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Lemon, Lime, Orange and Grapefruit: Citrus Allergy


While any food can theoretically cause a food allergy, citrus fruits are fairly low on the list.  However, allergy to citrus has been associated with adverse food reactions ranging from mouth itching to anaphylaxis.

The Genus “citrus” includes lemons, limes, oranges and grapefruits.  There is allergic cross reactivity between these citrus fruits, suggesting allergy to one, increases the risk of allergy to another in the group.  The seeds (which are abundant in protein) have increased allergenicity compared to the pulp or juice and share similar protein allergens.

Frequently, citrus allergy is associated with pollen allergy (especially grass) due to cross-reactive (shared) proteins.  Also, citrus allergy shares a common Cit s 1 and Cit s 3 profilin isoform that is found in apples.


  • A child with milk allergy had an anaphylactic reaction to lemon sorbet, but it turned out to be cross contaminated with milk.  He was not allergic to lemon.
  • An adult with peanut allergy had co-sensitivity to citrus seeds and had anaphylaxis after using lemon soap containing crushed lemon seeds.
  • A 17 year-old female with cashew allergy had been experiencing mouth itching and lip swelling with citrus for 10 years before she had anaphylaxis after eating lemon sorbet (lemon juice + lemon peel).  She was skin test positive to lemon and orange pulp as well as grapefruit peel.


  • Lime juice can cause dental erosion and decrease the anti-coagulant effect of Warfarin (Coumadin).  In rats, lime juice can partially block ovulation and may decrease fertility.    I was unable to find any reports on allergic reactions to lime juice.
  • Oils in the rind of limes contain fucocoumarin which in some persons can be sensitizing and if contact is followed by sunlight exposure, a phototoxic reaction can occur which manifests as a red, itchy rash. This is called a phytophotodermatitis.  This citrus peel allergy from lemon, lime and oranges is triggered by limonene and lesser contact allergens geraniol and citral.  Beware bartenders: twisting lime into gin and tonics at the poolside bar may be hazardous to your skin!

Oranges (especially Mandarin):

  • Anaphylaxis: A case in Greece identified a heat stable protein rather than the usual lipid transfer protein.
  • In 2012, a case report published in Annals of Allergy described a 2 year-old boy who developed food-protein induced enterocolitis (repetitive vomiting, diarrhea, dehydration, lethargy) occurring 1-2 hours after drinking orange juice.  Skin and blood tests for allergies are negative in this type of reaction.
  • Cashew and pistachio allergy are more common in children with orange seed allergy.  A child in Australia with cashew allergy chewed and swallowed the seeds from a mandarin orange and had a severe reaction within 1 hour.  He could drink the juice with no problems!


  • Food-dependent exercise-induced anaphylaxis has been reported for orange and grapefruit.  This occurs when ingestion of the food and exercise occur within 2 hours.  Exercise alone or eating the food without exercise will not trigger the allergic reaction.

At Family Allergy & Asthma Care of Montana, we specialize in assessing and treating food allergic reactions.  If you suspect an allergy to citrus, call us.   If you have had a reaction to lime juice, you may the first!

This information is solely for informational purposes and not intended as a substitute for consultation with a medical professional.  


  1. BridgetBridget11-17-2014

    I’ve had a reaction to lime juice/limes. I don’t get hives or anaphylaxis, but I do get violently ill (nausea and vomiting). Also I don’t have any reaction to lemons, oranges or grapefruit.

  2. tessatessa11-26-2015

    I have had allergic reactions to oranges, lemons, and limes. I have avoided grapefruit, pineapple is less severe but painful at my last exposure. I carry epi pens. A few years ago accidental lime exposure sent me to the er (vomiting, itchy painful throat, shortness of breath). Recently just smelling freshly peeled oranges caused a serious allergic reaction. My allergist said I’m out of luck, she can’t help me.

  3. Elizabeth HaleElizabeth Hale05-28-2016

    I have a severe allergy to lime but not lemon or orange. It has resulted in anaphylaxis in the past.

    • Sandra LevineSandra Levine03-29-2017

      I have begun taking 4,000 iu of vitamin D3 every morning. My hives have diminished by 80 percent. I still get itchy when i wake up, and throughout the day…. but the hives are so much more under control. It does make me a little bit tired… however,… it makes a huge difference.

  4. Ive had reactions to lemons, limes,and oranges of lips break outs and itching and burning feelings of my lips

  5. KristinKristin07-21-2016

    I have severe diarrhea with mandarin oranges, skin reactions to grapefruit, lemon, and lime. My tongue swells with limes and pineapple. I also had a skin reaction recently to Vitamin C supplements I was taking since I cannot eat Vitamin C rich foods. According to what I have read online you cannot be allergic to Vitamin C itself, but everything I have experienced seems to point that way for me. Has anyone else experienced this?

    • AmbertarpAmbertarp05-25-2017

      I have this same issue. My dr. Thinks it’s “unexplainable” because you can not be allergic to the vitamin it’s self but even after our food tolerance test he totally can see it has to be. He even had me take a suplement while in office for the food test and it took a matter of maybe 35-40 minutes for my skin to start getting itchy and for him to see the reaction I was clearly having. He wished me luck and said not to take any more.

  6. shreedarshaneeshreedarshanee08-24-2016

    i have citrus allergy from past 2 years. citrus fruits were my favorite fruits. I never had allergy before. But after I came to a new place I have been diagnosed with lots of pollen allergy and food allergy. last year Dr. confirmed that I have citrus fruits allergy. whenever i contacted with any of the citrus fruit I develop sneezing, itchy throat, and severe rashes on body. I dont know why it started so suddenly. I stay in hostel so m compel to have mess food which is high risk of contamination with my allergens. wanna get rid of allergy. wanna have lemon again..

