GRAPEFRUIT ALLERGY
Key Allergens
Grapefruits are in the
Rutaceae family of plants. Other plants in this family include, oranges, limes and lemons.
Other citrus fruits contain
Lipid Transfer Proteins (LTPs). It has been suggested that grapefruit also contain these proteins. LTPs are panallergens with the potential to cause severe allergic reactions.
Grapefruit contains pectin, which has also been shown to cause allergic reactions in some individuals.
Oranges contain gibberellin proteins, there is a possibility that these are also present in grapefruits.
It is strongly advised to avoid eating grapefruit if are taking certain medicines. This is because grapefruit contains naringin, bergamottin and dihydroxybergamottin, all are involved in inhibition of a protein called CYP3A4. The lack of this protein can drastically alter how medications work in the body.
Like other citrus fruits grapefruits contain
furanocoumarins. These chemicals can get on the skin and in combination with ultraviolet light (sunlight) can cause a sunburn like rash. Furanocoumarins are found in higher concentrations in fresh herbs and are natural irritants which can cause allergic contact dermatitis. This is more common in occupations where you are frequently coming into contact with the food, like chefs, cooks, growers and pickers.
Food Intolerances
Grapefruit is a low FODMAP food, FODMAP stands for
Fermentable
oligosaccharides,
disaccharides,
monosaccharides
and
polyols. Foods high in FODMAPs can cause symptoms of food intolerance, affecting the gastro intestinal system and this can be mistaken for a true IgE food allergy.
Fresh grapefruits are high in salicylates, grapefruit juice is moderate.
salicylates. Salicylates have the potential to cause worsening of asthma, swelling, itching and hives as well as food intolerance symptoms in people who are sensitive to salicylates.
You can read more about
Food Intolerances on the dedicated Food Intolerance Page.
Associated Syndromes
Grapefruit allergy is linked to Food Dependent
Exercise Induced Anaphylaxis, but the allergenic protein responsible for this has not been identified.
Grapefruit is also linked to
Latex Food Syndrome. This is usually caused by hevein, chitinase or profilin proteins. To date none of these proteins have been identified in the skin of grapefruits, so it is not known what causes this.
Cross Reactivity
Other foods containing gibberellins include apricot, peppers, cherries, chilli, oranges, peaches and pomegranates.
Foods containing hevein or chitinase proteins (linking them to Latex Food Syndrome) are avocado, banana, chestnut, coffee, corn, kiwi, pomegranate, apricot, cassava, dill, goji berry, potato, swede and turnip.
Note that these food lists are not exhaustive, the most up to date information is on the Cross Reactivity Tool.
Resources
Websites
Allergen Encyclopedia - Grapefruit
ATP Science - Salicylate Food List
Healthline - Low FODMAP Foods
Science Direct - Bergamottin
Science Direct - Naringin
Articles and Journals
Food allergy outside the eight big foods in Europe: A systematic review and meta-analysis, 2024
Allergic contact dermatitis from essential oil in consumer products: Mode of uses and value of patch tests with an essential oil series, 2023
Citrin: a novel food allergen in citrus seeds and citrus-derived pectin that shows cross-reactivity with cashew and pistachio, 2023
Sensitization to Gibberellin-Regulated Protein (Peamaclein) Among Italian Cypress Pollen–Sensitized Patients, 2022
Pollen/Fruit Syndrome: Clinical Relevance of the Cypress Pollen Allergenic Gibberellin-Regulated Protein, 2019
Identification of gibberellin-regulated protein as a new allergen in orange allergy, 2018
A squeezable case of anaphylaxis, 2018
Anaphylaxis secondary to an emulsifier in almon yogurt in a cashew/pistachio sensitised patient, 2018
Latex Allergy: Overview and Recommendations for the Perioperative Management of High-Risk Patients, 2017
Allergy to citrus juice, 2013
A clinical study of admitted the review of cases of food-dependent exercise-induced anaphylaxis, 2009
Pectin anaphylaxis and possible association with cashew allergy, 2006
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