Tree Nut Allergies: An Overview

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Tree nut allergies are one of the most common types of food allergies occurring in both children and adults. Tree nut allergies affect about 1 in every 100 people and like peanut allergies, the symptoms are often life-long, with only about 9 percent of children able to outgrow their tree nut allergy. The reaction to tree nut allergies can vary quite a bit. In milder cases, it may cause symptoms such as a dry, scratchy throat or tightness in the chest. But as with peanut allergies, the reaction to tree nut allergies can also be quite severe, often causing anaphylaxis, a life-threatening reaction to the allergenic proteins.

Similar Allergens

Tree nut allergies should not be confused with peanut allergies, which is a similar food allergy. Peanuts, however, are classified as a legume, related to beans and peas, and its allergenic proteins are distinct. While tree nut allergies can be just as severe and occur just as frequently as peanut allergies, peanut allergies are generally more widely recognized, so parents with children suffering from tree nut allergies may feel a lack of support in their child’s classroom or other social setting. As information and sympathy spreads, policies and attitudes are slowly changing, but in the meantime it’s important to remain vigilant.

Pine nut allergies, which are unrelated to tree nuts, are also a similar allergy, though people may be allergic to both. The reactions to tree nut, peanut, and pine nut allergies can be very similar, and potentially very severe.

Coconuts are classified by the Federal Drug Administration (FDA) as tree nuts, but coconut is botanically recognized as a fruit, and most people with a tree nut allergy can safely eat coconut (although an allergy to coconut is also possible.) Always check with your child’s healthcare provider if you have any concerns about coconut or another food.

Foods to Avoid

Like all food allergies, there is no cure for tree nut allergies, and there is no medical treatment, though an epinephrine shot may be administered to counter an extreme reaction (anaphylaxis). It is recommended that anyone suffering from a tree nut allergy or any other food allergy have and EpiPen or similar epinephrine injector for emergency use. As with any allergy or intolerance, the best medicine is strict and careful avoidance. People with tree nut allergies are commonly allergic to more than just one type of nut, and so avoidance of all varieties of tree nuts is usually advised.

Common types of tree nuts include:

• Walnuts

• Pecans

• Cashews

• Macadamia nuts

• Pistachios

• Almonds

• Hazelnuts

• Brazil nuts

• Chestnuts

Tree nuts can be found in some unexpected places, so it’s helpful to always read food labels and be aware of the risk of cross contamination. However, don’t assume that just because a food label does not specify tree nuts on the ingredient list that the food item is safe. Remember, the “May Contain” portion found on some ingredient lists is voluntary (not required by law). Most major food production companies have a phone number written on the packaging for more information. It’s important to be aware of the potential danger in common foods and other items such as:

• Cereals

• Flavored coffee

• Granola

• Crackers

• Chocolates

• Ice cream

• Pesto sauce

• Lotions and soaps (tree nut oils)

If you notice symptoms arising from exposure to tree nuts or suspect a tree nut allergy in your child, it’s important to get him or her evaluated by a healthcare professional right away. Living with a food allergy can be scary and stressful for both child and parent, and being armed with the proper information and diagnosis are the surest ways to know the right steps toward healthy living and peace of mind.


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