What causes citrus fruit allergy

This is a resources and information sheet for people who suffer from citric acid intolerance. This rare food intolerance is a extremely hard one to manage because citric acid is enormously widely used as a food additive: it has a huge number of uses, from preservative to acidifier to catalyst for other additives to flavouring, and it’s almost as common as wheat in modern foods.

Intolerance versus allergy

Citric acid intolerance is not the same as citrus allergy.

Citrus allergy sufferers reply to substances specific to citrus fruits such as limonene or specific proteins found in the fruits, whereas citric acid intolerant people react only to citric acid, which is found in a number of fruits and even some vegetables, and is used as a food additive.

Citric acid intolerance is not a «true» food allergy — that is, it’s not an autoimmune response to a chemical in food. Intolerances happen when the body lacks some chemical or enzyme necessary for it to properly digest a specific substance: one of the most common is lactose intolerance, which is caused by a genetic difference which makes the body of a sufferer unable to produce the enzyme lactase.

Currently, I don’t know what quirk of body chemistry makes people intolerant to citric acid — but I do know that the problem runs in my family!

It’s significant to manage food intolerances as the body’s negative response to the food in question can damage the lining of the gut and impair digestion (particularly true of coeliacs). This in turn can predispose the sufferer to acquire true allergies, as poorly digested food proteins enter the bloodstream through the damaged gut wall and the immune system is exposed to unusually high levels of them.

What causes citrus fruit allergy

The significant difference between a food intolerance and a food allergy is that an allergic response will happen in exactly the same way however little a quantity of the allergen a person eats, for example in peanut allergy where even a trace of peanut can induce anaphylactic shock. Food intolerances, on the other hand, cause problems only in proportion to the quantity of the problem substance you’ve eaten: lactose intolerant people, for example, are commonly reckoned to be capable to «get away with» up to 250ml of milk a day without suffering severe symptoms.

However, since some food intolerances can damage the gut and contribute to allergy problems — and particularly since information about citric acid intolerance is so hard to get hold of — I tend to treat citric acid intolerance as analogous to coeliac disease, and to avoid citric acid completely.

Due again to the lack of information available about citric acid intolerance — apparently it’s extremely rare — I can’t provide here a list of known symptoms, but for myself I know it causes painful excess wind (gas), bloating, stomach cramps and diarrhoea. also suggests that other sufferers can experience skin rashes.

How citric acid is manufactured

Most commonly, by fermenting cane sugar or molasses in the presence of a fungus called Aspergillus niger.

It can also be obtained from pineapple by-products and low-grade lemons, but basically, most of the citric acid that’s used as a food additive is mould extract. (Yeast allergy sufferers own to avoid it for exactly that reason, apparently). Sounds a lot less appetising when you ponder about it love that, doesn’t it?

My story

I’m 28 years ancient at the time of writing, and own suffered from occasional bouts of IBS since coming below with gastroenteritis in 2001. In early 2006, the IBS returned, but was far worse than previously — I found that about half the time, my stomach would just shut below on me completely half way through a meal and I’d feel completely unable to eat any more.

To start with I was extremely confused and concerned by the fact my digestive system appeared to own completely changed the way it worked, for no readily apparent reason; I did the usual things that assist my IBS, such as eating easily digested foods, cutting out alcohol, fat, sugar, and foods containing extremely large amounts of roughage: I patiently consumed yoghurts and drinks containing friendly bacteria, but every to no avail. After some three months of this I eventually went to my doctor to enquire if I might own a food allergy, and explained that there’s a history in my family of reacting to extremely sour citrus fruits, or large quantities of them.

She explained that it was likely I suffered from the same thing, and got me to hold a food diary. It took less than a week of analysing the content of foods I reacted to before I realised that citric acid was the culprit: any food containing it in anything other than tiny amounts caused me to bloat up enormously with painful excess wind, overstimulated my bowels and hence stopped me feeling hungry due to the nausea caused by my intestines doing gymnastics.

What causes citrus fruit allergy

Cutting citric acid out of my diet to make certain the effects vanished and I’d identified the correct problem was the obvious next step. It’s not simple to do at every because citric acid is one of the most common additives around (see the ‘Managing citric acid intolerance’ section above), and I began to develop a genuine appreciation for the difficulty coeliacs and yeast allergics suffer in suermarkets! But it is possible, especially if you’re willing to cook and bake yourself instead of relying on convenience foods and readymade stuff.

After a few misfires and accidents with foods I was used to being ‘able’ to eat turning out to contain citric acid, I found that the painful wind and inability to eat subsided; a few weeks after that I discovered I’m also lactose intolerant, and after cutting cow’s milk out too I was left only with the IBS. You almost never ponder you’ll welcome IBS, but after three months of anxiety and weight loss, it was as large a relief as coming home after a stressful trip!

