If you suspect you have a nut allergy or have recently been diagnosed with one, you’ll need to take extra precaution when handling and consuming food. Some food allergies are more serious than others, and a nut allergy can be particularly difficult to control because of how many foods contain peanuts or tree nuts. Even trace amounts of these nuts can cause serious allergic reactions which could result in death.

What Is a Nut Allergy?

A nut allergy is a type of food allergy. A food allergy occurs when consuming a particular type of food triggers an immune response, otherwise known as an allergic reaction. An allergic reaction will occur because the immune system attacks proteins in the food which, to non-allergens, are harmless. As Food Allergy reports, it’s been estimated that as many as 15 million Americans have a food allergy of some kind. Although peanut and tree nut allergies are very serious, they are not the most common type of food allergy. A seafood allergy is seen far more often than a nut allergy, as there are four times as many people allergic to seafood than to peanuts. Food allergies have become an especially growing concern for children. Over a third of the people with food allergies are children under the age of 18. Additionally, the Centers for Disease Control and Prevention has indicated that between 1997 and 2011, food allergies in children have increased by 50%. Peanut and tree nut allergies tripled in children in that timeframe. Boys are more likely than girls to develop food allergies in childhood. Childhood food allergies cost nearly $25 billion annually. Children are taken to the hospital by ambulance over 300,000 times per year because of food allergies. Additionally, someone is sent to the hospital because of a food allergy every three minutes. Children with food allergies are also more susceptible to other allergic conditions. They are two to four times more likely to suffer from asthma or eczema.

Peanut Allergies vs. Tree Nut Allergies

Although there are over 170 known foods that can cause allergic reactions, both peanut and tree nut allergies are considered to be one of the eight main food allergens. However, tree nut allergies are different than peanut allergies. When determining which food allergy you may have, it’s important to consider the differences between the two. There’s a greater likelihood of having a peanut allergy than a tree nut allergy. About 1 in every 100 people has a peanut allergy, while 1 in every 200 people has a tree nut allergy. Peanuts grow underground, which is why they are classified differently than tree nuts. With that being said, many people are often allergic to both peanuts and tree nuts. It’s been estimated that anywhere from 25% – 40% of peanut allergy sufferers are also allergic to at least one tree nut. In total, an estimated three million Americans live with a peanut and/or tree allergy. According to the American College of Allergy, Asthma, and Immunology, those with tree nut allergies are typically saddled with the allergy for their entire lives. Fewer than 10% of people with a tree nut allergy will outgrow the allergy. Peanut allergies are outgrown at a 20% rate. These rates are both much lower than the rates seen for milk, wheat, soy, and egg food allergies. These allergies are almost always resolved before a child reaches adulthood.

Types of Nuts That Cause Allergies

There are a number of different nuts that can cause an allergic reaction. Not only is it important to avoid these nuts, but it’s also important to monitor labels of processed foods to ensure they don’t contain any of these products. The Food Allergen Labeling and Consumer Protection Act mandated that the obvious presence of these items be highlighted in the ingredients list. If you have a particularly sensitive nut allergy, you’ll likely need to check the label of any food you consume. Many labels will tell consumers if food has been manufactured in a facility that also processes nuts, indicating that there may be trace amounts of nuts in the processed food. Many allergic reactions are caused by foods that appear to be safe. Foods can either be mislabeled or unknowingly cross-contaminated during preparation and are most likely to cause an allergic reaction. You may be unsuspecting of some foods or beverages that you wouldn’t think would cause a reaction. For example, alcoholic beverages often contain nuts or nut flavoring, making them a subtle trigger. You may also have to avoid certain products, such as lotions, soaps, and shampoos.  Many of these products contain tree nut oils, which could irritate the skin and cause an allergic reaction.

Tree Nut Allergies

Popular tree nuts that often trigger an allergy include:

• Walnuts
• Almonds
• Hazelnuts
• Cashews
• Pistachios
• Brazilian nuts
• Macadamia nuts
• Coconut

A full list can be seen here.

Peanut Allergies

Peanuts are the only nut in this family that triggers an allergic reaction. However, this includes all variations of peanuts, including peanut butter, peanut powder, and peanut oil. Living with a peanut allergy can be dangerous because of the frequency in which peanut ingredients are found in foods. In cases of extreme severity, an allergic reaction can occur just by inhaling airborne particles.

Nut Allergy Symptoms

There are a number of common symptoms that could indicate a nut allergy, including:

• Wheezing or coughing
• Trouble breathing, including shortness of breath
• Hoarseness, throat tightness or difficulty swallowing
• An itchy mouth or throat
• A runny nose or nasal congestion
• Stomach irritation or cramps
• Vomiting and diarrhea
• Itchy, swollen or watery eyes similar to spring allergies
• Hives or otherwise raised skin
• Red spots
• Swelling
• A decrease in blood pressure

Anaphylaxis

Both tree nut allergies and peanut allergies are linked to anaphylaxis, which is also often seen in shellfish allergies. Anaphylaxis is a rapid-onset allergic reaction that can quickly turn fatal if not treated properly. If anaphylaxis strikes, breathing will be impaired, and the body will likely enter a state of shock. Anaphylaxis reactions cause a hospital visit every six minutes. Young adults and teenagers are at the greatest risk of fatal anaphylactic reactions. Asthma sufferers are at greater risk to suffer a fatal anaphylactic reaction. Reactions may not be immediate, as some anaphylactic reactions take as long as four hours to occur. It’s also possible to have an anaphylactic reaction without displaying other common symptoms, such as skin symptoms. Those that suffer from an anaphylactic reaction need to be administered epinephrine, otherwise known as adrenaline. This needs to be administered as soon as symptoms appear in order to reduce the chance of death. Nut allergies are the most common cause of food-related deaths. This drug is only available in prescription form, under common brand names such as Auvi-Q, EpiPen, or Adrenaclick. If you know you have a serious food allergy, it may be beneficial to have epinephrine nearby at all times, readily accessible if a crisis situation occurs. You should always make your family, friends, and coworkers aware of where the drug is stored so that they can access it if needed.

Managing a Nut Allergy

Unfortunately, there is currently no cure for food allergies. Those diagnosed with a food allergy will have to take care to avoid foods that could cause an allergic reaction. Doctors have been experimenting with a number of different food allergy therapies, although none have so far proven safe or effective for the general public. If you believe you have a food allergy, you should contact your trusted healthcare professional. Your doctor can administer a number of tests to determine what foods you are allergic to. Even though there is no cure, your doctor can give you tips and pointers for living with a food allergy. Identifying which nuts you are allergic to could end up saving your life, so it’s important that you are properly diagnosed. Nearly a quarter of the epinephrine injections that were administered at school involved children who were not aware that they had a food allergy when the reaction occurred. A scary situation like this can be avoided through proper diagnosis. Your doctor will most likely test for the allergen-specific immunoglobin E. This antibody attaches itself to allergens, prompting many common food allergy symptoms. Your doctor may also need you to complete an oral food challenge, in which you ingest possible allergens while under medical supervision. Parents should know that younger siblings of children with a food allergy are more likely to develop the allergy themselves. If one of your children has been diagnosed with a nut allergy, you should also have their siblings tested as well.

Some with tree nut allergies find that they are only allergic to one specific type of nut, but it’s generally recommended that all tree nuts are avoided as a safety precaution. It’s better to be safe than sorry, and most doctors will advise you that the risk is not worth it when it comes to a food allergy.