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Nut Allergy

Nuts include all the tree nuts such as walnuts, almonds, cashews, chestnuts, pecans, hazelnuts, pistachios, Brazil nuts, pine nuts, beechnuts, macadamia nuts, gingko nuts, hickory nuts and lesser-known litchi nuts. Nut allergy is one of the most common food allergies found in both children and adults, predominantly occurring in children. Nut allergy is considered to be a problem that persists throughout the lifetime; only less than 10 per cent people outgrow it at a later stage. 90 per cent children with nut allergy were reportedly found to retain it for their lifetime. Tree nut allergies have significantly increased in the last decade among children. Most of the people allergic to one tree nut can also be allergic to other tree nuts due to cross-reactivity among the families of tree nuts. Each is a close relative of other; therefore, chances of cross-reactivity are more.

What is nut allergy?

Nut allergy is a hypersensitivity reaction to all the dietary tree nuts, occurs either after consuming them in raw or processed form or due to contact of products containing nuts with skin. Tree nut allergy should not be confused with peanut allergy because peanuts do not belong to the family of tree nuts. They grow underground; hence belong to the family of legumes.


Any type of nut allergy is a reaction of the immune system. Someone who is allergic to nuts, their immune system mistakenly identifies nut proteins as harmful pathogens and triggers the production of antibodies. First exposure of immune system to nut proteins does not show any allergic sign or symptom. During the next exposure, the antibodies recognize the proteins as allergens and immediately signal the immune system to release allergy causing chemicals called histamines to eliminate the allergens from the body.

Symptoms of nut allergy

The symptoms of tree nut allergies range from mild irritations to fatal anaphylaxis. The severity of symptoms varies from person to person. Let us discuss the mild symptoms first. They include:

  1. Skin related symptoms such as hives, welts, itchy rashes, swelling and redness
  2. Difficulty to breathe
  3. Stuffy or runny nose
  4. Sore throat
  5. Sneezing
  6. Itchy or watery eyes
  7. Stomach cramps
  8. Nausea or vomiting
  9. Diarrhea

Life-threatening anaphylaxis symptoms include the following:

  • Constriction of airway
  • Swelling in throat
  • Blockage in throat, hence difficulty to swallow
  • Facial swelling
  • Itchiness in skin
  • Extreme difficulty to breathe
  • Dizziness or fainting

Risk factors

Although anyone can be a victim of tree nut allergy yet there are some significant linkages that increase the likeliness to develop allergic signs and symptoms. Such factors include:

  1. Asthma:According to reports, tree nut allergy was found associated with asthma in children. Children having asthma were more prone to tree nut allergy and vice versa as compared to children without asthma.
  2. Peanut allergy:If your child is allergic to peanuts, they can also be allergic to tree nuts. It does not always happen but the possibility cannot be ruled out.
  3. Past allergy:Most of the allergies developing in childhood get mitigated by adulthood; tree nut allergy is an exception though. If your child falls in the category of 10 per cent population who outgrow it at a later point of time; the risk of the allergy returning in active form still exists.
  4. Family history:Younger siblings of children having tree nut allergy are at greater risk of being allergic to tree nuts.


If the signs and symptoms are suspicious and direct towards tree nut allergy, it is always advisable to get it diagnosed by an allergist at the earliest to avoid harmful consequences. An allergist conducts a series of formal allergy detecting tests unless he is confirmed about the existence of allergy. Tree nut allergy diagnosis includes skin prick tests and blood tests to determine the presence of IgE antibodies to the specific allergens.

Other associated allergies

Having one tree nut allergy increases the likeliness of having other tree nut allergies as well. Moreover, peanut allergy is also associated with tree nut allergies. It happens either spontaneously or due to cross-contact.

Treatment of nut allergy

The first and foremost way to treat tree nut allergy is to survive on a diet devoid of tree nuts. This should be followed for the rest of the life once tree nut allergy is detected.

Mild skin reactions such as rashes and hives can be treated with antihistamines such as diphenhydramine or loratidin. Skin irritations can also be soothed momentarily with the help of cold, wet compress. Antihistamines also help relieving runny nose and watery eyes. To get rid of runny nose, antihistamines are combined with a type of decongestant like pseudoephedrine.

Severe anaphylaxis symptoms are treated with intravenous dosages of adrenaline and trip to emergency room. People with past-history of anaphylactic shock should always carry auto-injectors of adrenaline such as EpiPen. It immediately helps to bring the emergency conditions under control by causing the airway to reopen and thus allowing the anaphylactic patient to breathe again at a normal rate.

Diet, nutrition and caution

A person found allergic to any one tree nut is usually advised to avoid the other families of tree nuts as well as a precautionary measure. To be on the safer side, peanuts should also be avoided. All the tree nuts including a member of the legumes, peanut come in close contact while processing; hence, peanut is not free from risk. A person allergic to tree nuts should be highly cautious while having any of the following because these might contain the nut they are allergic to:

  1. Peanut content in beer nuts, peanut oil, peanut butter, baked goods, sweets, chocolate candies, nougat, salad dressings, mole sauce, glazes, vegetarian meat substitutes and marinades. Peanut is a common ingredient in Mexican, Asian and African recipes.
  2. Tree nuts are found in nut oils, pesto, cereals, nut extract, crackers, energy bars, chocolate candies, cookies, flavored coffees, marinades, frozen desserts and several cold cuts.
  3. Alcoholic drinks might also contain nut flavorings.

Always check for the food labels while purchasing any food product. Therefore, it is imperative that do not go nuts over nut allergy. Manage it with a slight change in your lifestyle and good level of caution.

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