of trigger foods are often effective in managing symptoms 2, 6
• In some cases, medication such as antihistamines and steroids may be necessary to manage symptoms 6
• Specific allergen immunotherapy has also been introduced as a treatment option for food allergies 6