Tag Archives: Allergies

Ask the Doctor: What is Oral Allergy Syndrome?

Do fresh fruits and vegetables make your mouth, lips and tongue tingle and itch? Dr. Reynold M. Karr answers important questions about Oral Allergy Syndrome (OAS), a Class 2 food allergy that may affect individuals with pollen allergies.

What is Oral Allergy Syndrome (OAS) and who does it affect?

Oral Allergy Syndrome mostly affects people with seasonal pollen allergy, typically allergic rhinitis, which is the medical term for hay fever.

What are the symptoms of OAS?

Common symptoms of OAS are itching of the mouth and throat beginning almost immediately after the food enters the mouth. It may last a few minutes but rapidly resolves once the food is swallowed.

Can an Oral Allergy Reaction result in anaphylaxis?

While this is certainly possible, systemic or generalized reactions occur in less than 5-10% of people with this disorder, and a large portion of these reactions are not anaphylaxis.

Which foods cause OAS? Which pollen allergies are linked to which foods causing OAS?

OAS is most often caused by uncooked (raw) fruits, vegetables, nuts, and spices. Cooking the foods breaks down the allergens in the food and usually eliminates the OAS reaction. Common pollen-food associations include: Birch tree pollen with pitted fruits; grass with watermelon, orange, and tomato; ragweed with melons and banana; and mugwort (weed) with a variety of vegetables and spices. A detailed chart is available at the American Academy of Asthma, Allergy, and Immunology (AAAAI) website.

As an adult with hay fever, is there a possibility I will develop Oral Allergy Syndrome?

Yes, but it is less likely the older you are. For reasons that are not completely understood, the condition appears to affect only a minority of hay fever sufferers, although it may be under-reported since mild reactions cause minimal annoyance and are often ignored.

Reynold M. Karr, M.D., is a board certified physician at UW Medical Center’s Allergy, Asthma and Immunology Clinic. He is also the medical director of PlasmaLab International in Everett.

Do you experience Oral Allergy Syndrome? You may qualify to donate plasma for allergy research.

Compensation is $185 per completed plasma donation.


What Asthma Taught Me About Anxiety

Growing up, my parents and I never realized I had asthma. I would get an occasional tight, itchy chest after playing outside, but I never felt very short of breath. “Allergies,” my family would say. And there was comfort in that assessment. As a young girl prone to anxiety, in particular health anxiety, assurance that I had nothing to worry about was always foremost in my mind.

Fast forward to adulthood, when in 2019, after a week-long antibiotic-induced gastroesophageal reflux disease (GERD) episode, I was finally diagnosed with asthma. The medical staff prescribed heartburn medication, methylprednisolone (a strong oral steroid), and inhalers, then sent me home with the reassurance that it would all settle down soon.

It didn’t.

What happened over the following several months taught me a lot about fear, resilience, self-advocacy, and how important having a top-notch asthma and allergy specialist really is.

Along with the asthma diagnosis in 2019, I was diagnosed with complex post-traumatic stress disorder (C-PTSD), meaning it has many contributing factors over a long period of time. I’d had it for decades, but never gave “it” a name. I had experienced many of C-PTSD’s textbook symptoms for as long as I could remember. They were issues I learned to cope with and compensate for, as many of us do with various struggles in life. (Trigger warning) One of the many contributing factors to my C-PTSD was having had an abusive ex in my college years smother me repeatedly with a pillow.

It goes without saying that breathing, freely and without restriction, is indescribably important to all of us. And when you’ve been abused like I had, it was impossible to forget the sheer terror of feeling that breath slip away. When you have asthma, you know that feeling too. And you’ll do just about anything to avoid experiencing the anguish again.

A woman with allergic asthma with anxiety checks her oxygen level.Which brings me back to my asthma diagnosis. The medicines they gave me worked, but only somewhat. I was finding myself in the urgent care clinics several times a week. With looks of sympathy and words of reassurance, the medical teams did the best they could to help me believe that this common ailment was under my control as long as I was medicated. Weeks stretched into months. I became obsessed with checking my oxygen levels several times a day. I talked to at least one after-hours physician per week. I was in almost constant fight-or-flight mode, all the while trying to put up a calm front for my youngest son. Here I was, the lady in charge, special needs homeschooling, head of household management, partner to my husband, you name it . . . but I could barely get through my day without a Xanax.