What causes citrus fruit allergy

As far as I can tell there’s extremely little information available about citric acid intolerance, apart from the fact that everyone who does comment on it says «well, it’s extremely rare». I’m planning to put any information I do discover up on this sheet, so please do hold checking back.

Notes and theories

From Henriette’s Herbal:

[Citric acid] exists in a free or combined state as citrate of calcium or potassium in numerous fruit-juices, as of whortleberries, cranberries, gooseberries, strawberries; blackberries, raspberries, red elderberries, currants, cherries, tomatoes, tamarinds, cayenne, and in the fruits of bittersweet and of a solanaceous plant of South America and Mexico, known as the «tomato de la paz» (Cyphomandra botacea).

It is also present in Jerusalem artichoke, dahlia tubers, and in the rhizomes of red puccoon, and Asarum europaeum. Both the tobacco plant and lettuce contain it. While abundant in the red elderberry the present supply is almost entirely derived from fruits of the orange family. England produces the acid on a large scale from Italian lemons and limes.

What causes citrus fruit allergy

It is also made from the sour oranges of Florida.

Vitamin B5: Some health food types theorise that vitaminB5 can improve the body’s ability to digest citric acid. I own no confirmation of this from a scientifically dependable source yet, but my personal experience does propose that spectacular reactions to citric acid were much more observable when my IBS was flaring up and making it hard for me to eat the main B5-containing foods in my diet, wheat bran and wheatgerm. The presence of B vitamins certainly seems to reduce my reaction to foods containing citric acid: Lucozade Sport, for example, or raspberry jam on wholemeal toast, are things I can «get away with» with only a relatively mild reaction, as opposed to the spectacular bloating and gas problems that a Kipling’s Victoria Slice, a lemon steamed pudding, or carrot-ginger-lime soup will cause me.

A food allergy is when the body’s immune system reacts unusually to specific foods. Although allergic reactions are often mild, they can be extremely serious.

Symptoms of a food allergy can affect diverse areas of the body at the same time. Some common symptoms include:

  1. an itchy sensation inside the mouth, throat or ears
  2. a raised itchy red rash (urticaria, or «hives»)
  3. swelling of the face, around the eyes, lips, tongue and roof of the mouth (angioedema)
  4. vomiting

Read more about the symptoms of food allergies.

Managing citric acid intolerance

Citric acid is an appallingly common food additive: it has an huge number of uses from providing a sharp, sour flavour to preserving and even acting as a catalyst to other preservatives.

What causes citrus fruit allergy

However, with careful attention to ingredients and a willingness to pitch in to cooking for yourself, it is possible to completely avoid citric acid. Making your own desserts and sauces is a grand way to avoid it, because it’s most common as a preservative in sweet foods and those containing fruit or tomatoes. Shop-bought fruit flavour yoghurts almost invariably contain it, for example, but home-made desserts and smoothies using non-citric fruit along with plain yoghurt, citric-free ice cream, milk, or apple juice make a yummy and additive-free alternative.

What causes citrus fruit allergy

Readymade sauces, especially pasta sauce, are another huge offender, so making your own unused food is a must. (Pasta sauce is somewhat dicey since tomatoes do contain citric acid, though in relatively little amounts: you may be capable to manage with tomato-based sauces in moderation. However, some varieties of canned tomatoes contain citric acid, so check the label before buying: organic canned foods are more often additive-free.)

«Going organic» is another excellent general tip for citric acid intolerants, since the organic food philosophy is to minimise the use of every food additives as well as eliminating pesticides and other agrochemicals.

Organic pre-prepared foods are likely to use fewer additives than non-organic foods, but conversely they also won’t hold as endless, and it’s still vital to check the label for citrus juices before you purchase.

Eating out can be a chore for any allergy or intolerance sufferer, but one handy way to check out in advance what you’re likely to need to avoid is to for recipes of dishes likely to be on the menu at the put you’re planning to eat. Doing this can give you a excellent general thought of how much citric-containing stuff your chosen cuisine tends to contain, and can assist you avoid restaurants where you’ll own little or no choice, but of course you should always enquire in the restaurant too to make certain that their special home recipe is still OK!

I own a personal theory, which I haven’t yet proved, that vitamin B5 or B vitamins in general may assist ameliorate the symptoms of having accidentally eaten citric acid. I’ll be testing this out in the future so please do check back again; I also hope to own more information about whether citrates (salts of citric acid which are also used as food additives) also provoke a reaction.