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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

Food is low in FODMAP Food is high in salicylates

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.



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

Let me know if you found any of these interesting or useful. If you spot an article or research that you think is interesting you can message me or tag me on Facebook, Instagram or Twitter - links at the bottom of the page.

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