  7. KellyKelly09-09-2016

    I have a severe anaphylaxis allergy to the skin or zest of citrus. Pineapple is fine and I have even taken a bite of grapefruit without a problem. Most people with a citrus allergy seem to be allergic to the fruit itself, but mine is only the skin. I am finding that citrus zest is used is many many foods now.
    The reaction takes 15 minutes or so to start but then the coughing and vomiting and wheezing start. My allergist didn’t believe me and had me bring in an orange and eat the peel in his office. Because it took awhile for the reaction to start, he had me eat more and more, insisting that I just had asthma… It wasn’t pretty. Afterwards, I was just told don’t eat it anymore. Carry an epi pen, inhaler, Benadryl, steroids, Pepcid AC… No resources.

  8. martha kendrixmartha kendrix01-11-2017

    I have concluded that oranges makes me wheeze and I itch under both arms.

  9. SandraSandra02-09-2017

    I am 49 years old… and I never had a bad allergic reaction to anything.

    Three months ago I went to the dentist… he used latex on my mouth for a dental dam

    That night.. when I came home.. I was rushed to the hospital, about to go into an shock. The er used an Epipen on me…. and I learned that I actually have a bad reaction to that …. I scream loudly for two minutes solid… felt like I was being run over by a train

    Since then, I also have become allergic to all citrus fruits…… rushed to the hospital twice… but now I know… unless I am unable to breathe… that I do not need medical attention. It is scary, however, because when I have one of these allergic reactions… I panic big time… so it appears to me that I can no longer breathe.

    A few weeks ago, I began waking up every single morning with a bad case of hives. I just don”t understand it. I take Benydrl and Pepcid… and it usually goes away after about an hour,.

    So, I have a serious allergic reaction to citrus fruits and latex
    I wake up each morning with a bad case of hive,.
    The doctor could find no explanation for my problem…….. this is getting to be a bit overwhelming for me.

    • jsummersjsummers09-18-2017

      hives could be an anxiety thing. I was having hives before bed every night and dr gave me Xyzal, its finally OTC. It worked! We figured out that it was anxiety and not allergies causing the problem! good luck!

  10. MarthaMartha02-13-2017

    I am experiencing an increase in sensitivity to all citrus juices and oils. I react with a rash if there is physical contact, with an asthmatic reaction if inhaled, with mouth ulcers, migraine headaches and diarrhea if ingested. The quickest reaction is when inhaled.. nearly instantaneous. Is there any treatment?
    It is nearly debilitating and therefore frustrating.

  11. LizLiz04-18-2017

    Limes and lime juice causes hives and anaphylaxis in me- lemons and orange do nothing. Have had this since I was four years old, currently am 44.

    • jj06-08-2017

      Wow…I have just been squeezing lemons and limes the past week…..first time in over a year, and my nose is stuffy, eyes are red, throat burns, heartburn (which I NEVER get). I am a decade younger than you. The last time before this I stopped eating lemons because they did the same thing. Is there anymore information you can provide on your symptoms and why you may think it is? There is close to no information on lime juice allergy on the web. Thank you in advance

  12. JanetJanet05-06-2017

    Have avoided all citrus, fresh tomatoes and walnuts since I was a kid. Their juice burns my skin like acid, and if I taste any of them I get cankor sores on my tongue. Also had same symptoms with bad stomach rash after eating pineapple as a kid so avoid that as well.

  13. EckoEcko05-11-2017

    I have just recently become severely allergic to a few things after moving to a couple different environments. Orange is the most severe. I seem to have the same reaction whether I eat it or I inhale it, I instantly become dizzy, light headed, extremely weak, nauseous and I can not think or speak clearly. I ended up in the er last week thinking I was having a heart attack or stroke, which then caused a panic attack because someone had a citrus diffuser in their classroom. I am becoming more and more sensitive to it.

  14. AnnieAnnie06-28-2017

    My daughter for years often had vomiting after eating, particularly in restaurants. It was found she is allergic to citrus. She had asthma but had never had anaphylaxis. After cutting it out of her diet, though, the allergy became more sensitive. She has had several anaphylactic reactions in the past year. Once when someone opened a Tupperware container of cut oranges, once when she wiped down a table where orange juice was served, twice because of lemon containing cleaning products just being used nearby. All confirmed anaphylaxis by the ER, so not just asthma or panicking (although that would be understandable at this point). Trying to figure out how she can lead a normal life. Had to give up eating in restaurants, working in childcare (orange juice and slices), food service (obviously), and the latest was a cleaning product in an office setting. Now the employer is saying they can’t accommodate her after the ambulance had to be called. Really? How hard is it to switch cleaning products? I think they just don’t want the liability, as they were informed of the allergy prior to the incident. It’s not like they manufacture the stuff. With her next job, she’ll have to check the cleaning products, wearing gloves while dong so.

  15. TracyTracy12-15-2017

    I recently got a severe headache and my face felt flushed after eating a pastry with orange icing. Sometimes I get stomach aches from orange juice so these other symptoms are a little confusing.

  16. MakMak01-22-2018

    I use to not have an allergy to citrus. In about 12th grade I noticed every time I would eat a lemon My stomach would be upset. Eventually I thought it was because of the acid from the lemons, but them my lips began to tingle and my tongue went numb. The smell now gives me migraines and makes my throat close up. I just find it strange how I never had an allergy and now for 5 years I cant be around them without an Epi pen being brought out. (The allergy has gotten worse and limes, oranges, and grapefruit all both me now as well).
    But I was wondering does anyone have problems with artificial flavoring as well because my throat has closed because of a lemon cough drop and dont get me started on artificial lemonade.

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