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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.

  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?

  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.

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