Silver Birch tree pollen allergic individuals with Spring hay fever are prone to develop oral symptoms of itching, swelling and oral tingling when they eat certain fresh fruits and nuts such as apple and hazelnut. A detailed study by UK GPs has shown that 2% of the general population suffer with Pollen-food Syndrome (PFS). About 50 to 90% of individuals sensitive to Silver Birch tree pollen will exhibit these oral symptoms in addition to their hay fever in the early Spring (typical tree pollen season).  PFS is most commonly associated with raw fruits (apple, cherry, pear and stone fruits) as well as nuts (hazelnut, Brazil nut, walnut and peanut).  Peak incidence occurs in the teens and early 20’s. 

 Many people report adverse oral reactions to foods (RRF) but have no hay fever or Silver Birch pollen allergy.  These people are more likely to report reactions to other foods such as cow’s milk, egg, wheat and seafood.

 Reference: Skypala I, Bull S, Durham S et al. The prevalence  of FPS and prevalence and characteristics of reported food allergy: a survey. Clin Exp Allergy 2013 (43); (8); 925-937.