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Key Allergens

Lemons are in the Rutaceae family of plants, other fruit in this family include oranges, grapefruit, kumquat, lime and sichuan pepper.

The allergen associated with lemon allergy is called Cit l 1.

Cit l 1 is a Lipid Transfer Protein (LTP), these proteins are resistant to heat and are found in many types of plants. Patients suffering from a more severe allergy to cooked fruit may be sensitised to this group of proteins.

Lemons also contain limonene, which is a component of the oils found in the peel of certain fruits. Limonene is a well known skin irritant - so may cause sufferers to react to the skin whilst being able to eat or drink the fruit.

There is an increasing amount of research into citrus seed allergy - it has been suggested that some allergic reactions have been triggered not by the fruit or peel, but by accidental consumption of the seeds. These allergic reactions may be triggered by proteins found in more commonly eaten seeds (like sunflower and pumpkin seeds) - seed storage proteins.

Like other citrus fruits lemons 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 high in histamine Food is high in sulphites Food is low in salicylates Food is low in FODMAP

Citrus fruits are considered to be high in histamine, so should be avoided for those who avoid high histamine foods.

Bottled lemon juice can be high in sulphites. Fresh lemons are lower in sulphites. Sulphites are inorganic salts used in preservations and have the potential to cause symptoms of food intolerance to those sensitive to sulphites, this food intolerance is more common in asthmatics. An improvement in symptoms can be made with a change to a low sulphite diet.

Lemons are low in salicylates. Salicylates in food have the potential to cause gastrointestinal food intolerance symptoms in people who are sensitive to salicylates.

Lemons are a low FODMAP food so are suitable for those following this diet. 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.

You can read more about Food Intolerances on the dedicated Food Intolerance Page.

Associated Syndromes

You may be suffering from LTP Syndrome if you have reactions to various fruits, vegetables and nuts and your reactions continue to be severe after you have discarded the peel and have cooked the food.

Eating lemons is also associated with phytophotodermatitis. This is a skin condition that occurs when a person gets the juice from the fruit on the skin and doesn't wash it off. The furocoumarins in the juice of the fruit are activated by the sun and cause an itchy rash on the skin.

Cross Reactivity

Common foods involved in LTP allergy include kiwi, strawberries, sunflower seeds, walnut, apple, mulberry, banana, pea, apricot, cherry, plum, almond, peach pomegranate, raspberry, tomato, grape, celery, peanut, asparagus, cabbage, broccoli, chestnut, lemon, tangerine, orange, hazelnut, lettuce, lentils, lupin, green bean, pear, mustard, wheat and maize.

Lemon allergens have shown cross-reactivity with the major peach allergen Pru p 3.



Science Direct - Lipid Transfer Proteins

Allergen Encyclopedia - Lemon

Lipid Transfer Proteins (LTP Syndrome)

Allergy to Fruit - Anaphylaxis Campaign

Do You Have a Citrus Allergy? Learn the Symptoms

What You Need to Know About Allergic Reaction to Essential Oils

DermNet NZ - Phytodermatitis

DermNet NZ - Lemon

Histamine Food List

ATP Science - Salicylate Foods

Sulfite Allergy Overview

Healthline - FODMAP foods

Articles and Journals

Optimization of the diagnosis and characterization of gibberellin-regulated protein sensitization: An Italian cohort study, 2024

Citrin: a novel food allergen in citrus seeds and citrus-derived pectin that shows cross-reactivity with cashew and pistachio, 2023

Pomegranate seed allergy in a child with multiple tree nut allergies, 2023

Food-dependent exercise-induced anaphylaxis to orange, with possible underlying thaumatin-like protein allergy, 2023

Delayed allergic reaction to eating lemon: case report, 2022

Evidence of mold allergy in patients with allergic reactions to packaged juice, 2020

Lemon seed allergy: a case presentation, 2020

Allergy to lemon: case of oral allergic syndrome associated with allergic otitis media and labyrinthitis in a patient with polysensibilization and multiple manifestations of allergy, 2019

Lipid Transfer Protein allergy in the United Kingdom: Characterization and comparison with a matched Italian cohort, 2019

Allergy to oxidized limonene and linalool is frequent in the U.K, 2014

Allergy to citrus juice, 2013

Citrus Allergy from Pollen to Clinical Symptoms, 2013

Anaphylaxis to lemon soap: citrus seed and peanut allergen cross-reactivity, 2007

Lipid transfer proteins and allergy to oranges, 2005

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 or Twitter - links at the bottom of the page.

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