Nut Allergies

Nut Allergies | Dr. Ali Ghahary

Along with dairy, eggs, soy and shellfish, nut allergies also rank high among the most common of food allergies that individuals are diagnosed with worldwide. Just like other food and non-food allergies, a nut allergy occurs when your immune system identifies the nut proteins as being harmful and releases a symptom-causing chemical (known as histamine) into the blood stream, ultimately triggering an allergic response. This reaction can happen as a result of direct contact with nuts (such as eating or touching them), inhalation (such as being around someone eating nuts, inhaling dust that has been contaminated with nuts, or from other sources like peanut oil or peanut flour), as well as cross-contamination (when certain foods you eat or surfaces you’re near are exposed to nuts.)

While anyone can develop a nut allergy, there are certain contributing risk factors. Your age, for example. Food allergies tend to be more common in children as their digestive system has not fully developed. As you age and your digestive system matures, you are less likely to react to foods. That being said, allergies can still develop at any age. The risk also increases if you’ve had a previous allergy to nuts, or if you have other food allergies or hay fever (which is common during the springtime as a result of pollen.) Allergies can also be hereditary, meaning that if there is a history of allergies in your family, then you’re also at risk of being allergic to the same or other foods. Studies have also shown that individuals who suffer from eczema are also more likely to develop allergies.

In addition to peanuts, some of the other nuts that individuals are commonly allergic to include hazelnuts, almonds, brazil nuts, cashews, macadamia nuts, pecans, pine nuts, pistachios, and walnuts. It’s very possible to be allergic to one nut and not the others; however, those with a tree nut allergy (hazelnuts) are often recommended to stay away from all types of tree nuts. It’s also possible to outgrow an allergy.

Not everyone will react to a nut allergy the same way – though when histamine gets released into the blood and triggers an allergic response, you can develop any of the following symptoms:

• Rash
• Itchy skin
• Hives
• Runny nose
• Stomach pain
• Nausea and vomiting

It’s also possible to go into anaphylaxis, which is considered a severe and life-threatening allergic response. Symptoms of anaphylaxis can include difficulty breathing, swelling of the lips or tongue, swelling or tightness of the throat, difficulty speaking, wheezing, persisting cough, and even dizziness and paleness. If you happen to develop these symptoms or see someone who you think may be going into anaphylaxis, it’s important to seek immediate medical attention by calling 911. Do not drive or walk yourself to a hospital or doctor’s office.

If you suspect you have a nut (or other) allergy, you will likely need to be referred to an allergist for a firm diagnosis. The most common test that an allergist will perform is known as a skin prick test. If you are allergic to a certain food, the pricked area will react by forming hives, a rash, or redness. You can also go for blood testing to confirm if you have any suspected allergies. In some cases, allergists will also have their patients try an elimination diet by avoiding the suspected allergens and then, under strict medical supervision, reintroduce them into their diet.

As for how nut allergies are treated, it depends on the severity of the allergic response. If you just develop a rash or hives, then allergies are commonly treated with over-the-counter medication such as Reactine or Benadryl. However, for individuals that go into anaphylaxis, they will need to be prescribed Epinephrine and keep it on hand at all times.