According to the Nemours Foundation, peanuts and tree nuts are the most common form of food allergies that have fatal reactions in people suffering from them. Peanuts come in as slightly more common an allergy than tree nut allergies. Many food allergies get worse and worse each time the body in question is exposed. For this reason understanding the symptoms that indicate a food reaction to peanuts or almonds is paramount to catching an allergy early and protecting yourself from future reactions which could, very realistically, risk your life.
Before getting into the symptoms of nut allergies, it must be understood that it does not follow that someone with a peanut allergy is going to have an allergic reaction to peanuts. Peanuts are not nuts; they are legumes or as most people refer to them, beans. They are not related to nuts and therefore the allergies have little in common. Therefore if you find yourself reacting to almonds, for example, it does not mean that you will also be allergic to peanuts.
As a general rule, allergies are defined as an immune system response to the offending material entering the body. This is to say that it involves the action of IgE (immunoglobulin E) and various anaphylatoxins which act to cause degranulation (the release of histamine from mast cells, as well as other mediator substances). For this reason, we do not say we are allergic to arsenic, though one could certainly argue that it hardly matters, the end result is the same. The term allergy, though, specifically refers to the inappropriate response by the immune system.
Unfortunately, science has not discovered the reason or cause of peanut allergies. There are many speculations about why about 1% of the population is affected by this allergy but at present, they are theories only, though some of them are quite plausible and emerging studies seem to be hinting at answers. The bottom line, though, is that about 1% of the population is allergic to peanuts and of those people, some are quite severely allergic and must be prepared to deal with an anaphylactic reaction should accidental exposure occur.
Symptoms of Peanut Allergy
Symptoms of peanut allergy range from mild to exceedingly severe. The most severe of which include vasodilation of the arterioles and bronchioles in the lungs (bronchospasm). This restricts the airways severely enough that it can cause death from suffocation or heart attack. Most people do not have reactions this strong. However, repeated exposure to peanuts may develop into anaphylactic reactions of this caliber. Peanut allergy symptoms include:
- Angioedema (lips, throat, skin and face swelling)
- Urticarial (hives)
- Atopic eczema
- Anaphylactic shock (constriction of airways, loss of consciousness, rapid pulse, severe drop in blood pressure)
- Intense abdominal pain
- Itching or tightening around the mouth, lips and throat
- Tightening of the chest
- Runny or stuffy nose
There is no known cure for allergic reactions to peanuts but there are effective treatments for peanut allergy symptoms. There is only one way to prevent reactions, and that is to completely abstain from contact with peanuts. Some people are so severely allergic to peanuts that even trace amounts from cross contamination will cause reactions so extreme vigilance is required to protect them. In general, though, the rule is simple: don’t eat peanuts.
In the case of anaphylactic reaction, the immediate treatment is injection with an epinephrine (adrenaline) to reverse the anaphylactic reaction. Once that has happened, immediate hospitalization for monitoring and further treatment is required. A second reaction can occur even after 4-6 hours which means that treatment must be readily and immediately available at all times until the danger period has passed. Over the counter antihistamine medications can be used in addition to (but never in replace of!) epinephrine in the case of a reaction.
Almond allergies are unique in that while they are a tree nut, and therefore in the top 2 contending slots for “most common food allergies” all by themselves they rarely give reactions to anybody. Best approximations on the frequency with which people develop almond allergies are somewhere between .2% and .5% in both children and adults. Even people who suffer from tree nut allergies are rarely allergic to almonds. However, just like with any other nut allergy, when an almond allergy surfaces for a person, it’s a big deal.
Almond Allergy Symptoms
Most almond allergy symptoms are mild and include itching of the mouth and throat immediately after eating an almond. However, anaphylactic reaction is also possible and can even be fatal. As mentioned above these symptoms include: dizziness, constricted airways, swelling of the face, throat and bronchial passageways, loss of consciousness and sudden drop in blood pressure.
Unlike peanut allergies, almond allergies provide the potential for something called “cross reactivity”. Cross reactivity is when related foods can cause the same reactions in people allergic to almonds. There are several cross relations to be aware of when dealing with an almond allergy.
- Birch Pollen Allergy- almond allergy for people who are allergic to birch pollen is the consequence of similarity between proteins in vegetable foods and pollen allergens. The proteins patients with this type of allergy react to are quickly broken down in the stomach and a result, reactions are generally mild. Patients with Birch Pollen cross reactivity generally can handle eating almonds that have been heat processed because the proteins they react to are destroyed by heat.
- Primary Tree Nut Allergy- the proteins causing the allergy in this instance resist heat and are not bothered by digestion meaning that people suffering from this type of allergy are likely to have much more extreme reaction. Because of the cross reactivity and the very close similarities biologically from one species of nut to the other when it comes to these specific proteins, patients need not to have been previously exposed to a particular nut to have a severe anaphylactic reaction. This is an important fact to be aware of. Generally it is assumed that first exposure won’t be as severe as a subsequent one but in the case of Primary Tree Nut allergy, it may not work out that way. If you have had a severe allergic reaction to a tree nut in the past, be aware that you are at serious risk for an even worse reaction should a different nut pass your lips. It is best to avoid almonds until a doctor can help you determine if cross reactivity is going to be a problem for you. The same holds true with peanuts, though clinical cross-reactivity with peanuts in this instance is exceedingly rare.
- Peach and other Rosacea family fruits- The almond is a tree nut but it’s part of the family of plants called Rosaceae. This family also includes peaches, apples, cherries, nectarines, plums, apricots and strawberries. Patients with this allergy react primarily to LTP (a heat stable protein) present primarily in Rosaceae in found in many other plant-derived foods. Unfortunately, LTP is known to be a widely cross-reacting allergen. About 25% of people with LTP allergies report reactions to almonds. Most people with LTP also react very strongly to peaches. Because LTP is also heat-stable and resistant to digestion, the propensity for severe reactions is quite high.
- Latex Allergies- infrequently patients who are allergic to natural rubber latex also report almond allergies. It’s not common but has been noted often enough it’s wise to be aware of this regardless.
Treatment for almond allergies is the same as peanut allergies. In the instance of anaphylactic reactions, a shot of epinephrine and a trip to the hospital will be required. In the case of milder reactions, immediate cessation of eating the offending food must occur and if needed to alleviate symptoms, the consumption of anti-histamine OTC medication is recommended.
Some Words about Avoidance
Both peanuts and almonds are a common ingredient in prepared foods so avoiding them isn’t as simple as never buying a bag of nuts at the grocery store. To protect yourself or a loved one (such as your child) be sure to carefully read the ingredients of every prepared food you buy. Never assume something is safe because you can’t imagine why it would have almond or peanut in it. Remember that both nuts are commonly used as extracts, oils and in the case of almonds, as milk. This includes ingredients that are cross reactive. If you think you or your child is cross reactive with something else, see a doctor and find out for sure. When you are in doubt about something containing an allergen, better to forgo it and find something else. Remember, protein particles are invisible to the naked eye. If something says on its packaged “processed in a factory that also processes” something you are allergic to, unless it guarantees that there has not been cross contamination, don’t buy it, find something else. Any time you think you may be experiencing peanut or almond allergy symptoms, cease eating the offending food immediately and seek treatment.