Allergies to fruit and veg? It could be LTP.

What is it?

LTP stands for lipid transfer protein and is indeed a protein found in most, if not all, plant foods. Allergy to this protein is more common in Mediterranean countries such as Italy and Spain.

The allergy often starts with sensitivity to the LTP of peach, called Prup3, this protein cross reacts with the LTPs contained in other foods, so it can spread not only to foods closely related to peach such as apples, plums, apricots, cherries etc., but also garlic, onions, strawberry, lettuce, hazelnut, cabbage and more!

Why are cross reactions such a huge issue with LTP allergy? Because LTPs are panallergens and often present a similar molecular structure with each other. This is the true nightmare of this condition.

Because this allergy affects such a large number of fruit and vegetables it is often confused with pollen food allergy syndrome or OAS (oral allergy syndrome) it’s not the same though! LTPs are stable and resistant to high temperatures, they can be processed and can still cause severe reactions such as anaphylaxis. On the other hand, reactions to cooked fruit and vegetables with OAS is often less likely.

My experience

It started in my late teens with a severe angioedema to peach. Up until then, I ate everything, peach included, with no symptoms. Following that reaction, I went back pretty quickly to my normal life. No other food ever bothered me.

I was diagnosed with LTP allergy in my late 20s, after some routine checks for my allergies, in Italy. However, seeing a positive RAST to so many foods, when really I had no symptoms, didn’t mean much to me.

Fast forward 10 years and my symptoms start to develop. It was less than a year after my pregnancy and just when I stopped breastfeeding my daughter that I noticed I was reacting, this time with symptoms related to my GI tract, to virtually all foods.

I had the opportunity to meet many doctors, allergist specialists, but also nutritionists, dietitians.. in short, nobody had a clue as to what I was going through. This was made worse by the fact that I live in the UK and 10 years ago when I tried to explain LTP allergy and my symptoms to some doctors here they thought I was crazy, or the way they put it “hypochondriac”.

[rant: I didn’t know whether to feel offended or simply concerned that they did not know about the existence of this condition, despite being diagnosed with it in another country 10 years earlier. You’d think they had the time to catch up..]

So I studied (still do actually). I read every published study about LTP allergy and food allergies in general and while there is some questionable information online, there are plenty of legitimate sources to study from (Pub Med being one of them) and without which, I would have missed valuable help. To top it up reading the hundreds of experiences from other people suffering from allergies, with all its debilitating consequences as well as what worked for themselves, helped me going through it all.

I learnt that just because it contains LTP it doesn’t mean that that food needs to go. I learnt that it is highly individual. That some foods are better tolerated than others and that often those ones that trigger more symptoms, apart from peach, are those closely related to the peach family, so apples, pears, cherries, apricots, plums… but also tree nuts, chestnuts, cabbage and lettuce. The list goes on. Environmental allergies are also possible.

With me it felt like this condition almost exploded overnight. My immune system just tilted on one side (Th2) perhaps helped by my post pregnancy hormones and quite a stressful time from what I can remember. I needed to find balance. I especially needed to reduce the ongoing and uncontrollable inflammation and calm my GI tract. First thing to do was an elimination diet. I eliminated the worst offending foods and kept those that I could tolerate best. This process is easier said than done. In fact, it still takes time today as the food triggers keep changing, allergies often spread, unfortunately. So I learnt to follow what my body tells me. For example, “I could eat pistachios before. It doesn’t feel like I can eat pistachios anymore (a month later). ” With LTP this can be a common scenario. Second, I got rid of everything processed, no junk, I did not want to create an extra burden of toxins that my body had to work hard to get rid of. I cut out (added) sugar from my diet, no matter how “healthy” it sounds: jaggery, coconut sugar, date nectar, cane sugar, maple syrup, honey etc.

My view is this: my body is fighting allergies, that alone is hard work. These allergens are ongoing, so in order to let my body do the job as best as it can I am going to keep it as clean as possible, this means clean diet, organic preferably. Sure, we can’t avoid all toxins (environmental for example), but that’s even more a reason to do what we can to balance our health!

My third step was to supplement to help with inflammation and managing the symptoms at the same time. Only a few actually helped and I stick with them to this very day. Good quality probiotics, l-glutamine and digestive enzymes are some of these. I also take some natural anti inflammatory ones.

In this optic it felt natural to study and to qualify as a nutritionist. Believe me, I am evidence that diet needs do vary from person to person.

However, while the changes I made allowed me to keep as healthy as possible in my circumstances, I still feel trapped as, unlike most people with a food allergy, I cannot completely cut out my inflammation at the source, or in this case my LTP allergen, at least, not without following a rather questionable diet, which, sooner or later, will present other complications. I learnt that keeping some of this inflammatory food in my dietary regime, despite being the most tolerated, has consequences. My digestion, for example, is surely compromised and with the years I developed other conditions.

It feels surreal being allergic to so many healthy foods, and it is frustrating that those very foods are at the core of our health.

You will see from some of my recipes I still use nuts, fruit and vegetables. I do consume some of them, however, mostly are for my family to enjoy. In the meantime I’m looking for a desensitisation programme that will hopefully induce tolerance to LTPs foods again.

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