Itchy lips or a scratchy throat after a raw apple, but apple pie is no problem? That is one of the most common food reactions adults describe in northern and central Europe, and birch pollen is usually part of the story. Our test checks your blood for IgE antibodies to two single apple proteins, as part of 300 allergens and allergen components including birch pollen.
Most people in northern and central Europe who are sensitised to apple react to Mal d 1. This PR-10 protein looks like Bet v 1, the main birch pollen protein, so the antibodies are really aimed at birch. Mal d 1 breaks down with heat, which is why baked apple, apple sauce and pasteurised juice are often tolerated when raw apple is not.
A different pattern is more common around the Mediterranean. There, people are more often sensitised to Mal d 3, a lipid transfer protein (LTP). LTPs survive heat and digestion, sit mainly in the peel, and are associated with reactions beyond the mouth. The panel measures both, so a doctor can see which pattern your blood shows.
The classic description is itching or tingling of the lips, mouth or throat within minutes of biting a raw apple, often in people who sneeze in spring. This is called oral allergy syndrome or pollen-food syndrome. It usually settles quickly once the apple is out of the mouth.
Less often, people report hives, swelling of the face, stomach symptoms or breathing trouble, more commonly with the LTP pattern. Swelling of the lips, tongue or throat, trouble breathing or feeling faint after eating is an emergency. Call 112 (EU) or your local emergency number. Do not wait for a test.
If birch is behind your apple reaction, other raw foods with PR-10 proteins often cause the same mouth itch: pear, cherry, peach, plum, hazelnut, carrot and celery are the usual suspects. If LTP is behind it, the list tends to include peach, nuts and other fruits with a sturdy peel protein.
So an apple result is most useful next to the rest of the panel. One finger prick shows apple, birch pollen, hazelnut, peach and celery side by side.
Your finger-prick sample goes to the lab, which measures IgE to two single apple proteins (molecular components). There is no whole apple extract on the panel. Your lab report gives each a measured value and class, from Negative to Very high. A positive result shows sensitisation, not a clinical allergy. Plenty of people with birch sensitisation show apple IgE and eat apples without trouble. Discuss the result with a doctor before you change what you eat.
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One finger-prick sample checks IgE to 300 allergens and allergen components, from birch and peanut to cat and house dust mite. Post it to the lab, and about 5 days after it arrives you get a value for every one. Our plain-English guide shows you how to read them. €399 in total, €1.33 per allergen.
The birch-like protein Mal d 1 breaks down with heat, so baked apple, apple sauce and pasteurised juice often cause no symptoms. That pattern is common but not universal. The LTP protein Mal d 3 survives cooking, which is why the test measures both.
Often, yes. In northern and central Europe most apple sensitisation is linked to birch pollen. The test checks apple and birch in the same sample, so you can see whether they appear together.
It depends on the protein. The LTP Mal d 3 sits mainly in the peel, while the birch-like Mal d 1 is in the flesh too. Your component result shows which one your antibodies recognise. Ask a doctor what that means for you.
It shows whether you have IgE antibodies to apple proteins, which is sensitisation. Whether that means a clinical allergy depends on your history of reactions. A doctor puts the two together and may suggest further tests if needed.
