Avocados have a fascinating history. They were a favorite among prehistoric creatures like giant ground sloths and mammoths, who spread the trees across continents by eating the fruit whole, then dropping the seeds miles away.

Central American farmers started cultivating avocados as far back as 5000 BC, and the plants came to California in the mid-18th century.

It wasn’t until the 1990s that avocados really caught on in the United States, and consumption has risen in dramatic fashion ever since.

In 1989, Americans ate about a pound of avocados per person per year. Today, that figure is up to seven pounds per person per year. California produces 300 million pounds of avocados per year, and Mexico dominates global production, sending 1.7 billion pounds to the US each year.

As you can imagine, the increasing popularity of avocados has inspired all sorts of new ways to include avocados in recipes. That means if you have an avocado allergy, it is harder than ever to steer clear.

These are the basics you need to determine whether you have an allergy to avocados, and if so, how to avoid exposure and manage symptoms if you have unexpectedly come in contact with the fruit.

What is the Allergen in Avocados?

Those with avocado allergies have an unusual set of obstacles. There is the standard issue that affects all individuals with food allergies – the fact that a substance in or on the fruit causes a negative reaction in the body.

People who have this type of avocado allergy tend to experience oral allergy symptoms in the mouth and throat.

This form of avocado allergy is closely related to birch pollen allergies, as your body is mistaking the proteins in avocados for those of birch pollen.

There is also a link between latex allergies and avocado allergies for the same reason. The body is reacting to similarities in latex and avocados.

Those who have this type of allergy may also notice reactions to bananas, kiwis, chestnuts, and papayas.

It can be difficult to determine whether you have an allergy to avocados if you are allergic to latex, because you could be reacting to the latex gloves that many people wear when handling food.

There is no definitive test for avocado allergies, so your allergist may recommend a food challenge. This involves eating a small amount of avocado and monitoring for an allergic reaction.

Alternatively, your allergist can use the skin prick method to test for reactions to birch and latex, which can give you a better idea of whether or not you are reacting to avocados.

What are the Symptoms of an Avocado Allergy?

If you have oral allergy syndrome related to avocados, you may notice symptoms as soon as you come in contact with the fruit. However, it is also quite common for symptoms to develop up to an hour afterwards.

Specifically, you may experience itchiness on your lips, mouth, and throat, ranging from minor to severe discomfort. You might also have swelling in and around your mouth, which usually passes fairly quickly. Over-the-counter antihistamines can help.

If your avocado allergy is more closely connected to a latex allergy, the symptoms will extend beyond your mouth and throat. Your lips may swell, and you might start sneezing. Your eyes may begin to itch, and you could have digestive issues.

In some situations, those with latex – avocado allergies develop hives, which are puffy red welts over large portions of your skin. In addition to antihistamines, you can try a cortisone cream on the affected area.

Very rarely, patients have had an anaphylactic response after coming into contact with avocados.

Anaphylaxis is marked by narrowing of the airways and difficulty breathing. This symptom is the most dangerous, and it is critical to seek immediate medical attention.

Can Avocado Upset Your Stomach?

Unfortunately, avocado allergies – particularly when associated with latex allergies – can upset your stomach. Many allergy patients report abdominal pain, nausea, and/or vomiting after consuming avocados.

You can soothe these symptoms with the same over-the-counter products you use for other digestive upsets.

Common treatments include over-the-counter anti-nausea (antiemetic) medications and antidiarrheal medications like loperamide (Imodium) or bismuth subsalicylate (Kaopectate, Pepto-Bismol).

Is Avocado High in Histamine?

In some cases, your allergic symptoms are caused by the high levels of histamine in avocados. This may indicate histamine intolerance, which is relatively common.

If you are particularly sensitive to histamines, you will also experience issues with other foods high in histamine, such as aged or fermented foods, canned and smoked fish, spinach, tomatoes, eggplant, strawberries, mushrooms, papaya, and pineapple.

This condition is a little different from a direct avocado allergy. For most people, the best way to treat it is with an over-the-counter antihistamine.

Foods to Avoid if You Think You Have an Avocado Allergy

If you have an allergy to avocados, it goes without saying that you should avoid foods that include them as a central ingredient. For example, keep an eye out for guacamole served as a condiment on sandwiches and as a side or dip with other dishes.

California rolls contain avocados, and they are often added into salads, burgers, and other popular menu items.

Unfortunately, avocados aren’t always easy to see. This is where it is important to read labels and ask your server for ingredient lists.

Many paleo and vegan recipes incorporate avocado to give a creamy texture, and it is sometimes used as a substitute for butter.

There are even recipes for baked goods like cookies and brownies that use avocado to create a light, fluffy texture.

You may also come across avocados as an ingredient in beauty products to boost the moisturizing effect.

Depending on the type of allergy you have, these products can cause a skin reaction when you use them. Examples include shampoos and lotions.

Keep an eye on ingredient lists, particularly if you notice any symptoms after use.

What Avocado Replacement Foods Can You Eat if Allergic?

If you are feeling lost without your avocados, don’t despair. There are a number of avocado substitutes that are safe, delicious alternatives. Many people with avocado allergies enjoy cooked chayote squash. It is particularly popular as a replacement for avocados in guacamole, as it has a similar texture.

Pureed green peas also serve as a tasty alternative to avocado. When added to recipes in place of avocados, it can be tough to tell the difference since they have a mild flavor. It’s fun to experiment with a variety of options to see which you like best.

How To Manage Avocado Allergy

Managing an avocado allergy is all about prevention. The best way to avoid a reaction is to stay away from avocados altogether. However, before you completely eliminate avocados, be sure you understand your specific sensitivity.

For some, the issue is pollen that has settled on the outside of the fruit. These individuals can continue to enjoy avocados when thoroughly washed or peeled and prepared by someone else.

Of course, even the most careful diners may come across avocados in unexpected places, especially now that they are so popular.

Make sure to let servers know of your allergy when placing your order, and be wary of foods that could have traces of avocados after being prepared in the same area. For example, guacamole and sour cream are often stored next to each other and served together in Mexican dishes. Cross-contamination is likely, so you may want to pass on both.

The bottom line is this: avocado allergies are inconvenient, but you don’t have to miss out on your favorite dishes as a result.

At home, most recipes can be prepared without the avocados and still be delicious. When you eat out, chefs will ensure you get wonderful flavor combinations despite the omission of avocados.

If you experience severe allergic reactions, be sure to carry appropriate emergency supplies like an epi-pen. As mentioned, avocados can turn up in unexpected ways, and it is best to be prepared for accidental ingestion. Check with your healthcare provider for more information on safely managing serious allergic reactions.