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Peanut Allergy

There can be a lot of anxiety and confusion about peanuts and peanut allergies. If you or someone you love is told they have a peanut allergy, that diagnosis can strike fear in your heart. This is in part because peanuts are most commonly associated with anaphylaxis, a life-threatening allergic reaction. It can also be difficult to deal with the loss of safety and spontaneity that comes with a peanut allergy diagnosis.

But understanding your peanut allergy may help calm your fears.

A peanut allergy is a common type of food allergy in both children and adults. A peanut allergy, like any allergy, is when your immune system identifies the proteins in peanuts as harmful. When you come into contact with these proteins, your immune system reacts and releases histamines, which then cause your allergic reaction.

Peanut allergic reactions are generally the most common culprit of fatal food–induced anaphylaxis, with the highest-risk groups being adolescents with asthma.1,2 In fact, studies show that people allergic to peanuts have a higher risk of anaphylaxis compared with people who are allergic to other foods, like milk or egg.3

And an allergy to peanuts usually lasts a lifetime—only about 20% of people with this allergy outgrow it.4 Some people, who eventually outgrow their peanut allergy, had previously had severe reactions to peanuts. So the severity of your reaction doesn’t mean you won’t outgrow the allergy.    

Peanut allergy symptoms

Peanuts are the number one cause of death related to food-induced anaphylaxis.5 Symptoms of anaphylaxis include impaired breathing, swelling in the throat, a sudden drop in blood pressure, pale skin or blue lips, dizziness and fainting. Anaphylaxis requires immediate medical attention. Although incredibly serious; anaphylaxis is thankfully very rare.

Less severe symptoms of a peanut allergy are similar to most allergy symptoms and include:

  • Itchy skin or hives
  • An itching or tingling sensation in the mouth or throat
  • Nausea
  • A runny or congested nose

Common peanut allergy triggers

If you have a confirmed peanut allergy diagnosis, you should avoid peanut in all forms including anything containing traces of peanut in it. Obvious sources include roasted, dry roasted, salted or plain peanuts and peanut butter. But peanuts can be a hidden ingredient in many foods—this is why it’s important to read the label or ask before buying or eating foods. Ingredients in packaged foods can change at any time—and without warning. 

Peanuts can be found in many foods and drinks, including:    

  • Baked goods like pastries and cookies
  • Candy including chocolates
  • Chili
  • Marzipan
  • Nouget
  • African, Asian and Mexican dishes
  • Sauces such as chili sauce, hot sauce, pesto, gravy, mole sauce, enchilada sauce and salad dressing
  • Glazes and marinades
  • Sweets like pudding and hot chocolate
  • Some vegetarian foods, especially meat substitutes
  • Foods that contain extruded, cold-pressed or expelled peanut oil

More than 10% of patients with peanut or tree nut allergy report experiencing reactions in restaurants or other food establishments.6 Because of their common use of peanuts, Asian restaurants, ice cream parlors and bakeries are considered high-risk for people with a peanut allergy. Even if you order a peanut-free item, there is the possibility of cross-contamination.

The importance of testing is to confirm if these drastic measures are required, since many patients react to peanut due to cross reactivity, with for example pollen, with the much less severe symptoms.





Peanuts are not tree nuts

Even though peanuts have the word “nuts” in their name, they are legumes, not nuts. Allergy to more than one nut is common. 1 out of 2 nut allergic teenagers react to more than one nut. 1 out of 3 peanut allergic patients also report tree nut allergy. And more than half of tree nut allergic patients report an allergy to peanuts.7-11

People with a peanut allergy also commonly avoid tree nuts because of the likelihood of cross-contact or cross-contamination—when one food comes into contact with another food and their proteins mix—during the manufacturing process.8-11

Learn more about tree nuts 

Am I allergic?

You may be so used to avoiding peanuts that you haven’t considered asking if you still need to. People who have high levels of peanut antibodies in their blood are most likely to have a peanut allergy for life.12-15 A simple blood test that measures these antibodies and can help your healthcare professional determine whether or not you or your child are likely to outgrow a peanut allergy. Knowing the true cause of your symptoms now may also help you avoid more serious issues in the future.15 For example, a food allergy reaction sends someone to the ER every 3 minutes.16

Knowing if you’re allergic and what you’re allergic to can help can help you get relief. Be sure to consult with your healthcare professional.

Learn more about testing

References

1.     Sampson HA, Mendelson LM, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992;327:380 –384. (III)

2.     Bock SA, Munoz-Furlong A, Sampson HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol. 2001; 107:191–193. (III)

3.     Scurlock AM, Burks AW. Peanut allergenicity. Ann Allergy Asthma Immunol 2004; 93(Suppl 3): 12–18.

4.     Fleischer D M, et al.  The natural history of tree nut allergy. The Journal of Allergy and Clinical Immunology, 2005;116(5), 1087-1093.

5.     Du Toit G, et al. Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy. The New England Journal of Medicine 2015, 1-11.

6.     Sicherer SH, Furlong TJ, Munoz-Furlong A, et al. A voluntary registry for peanut and tree nut allergy: characteristics of the first 5149 registrants. J Allergy Clin Immunol. 2001;108: 128 –132. (III)

7.     Sicherer SH, Burks AW, Sampson HA. Clinical features of acute allergic reactions to peanut and tree nuts in children. Pediatrics 1998;102(1):e6 


8.     Ewan PW. Clinical study of peanut and nut allergy in 62 consecutive patients: new features and associations. BMJ 1996;312(7038):1074-8

9.     Masthoff L, et al. Peanut allergy is common among hazelnut-sensitized subjects but is not primarily the result of IgE cross-reactivity. Allergy 2015; 70: 265–274.

10.  Maloney J, et al. The use of serum-specific IgE measurements for the diagnosis of peanut, tree nut, and seed allergy. J Allergy Clin Immunol. 2008;122:145-51.

11.  Ibid see also Sicherer SH, Munoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol 2003; 112(6):1203-7.

12.  Hourihane JO, et al. Peanut allergy in relation to heredity, maternal diet, and other atopic diseases: results of a questionnaire, skin prick testing, and challenges. BMJ 1996;313(7056):518-21. http://www.bmj.com/content/313/7056/518.  Accessed August 2017.

13.  Clark A. and Ewan P. Pediatr Allergy Immunol. 2005;16:507– 11.

14.  Eller E, et al. Cor a 14 is the superior serological marker for hazelnut allergy in children, independent of concomitant peanut allergy. Allergy 2016;71:556-62.

15.  Al-Ahmed N, et al. Peanut Allergy: An Overview.The Canadian Society of Allergy, Asthma and Clinical Immunology. 2008;4,139.

16.  Clark S, et al. Frequency of US emergency department visits for food-related acute allergic reactions. J Allergy Clin Immunol. 2011; 127(3):682-683.