What is peanut allergy?
Peanut allergy is one of the more common food allergies in children. The numbers affected have been rising over recent decades. About 20% of kids do grow out of it. But many people need to manage peanut allergy throughout their lives.
Awareness and understanding of peanut allergy has increased too. But unless you’ve had a diagnosis, you may not be confident of what the symptoms are or what to do when you spot them. That’s what our article is about. We also offer useful tips to help you avoid peanuts, whether it’s you who has this food allergy or someone in your family, a friend, colleague or even a customer. You can read about some of the treatment options too.
What causes peanut allergy?
Allergy happens when your body mistakenly identifies a harmless substance, or allergen, as a threat. In this case it’s certain peanut proteins. The first contact usually puts your immune system on alert and it produces Immunoglobulin E (IgE) antibodies. Now you’re sensitised.
Not everyone will go on to develop a food allergy. If you do, the IgE antibodies will recognise the peanut protein next time and trigger other cells to try to get rid of the threat from your body. This is an allergic reaction and it’s what causes your peanut allergy symptoms.
Peanut allergy: What to avoid
About a third of people with peanut allergy also have a tree nut allergy. Even if you don’t, it may be wise to avoid all nuts, not just peanut products. A microscopic trace of peanut can trigger a reaction. And there’s a risk of cross-contact between tree nuts and peanuts during processing.
Peanuts are legumes rather than nuts. They’re related to green beans and garden peas, soy, lentils, chickpeas and other dried pulses. Lupin is a legume that cross-reacts with peanut at a high rate. You may you know the garden plant with its long pointed flowers? Well, Mediterranean and some Asian cuisines use the beans and the seeds, whole and as a gluten-free flour. Lupin is a priority allergen covered by labelling regulations. Read the ingredients carefully.
It’s not common but around 5% of children with peanut allergies may get symptoms when they eat legumes. Ask your GP for advice on what not to eat.
Symptoms of peanut allergy
You may know that something’s wrong seconds after eating peanuts or minutes, although it can take up to two hours for symptoms to start. Here are some of the signs of a mild to moderate allergic reaction to peanuts:
A raised, itchy red rash (hives) – sometimes the skin can turn red and itchy but not raised
- 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
You may feel uncomfortable or quite unwell. Everyone experiences peanut allergy differently. Your symptoms may vary each time too.
Peanut allergy: Severe reactions
Peanut allergy can also cause a life-threatening allergic reaction called anaphylaxis. Seek medical attention straight away if you recognise any of these symptoms:
- Feeling lightheaded or faint
- Difficulties with breathing, such as fast or shallow breathing
- A fast heartbeat
- Clammy skin
- Confusion and anxiety
- Collapsing or losing consciousness
Your GP may prescribe an adrenaline auto-injector for you to use immediately if you have a severe allergic reaction. Your family and friends might have to help you with the auto-injector so make sure they’re prepared.
Meanwhile an allergy bracelet or necklace tells people who don’t know you that you might need emergency treatment. Always go to hospital if you have a severe reaction. The symptoms of anaphylaxis can flare up again up to eight hours later.
Can you suddenly develop a peanut allergy?
Peanut allergies tend to start in childhood. It’s much less common for adults to start reacting to peanuts but it can happen. Your immune system is constantly learning and adapting to new threats throughout your life. And peanut is one of the most common adult food allergies.
If you start noticing symptoms of food allergy, no matter what you’ve eaten, talk to your GP. Getting a diagnosis is the first step to managing the risk of future reactions. Be ready to describe your symptoms; keeping a food diary can help. Is there allergy in your family? If so, that’s important too. Your GP may also suggest allergy testing.
Testing for peanut allergy
Diagnosing food allergies can take more than one allergy test. A skin prick test is often the starting point. If it’s inconclusive you may need an allergy blood test too. Your GP or allergist will interpret the results for you.
Some proteins are more likely to trigger a severe reaction. Another type of blood test called a component test can look for these and help assess your risk level. The test can also distinguish between peanut allergy and oral allergy syndrome, which is a cross-reaction. You may have a tingly mouth when you eat peanut and discover you could be allergic to birch pollen.