Why wasn’t I like all of the other people with asthma I knew? My upbeat energetic neighbor? My child’s favorite therapist? The checker at the grocery store? All with asthma. But all of them with it seemingly “under control.” Living their lives. Not running to clinics constantly. And from what I could tell, not living in daily fear.

Then one day, my regular asthma and allergy physician, a nice guy who was very by the book, was out of the office. I was scheduled instead with his partner. Now this physician, he was different . . . he was a breath of fresh air, pun intended. His motto was: think outside the box, do whatever works and test, test, test until you find all of the contributing factors to your asthma. Plus, he thought it was a shame my abusive ex hadn’t gotten run over by a truck, which he followed up with by saying “nothing is scarier than when you can’t breathe and with C-PTSD you’re constantly being triggered.” I had been waiting for a physician treating my asthma, any of them, to say those words. To finally get it. I cried through our whole first appointment.

Keeping his promise, my new asthma specialist sent me to several other specialists for testing.

A woman with allergic asthma and anxiety is also diagnosed with vocal chord dysfunction. I learned that I also have vocal chord dysfunction, an evil asthma mimic that affects my upper airways and throat. We also discovered I have a rare condition called jackhammer esophagus which contributed to my GERD. GERD is extremely hard on your lungs. Coupled with my severe allergies, I had basically the perfect breathing disorder storm.

Some medications we tried were failures, others gave me back a semblance of the control I desperately craved. My physician had all kinds of unique delivery methods he was famous for, too. (Have you ever taken your puffer medication through a baby bottle nipple in your nose? Who knew?) He wouldn’t give up until I got better. In retrospect I think it was partly because he cared about me, and partly because he wasn’t used to failure and refused to accept it. At various points I’m sure I drove him and his staff crazy with my seeking comfort and encouragement. But gradually, and without me noticing it was happening at first, I realized I’d gone days without talking to him. Days without panicking. I daresay even a full 24 hours without checking my oxygen. The medicines were working.

So, I started to take my son outside to play. And I mean really play.

I wasn’t acting anymore. I actually felt relaxed. I could focus again, on life beyond just basic body vitals. I trusted my lungs to keep bringing in the fresh outdoor air. I trusted myself to take care of any symptoms as they arose, but without dreading that they inevitably would rise. I learned that I had control. My body was not attacking me. No one was attacking me. Ever again.

My advice in dealing with your own health challenges is this: Remember that the path to health may often seem convoluted and exhausting, but don’t give up. Keep advocating for yourself. It’s okay to question the answers. And remember how brave you are.

Dedicated to George Floyd, who couldn’t breathe.


Do stress and anxiety affect your asthma? Learn more.

Control your anxiety to help manage your asthma. Learn more.

Respiratory therapists share their thoughts on asthma and anxiety. Learn more.

Vocal cord dysfunction (VCD) or paradoxical vocal fold movement (PVFM). Learn more.

Jackhammer esophagus – a motility disorder of the esophagus. Learn more. 

Do you experience allergy-induced asthma, with or without additional medical conditions? PlasmaLab in Everett WA is seeking candidates for our Allergy Antibody Plasma Donation Program to support allergic asthma diagnostics and medical research.


Melonie McCoy, Freelance Writer


Melonie McCoy, Freelance Writer

I write about attached parenting, LGBTQ families, asthma awareness, and Scotland whenever possible, as they are all dear to my heart. I’m launching Highland Lass Copywriting soon and hope someday to visit the land of my obsession.



Thank you, Mel McCoy, for sharing your brave story about asthma and anxiety.



Sesame Allergy – The Ninth Most Common Food Allergy in the United States

According to a 2019 New York Times report, at least one million children and adults in the United States are allergic to sesame, an ingredient used in everything from soups to snack bars.

Dr. Ruchi Gupta, director of the Center for Food Allergy and Asthma Research at Northwestern’s Feinberg School of Medicine in Chicago, notes that sesame is in a lot of foods as hidden ingredients and is very hard to avoid. She considers it the ninth most common food allergen in the United States.

Gupta’s team’s research indicates that 4 in 5 people with sesame allergy have at least one other food allergy.

