Nut allergy symptoms
Nut allergy affects around 1.4% of people in Europe. That’s an awful lot of people who may have to deal with nut allergy symptoms. So what are they?
This article explains how to spot food allergies caused by peanuts and tree nuts. Also why it’s important to get medical advice as soon as you do spot them. (Both can cause severe reactions as well as stomach cramps). Your doctor can give you practical tips and explain the treatment options. Don’t let nut allergy symptoms hold you back.
Checklist of common nut allergy symptoms
Food allergy symptoms can vary from one person to another. But these are some of the telltale signs that you may be allergic to tree nuts or peanuts:
- Skin reactions – an itchy red rash (hives), often raised but not always
- Tingling or itching in the mouth
- Swelling of the face, mouth, throat, or other parts of the body
- Difficulty swallowing
- Wheezing or shortness of breath
- Feeling dizzy and lightheaded
- Feeling sick (nausea) or vomiting
- Abdominal pain or diarrhoea
- Hay fever-like symptoms such as sneezing or itchy eyes
Eating a tree nut or peanut by mistake may give you mild nut allergy symptoms. That doesn’t mean you couldn’t have a more serious allergic reaction another time.
How to recognise severe nut allergy symptoms
The medical name for severe reactions is anaphylaxis and it can affect your whole body. These are the symptoms to watch out for:
- Feeling lightheaded or faint
- Difficulties with breathing, such as fast or shallow breaths
- Wheezing
- A fast heartbeat
- Clammy skin
- Confusion and anxiety
- Collapsing or losing consciousness
- Tingling in the hands, feet, lips or scalp
The risk of it happening may be higher if you’re stressed or unwell or if you’re taking certain medications. Your GP will advise you about that. It’s rare but exercising just before or after eating nuts can also cause a severe reaction if you’re allergic to them.
Having anaphylaxis once puts you at greater risk of it happening again.
How long does it take for nut allergy symptoms to start after eating?
Even tiny traces of allergen can cause nut allergy symptoms. Usually, you’ll know something’s wrong in minutes or even seconds. Sometimes it can take up to two hours after you’ve come into contact with nut protein. With anaphylaxis there can be a second wave of symptoms up to eight hours later.
Call an ambulance if you think you might be having a severe reaction. The same goes, of course, if you recognise the symptoms in someone else. Anaphylaxis can be life-threatening.
Treatment for nut allergy symptoms
Mild symptoms may respond to antihistamine. A severe reaction is a medical emergency that needs immediate treatment. That’s why doctors often prescribe adrenaline auto-injectors.
The advice is to carry two auto-injectors at all times in case one doesn’t work. The people close to you may need to help, particularly if the reaction is making you confused. Show them what to do.
Why do nut allergy symptoms happen?
Your immune system is very clever. It fights infections and stays on guard in case you encounter harmful substances. Sometimes, though, it takes fright at ordinary foods like crunchy peanut butter or frozen desserts with nutty sprinkles on top.
The trigger for the allergic reaction is one or more of the proteins in the nuts. Your immune system spots the allergen the first time you meet it and produces what are called Immunoglobulin E (IgE) antibodies. Your body is now sensitised to the tree nut or peanut. Some people never get past this stage. Others go on to have nut allergy symptoms whenever they meet that trigger again. That means they've developed an allergy to peanuts or tree nuts.
Can you suddenly get nut allergy symptoms?
The immune system adapts to new threats, real or otherwise, throughout your life. So it is possible for adults to develop tree nut allergies or peanut allergies, seemingly out of nowhere. But it’s more common for reactions to start in childhood and linger on. An allergy to peanuts may show itself in babies as young as six months old. For tree nuts, it tends to be after the age of one. And kids often don’t grow out of nut allergies.
Children of allergic parents are at greater risk of nut allergy symptoms. There also seems to be a link with egg allergy and with severe eczema. Both make nut allergies more likely.
Peanut allergy and tree nut allergy triggers
We’ve been talking about nut allergy symptoms as a kind of shorthand. But peanut allergy and tree nut allergy are different conditions. A peanut is a legume, first cousin to peas and beans. It may be your only trigger. But about a third of people who are allergic to peanuts also react to tree nuts. These are some common types that can cause allergic reactions:
- Almonds
- Brazil nuts
- Cashews
- Hazelnuts
- Macadamia nuts
- Pecans
- Pistachios
- Walnuts
Different tree nuts have similar allergenic proteins. You could get nut allergy symptoms from pecans if you’re allergic to walnuts. Pistachios and cashews can also cross-react.
Looking beyond the nut category, pink peppercorns also have similar proteins to cashews. People with nut allergies may react to sesame. Other legumes like soy and lupin can cause allergic symptoms if you have peanut allergy.
Getting a diagnosis for your nut allergy symptoms
Make sure you can describe your allergic reaction in detail; when and where it happened, what you were eating, what it felt like and how long it lasted.
Your GP will also want to know if anyone in your family has had nut allergy symptoms. And you may need a skin prick test or allergy blood test. An oral food challenge is less common but can be useful if other test results are unclear. You’ll eat small amounts of your trigger at the clinic while the allergist or their nurse monitors you for nut allergy symptoms.
How to manage nut allergy symptoms
Avoidance, as it’s called, is the first step in managing any allergy. It’s vital if your trigger is a tree nut or peanut because of the risk of a severe reaction. Nuts have many uses:
- Food: Nuts may be in plain sight, salted and roasted for snacking, or in nut butter. They’re also a popular ingredient in packaged food and when you’re eating out or at friends’ homes. Read food labels and menus carefully. And always ask if you’re in any doubt. Some alcoholic drinks contain nuts too.
- Medicines: If you have peanut allergy, speak to your GP before taking any medications. Some contain peanut oil, as well as sesame or soya which can cross-react with peanuts. The ingredients should be in the instruction leaflet and possibly on the packaging.
- Cosmetics and toiletries: Refining almond, peanut and macadamia oil for personal care products changes the proteins. The same goes for shea butter. The risk of nut allergy symptoms is higher with products using cold-pressed oils. Unlike food labels, those on cosmetics and toiletries often use the Latin names for plant-based ingredients. You’ll find a glossary of common allergens in our nut allergy article.
- Pet food: Choose nut-free petfood. That reduces the risk of exposure, both direct and second-hand if the dog licks you after eating.
Nut allergy symptoms from cross-contamination
Tiny traces of nuts can spread easily and widely. Factories may process several different types so cross-contamination is a risk. It may be wise not to eat any tree nuts or peanuts even if you’re allergic to only one nut protein. It’ll help avoid accidental exposure.
Cross-contamination can happen in restaurant kitchens, cafés and ice cream parlours too. So tell people about your allergies and ask if they use nuts. And be careful how you prepare and store food in your own kitchen. Peanut particles can linger in human saliva too. Don’t share cutlery. And ask anyone you plan to kiss not to eat nuts.
Is there a cure for nut allergy symptoms
No there isn't. But you may be thinking of immunotherapy, also known as desensitisation. Food allergies are harder to treat this way but oral immunotherapy is now available for peanuts. It aims to change the way your body reacts so that you have some tolerance. Accidental exposure to peanuts may be less likely to cause severe allergy symptoms.