If the peanut allergy diagnosis still isn’t clear, you may be invited to the allergy clinic for an oral food challenge. This involves eating tiny amounts of an allergen, perhaps peanut butter, under close medical supervision. An oral food challenge can help determine whether a child has outgrown their peanut allergy.
How to manage peanut allergies
There’s no cure for allergy yet but desensitizing your immune system could help prevent a severe reaction. Allergy immunotherapy is a long-term treatment involving repeated tiny doses of peanut allergen over several years. It isn’t suitable for everyone. Your GP or allergist can tell you more. Otherwise your treatment plan is likely to be a mixture of avoiding peanut and treating your symptoms in case of accidental exposure.
Peanut allergy can be frightening. And that’s something to manage too as stress hormones can set off physiological changes in the body. For some people with this food allergy even the smell of peanuts can cause a drop in blood pressure as part of this conditioned response.
6 peanut allergy tips
The first three of our tips involve reading labels. But if you’re in any doubt call the manufacturer to check if there could be peanut in their product.
Asking questions can help you judge the level of risk in other situations too, for instance before you eat out or travel. It may feel awkward talking about health matters with strangers. But it’s important to get used to telling people about your peanut allergies.
- Read food labels: Food manufacturers have to list peanut on their packaged foods as one of the major allergens. So look for it in the ingredients.
Read cosmetics, toiletries and medicine labels: Food allergen labelling rules do not apply here. Manufacturers usually describe what’s in their products. But the convention is to use Latin names for plant-based ingredients. Arachis or Arachis hypogaea means peanut.
Ask your GP for advice on what to avoid. Heat changes proteins so highly refined peanut oil is less likely to cause an allergic reaction. But artisan bodycare products may use cold-pressed peanut oil.
- Read petfood labels: Peanut is a familiar ingredient in petfood and treats. Allergens can linger in the animal's saliva and transfer to whatever or whoever they lick.
- Expect the unexpected: We’ve mentioned cross-contamination between peanuts and tree nuts. Also take care anywhere that serves peanut containing foods where the traces may transfer to what you’re eating. For instance, that could be at the ice-cream parlour, salad bar or street food stall.
- Clean up: Cross-contact can happen at home too. It may not be possible to banish peanut entirely. In which case, be careful traces don’t linger on kitchen surfaces, crockery or utensils. Disposable wipes are better than dishcloths and sponges (they’re useful if you’re travelling too). And always wash your hands.
- Quiz your date: Studies have shown that tiny particles of peanuts can linger for several hours in our saliva. So take care when kissing (or sharing cups and cutlery).
Peanut allergy treatment
Your body releases histamine as part of an allergic reaction. Antihistamine can help block that. It’s a common treatment for milder food allergy symptoms including those caused by peanuts. Ask your pharmacist for advice about the different types available over-the-counter.
With peanut allergies, it’s very important to have treatment for severe allergic reactions close by too. That’s the adrenaline auto-injectors. The advice is to carry two of them with you at all times.
Peanut allergy at school
By law, children with any medical condition including food allergy must be able to eat school meals safely. Any food, whether it’s packaged or served on the plate, has to be clearly labelled as containing peanuts.
Share your child’s peanut allergy management plan and ask how the school handles allergy medicine. Are teachers trained to use an auto-injector in the event of a severe reaction? Make sure your child knows what peanut anaphylaxis might feel like and how to get help quickly.
When they’re ready, your child will start looking after their own allergy medicine. They may be carrying adrenaline auto-injectors once they get to secondary school. But it has to be right for your child. Why not ask your GP’s advice.
Is peanut allergy preventable?
Allergy experts think introducing babies to peanut (and other food allergens) from six months old might make the immune system more accepting. That could help prevent peanut allergy. Why not ask your GP about this? It’s especially important to get advice if your baby has eczema (atopic dermatitis) or if food allergy runs in the family. Both make it more likely a child could also develop food allergies. And reactions can start as young as six months old.
We’re here to help
We hope you found this article helpful. If you know anyone else affected by peanut allergy, please do share it with them. You can also find klarify on Facebook and Instagram. Or send us an email with any questions we may not have answered.