**Expect willingness to accommodate dietary restrictions, but don’t assume familiarity with oral allergy syndrome—or with which foods fall into your trigger categories.** The available evidence is limited, so I wouldn’t assign Bhutan a single nationwide level of allergy awareness.

There’s a particularly relevant firsthand report: a [2013 discussion of this exact question](https://travel.stackexchange.com/questions/13879/how-well-are-allergies-understood-in-bhutan) includes the traveler’s post-trip update. They reported very few difficulties, said food restrictions were respected, and found that many people spoke some English. However, people didn’t necessarily understand what counted as a fruit or nut, and most meals on their trip weren’t ordered à la carte. That’s encouraging, but it’s an older, individual experience.

Current Bhutan operator [MyBhutan explicitly handles allergy requests](https://www.mybhutan.com/policies/tnc), while warning that kitchens’ standards for separating allergens may differ and that travelers should remind whoever serves their food. That supports planning ahead and checking at each meal.

**I’d bring a short reusable allergy card, rather than explanatory flyers.** For your situation:

- Give your operator or guide an **exact list of foods**, rather than “fruit,” “nuts,” or just “OAS,” and ask them to brief each kitchen.
- Specify **raw versus cooked for each trigger**, according to what you already know you tolerate. Cooking often helps with OAS, but isn’t a universal guarantee. [ACAAI guidance](https://acaai.org/allergies/allergic-conditions/food/pollen-food-allergy-syndrome/)
- Have your guide help prepare or check a Dzongkha version of the card.
- Use concrete wording: “These foods cause an allergic reaction. Please check with the cook, including sauces and garnishes.”

You may need to repeat the practical instructions at each new kitchen; you shouldn’t need to teach everyone the medical mechanism. A guide who understands your specific restrictions should make that much easier.