  • More than half have a peanut allergy
  • One in three have tree nut allergy
  • One in four have egg allergy
  • One in five have cow’s milk allergy

It is important to note that sesame labeling is not required by law as it is with eight common food allergens: egg, milk, peanut, tree nut, wheat, soy, shellfish, finfish, and the proteins derived from these foods.

Individuals with sesame allergy and parents of children with sesame allergy need to be diligent in determining which foods are safe to eat. Sensitivity to sesame varies from person to person, and reactions can be unpredictable.

A mild reaction once does not mean the individual will always have a mild reaction – the next reaction may be a life-threatening anaphylactic reaction. Individuals with sesame allergy are encouraged to keep an epinephrine auto-injector at all times as the first-line treatment for anaphylaxis.

Possible symptoms of a sesame allergy include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Hives
  • Abdomen pain
  • Coughing
  • Hoarse voice
  • Itchiness in the throat or mouth
  • Redness in the face
  • Swelling
  • Difficulty breathing
  • Low pulse rate
  • Life-threatening anaphylaxis

Sesame ingredients can be listed by many uncommon names, so it is important to read food labels and ask questions about ingredients. Sesame can also appear undeclared in ingredients such as flavors or spice blends. Foodallergy.org lists the following alternate names for sesame ingredients.

  • Benne, benne seed, benniseed
  • Gingelly, gingelly oil
  • Gomasio (sesame salt)
  • Halvah
  • Sesame flour
  • Sesame oil
  • Sesame paste
  • Sesame salt
  • Sesame seed
  • Sesamol
  • Sesamum indicum
  • Sesemolina
  • Sim sim
  • Tahini, Tahina, Tehina
  • Til

In non-food items, the scientific name for sesame, Sesamum indicum, may be on the label.

  • Cosmetics (including soaps and creams)
  • Medications
  • Nutritional supplements
  • Pet foods
  • Bird seed

Learn more about sesame allergy at the American Academy of Allergy, Asthma & Immunology’s website.

Do you experience sesame allergy or another food allergy? Consider becoming a plasma donor for allergy research.

Sublingual Allergy Tablets Are an Effective Treatment for Allergies

Individuals with allergies to grass, ragweed and/or dust mites may benefit from sublingual allergy tablets available by prescription from an allergist.

Sublingual allergy tablets have been used in Europe for several years. In recent years they were made available in the United States. For some patients, sublingual allergy tablets are an effective alternative to allergy shots.

According to Dr. Reynold Karr, an allergy and immunology specialist at the University of Washington Medical Center, the treatment involves placing an allergen tablet, such as one consisting of purified grass pollen, under the tongue each day at home.

“The tablet dissolves in seconds and the risk of a severe allergic reaction is very small,” Dr. Karr said.

When to Begin Sublingual Allergy Tablet Treatment

For grass and ragweed allergies, treatment is seasonal and should be started 12 weeks before your particular pollen season begins. Timing is critical, so it’s important to see your allergist at least four months before your allergy season begins. Allergy testing to confirm your sensitivities may be performed. Your doctor will direct you on when to begin taking your treatment based on your community’s pollen count history.

Sublingual treatment for dust mites is year-round.

Successfully Using Sublingual Allergy Tablets

When using sublingual immunotherapy for allergies, it’s important to place the tablet underneath your tongue and allow it to dissolve completely. Why? If you simply swallow the pill, the purified pollen will be destroyed by the digestion process. In placing the tablet underneath your tongue, the immunotherapy is distributed directly into your sublingual vein located in the floor of your mouth.

There are pros and cons to using sublingual immunotherapy to treat allergies. Side effects among children and adults are usually local and mild. Your allergist will guide you in your treatment plan.


Do you experience grass allergies (also known as hay fever)? Learn how you can donate your antibody-rich plasma to support allergy diagnostics and research. 

Ready to schedule your screening appointment and IgE allergy test to see if you qualify for our Allergy Antibody Plasma Donation Program in Everett WA?



RaeJean Hasenoehrl, Writing and Marketing Specialist

I am the Outreach Coordinator at PlasmaLab International in Everett. I am also a freelance writer and novelist, wife and mom and grandma, gardener and hay fever hater. Genetically speaking, mom and dad passed their allergies on to me, and I passed them on to my children. I’m sure our grandkids will be riddled with allergies, too. (Sorry, kiddos.)  Our family should own stock in the Kleenex company. Just sayin’.