I have a lot — a lot — of allergies; I carry an EpiPen for nuts and shellfish, I have an acute gluten intolerance, and I have a bevy of other issues with foods related to something called oral allergy syndrome, which occurs when someone’s body responds to the proteins in things like raw fruits and vegetables the way that it does to plants and pollens during seasonal allergies.
This complicates a lot of things in my life — eating, chief among them. But dating can also prove a little tricky. I had a horrible gluten exposure recently and found myself nervously googling “can you get gluten’d from semen” at like 3 a.m., which honestly, was not a high point in my life! (You cannot.)
I’ve taken to telling new partners to avoid eating nuts before we go out because I have to be careful about getting trace amounts of nuts (the food kind) in my mouth.
At 26, I am still navigating how to have fun and stay safe when I have all these things to consider. So, I decided to talk to an expert — David Stukus, MD, Associate Professor of Pediatrics, Division of Allergy and Immunology at Nationwide Children’s Hospital — and ask him about all things allergies and dating.
Oral allergy syndrome is a unique condition caused by cross reactivity of plant proteins in fruits and vegetables with those found in pollen; these proteins are normally very easily destroyed by cooking or processing these foods and would not likely be present in saliva.
Even if they were, the symptoms of oral allergy syndrome are usually confined to the mouth and throat. It is important to note that saliva is our first line of digestion so any food protein eaten will already start to be broken down inside the mouth by the enzymes found in saliva.
However not everyone with a food allergy has the same threshold for reactions, and especially severe reactions. For example, only about 5 to 10 percent of all people allergic to peanuts will react at all if they eat a trace amount, let alone have a severe reaction to that level.
Not all foods are associated with the same risk of causing a reaction through trace exposures, either. Blanket statements do not apply in this realm.
The risk will vary by timing of exposure — if someone just ate a food allergen then kissed someone who is allergic within 1 to 2 hours, that risk is much greater than if they ate the food earlier that day or the day before.
The type of allergy absolutely matters as well; realistically, risk pertains to those with IgE mediated immediate onset food allergies, in which exposures to allergen cause immediate symptoms such as itching, swelling, rash, vomiting, breathing difficulty, or anaphylaxis.
Patients with celiac disease can have symptoms after ingestion of small amounts of gluten, but this would be unexpected from kissing someone and very different than anaphylaxis.
There are limited studies looking at effective ways to completely eliminate food protein from saliva after ingestion. However, it appears that peanut protein is almost completely eliminated from saliva after someone eats peanut butter once that person eats a non-peanut meal or snack and especially after a period of 2 to 3 hours.
Brushing teeth and rinsing with mouth wash are also pretty good at removing peanut as well, but not 100 percent.
It’s important to note that these studies look at very sensitive assays to detect any measurable peanut protein, but whether that’s enough to cause any reaction, let alone a severe reaction, is a whole other question.
As such, a reasonable measure is for the person who doesn’t have a food allergy to eat a non-allergen containing meal/snack sometime after they last ate the food allergen and ideally not eat the allergen within a few hours of kissing.
There are very rare case reports of food allergens being transmitted during sexual intercourse from a man’s semen to a woman’s vagina. I’d like to emphasize VERY RARE and this is not a realistic risk for most people to worry about.
Anyone engaging in oral sex should follow the same advice for kissing as residual allergen in saliva from a recent meal could cause localized irritation of any mucosal surface if contacted through saliva. This would most likely manifest as local itching/burning and possibly swelling.
Food allergens can be transferred to surfaces and skin through direct contact with the food, but soap and water or any cleaning wipes can effectively remove protein from surfaces.
It makes sense to wash hands before engaging in intimacy and I hope no one goes from eating a peanut butter sandwich straight to the bedroom!
Transfer through condoms and lubricants would be unlikely unless you could visually see food on someone’s hands or fingers while they applied those items.
Anyone with food allergies will likely be versed in avoiding use of those foods during any type of intimacy, so hopefully this goes without saying but a hidden food allergen may be present in something like whipped cream that may be used. It makes sense to read labels of any food brought into the bedroom.
I strongly recommend making this a part of the conversation early in the relationship. It takes some practice feeling comfortable talking about it, but it can be straightforward and actually increase the personal connection with someone else.
It can be as easy as saying: “I am allergic to xxx food and need to make sure I don’t accidentally eat it. If I do, I could have hives, itching or even difficulty breathing. I’ve been pretty good at avoiding it but need to make sure I always read labels and discuss with waitstaff at restaurants. I also need to always carry my epinephrine autoinjector just in case I accidentally eat something I’m allergic to and it makes me sick. Would you like for me to show you how to use it?”
It can be difficult for some people to open up and talk about personal matters, but one of the things we try to educate people with food allergies about is being their own advocate.
We want people with food allergies to feel empowered to navigate the world we live in without excessive fear. With practice, preparation, and communication, anyone can develop confidence.
Caroline Reilly is a Boston-based reproductive justice advocate, writer, and law student. You can find her work on the Washington Post, Teen Vogue, Bitch Media, and Rewire.News, where she writes about medical misogyny, sexual violence, abortion access, and more. Find her on Twitter.