Peanut Allergy: A Full Guide To Symptoms, Treatment, Testing, And More

Peanut Allergies: A Comprehensive Guide To Symptoms, Testing, Treatment, And More

March 6, 2020 Updated June 15, 2021

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Peanut allergy — just the phrase sends cold shivers down the spine of parents and caretakers who have to help an allergic child navigate a world where peanuts, or traces of it, are everywhere. It’s also a reality many adults living with the allergy deal with.

By now we all know the dangers of rashes and anaphylactic shock related to the popular legume (that’s right, peanuts are a legume, like peas!), which is why giving our little ones their first tastes of peanuts can be so scary. And as more adults or children are diagnosed with peanut or other common food allergies, the beloved peanut spread that was basically 90 percent of our diet as kids is now the bane of every preschool — and for good reason. Taking the allergy seriously — whether you or your child has it or not — is the only way to avoid a potentially deadly reaction.

The truth is that a peanut allergy can be scary and overwhelming to deal with, luckily we have some helpful advice on how to navigate the terrifying and anxiety-inducing world of peanut allergies from Dr. Jennifer Collins, an allergist with eight years of experience, and Dr. Tricia Lee, a pediatric allergist at Hudson Tribeca.

They help break down the dangers, clear up some common misconceptions, and offer some helpful guidance to anyone living with the allergy.

What is a peanut allergy?

A peanut allergy occurs when your body “produces a protein that’s directed towards the peanut protein, that triggers your body to have an allergic inflammation that leads to an allergic reaction,” Collins explains.

What are peanut allergy symptoms?

Symptoms can vary greatly from patient to patient, according to Collins, but could include:

  • Rash
  • Hives
  • Nasal congestion
  • Runny nose
  • Abdominal pains
  • Nausea
  • Vomiting
  • Difficulty breathing
  • Swelling in lips or tongue
  • Throat swelling 
  • Anaphylaxis

Anaphylaxis is the most serious allergic reaction to peanuts. It’s a severe allergic reaction that usually happens right after exposure to the allergen. If your child experiences anaphylaxis, you have to administer an epinephrine shot and call 9-1-1 to get them to the ER right away.

What is a peanut allergy test?

According to Collins, there are three ways to test for peanut allergies, specifically for kids. One of them is, well, to let your kids try to ingest some peanuts. Most of us hold this test in the lab known as our kitchen or dining room (which honestly, looks a little like a mad scientist lab when you have little babies lobbing food all over the place.) According to Cleveland Clinic, most kids should be exposed to peanuts and other allergens before age 1. Once you’re a few weeks into solids, you can mix some peanut butter into your baby’s purees. You should only do this after you’ve consulted with your child’s pediatrician about the safest way to introduce peanuts to your baby.

There are two other ways to test for a peanut allergy in a doctor’s office. One of them is through what doctors call a skin prick test. “A small amount of the protein is put on your arm or back and you’re pricked,” Collins explains.

Then, of course, there’s old-fashioned bloodwork. What kid doesn’t love to have their blood drawn?! If you’re going for this, may we suggest a post-doctor visit treat — for parent and child. You can test for allergies through a blood test called the RAST test or immunofluorescence test. The test checks the blood for antibodies that will indicate whether the person has an allergy.

Lee notes it’s important to remember that when it comes to allergy testing, you are only going to see results if the allergy is life-threatening.

How do you treat a peanut allergy?

The best practice right now is strictly through avoidance of the peanut. While there are peanut allergy treatments that are being looked at currently for treatment or prevention of peanut allergies, nothing has been approved by the FDA as of yet.

Lee agrees that right now, your only FDA approved course of action is avoidance, but she’s optimistic about future treatments for peanut allergies: “For peanut, we will hopefully have two FDA approved products of certainly increasing your tolerance threshold and maybe even desensitizing you — one is going to be a peanut patch and the other an oral immunotherapy treatment. So we obviously have a lot of hope in those products as well as some upcoming research.”

Are there different peanut allergy symptoms for adults and kids?

According to Collins, symptoms don’t differ based on age. Though, parents’ reactions to allergic reactions may vary depending on the age of the allergic kid and their experience spotting and reacting to symptoms.

Can you outgrow a peanut allergy?

While some food allergies, like milk, can be outgrown, typically, with a peanut allergy, most patients don’t outgrow it. That said, it could change in severity or become milder, per Collins.

However, according to Lee, “around 20 percent of people outgrow a peanut allergy,” which is statistically just way lower than many allergies, like egg or dairy.  This can be confusing, so it’s always best to confer with an allergist, as they have a better understanding of you or your child’s medical history.

Are allergic reactions only a result of ingestion?

When it comes to what’s going to actually cause the allergy, as we’ve mentioned above, it’s the protein in the peanut. So the smell of peanut butter, while extremely powerful, will not cause an allergic reaction. Still, Lee says: “with peanut allergy, my biggest concern for food-allergic patients is ingestion.”

According to Lee, having a severe reaction is usually a result of the ingestion of the food. But there are situations that may cause the peanut protein that causes allergic reactions to get into the air, like when you roast or boil peanuts.

You may have also noticed that most airlines are starting to ban peanut packets, there’s a reason for that: When you open a peanut packet if you take a quick inhalation of that peanut dust in the air,  you can have an allergic reaction to the protein in that dust — though as Lee says, that’s a very rare situation.

Food to Avoid if You Have a Peanut Allergy

Giving one answer to this question is misleading, according to Collins. “Some people are just allergic to peanuts and don’t have to worry about other things but other people have other allergies along with the peanut allergy,” Collins explains. “That’s where really talking to an allergist can help guide you on how to introduce things,” Collins explains, “What to look for and the foods that may or may not cross-react with a peanut — what’s going on with the actual individual. It’s much more patient-directed.”

However, we’ve included a primer list on foods to avoid below. Note: some include non-peanut foods and products that are often packaged in the same facility as peanut packaged goods.

  • Arachis oil (another name for peanut oil)
  • Artificial nuts
  • Beer nuts
  • Cold-pressed, expelled, or extruded peanut oil
  • Ground nuts
  • Lupin (or lupine) a common flour substitute in gluten-free food.
  • Mandelonas (peanuts soaked in almond flavoring)
  • Mixed nuts
  • Monkey nuts
  • Nut meat or nut meal
  • Nut pieces
  • Peanut butter
  • Peanut flour
  • Peanut protein hydrolysate

When do kids develop a peanut allergy?

While some babies may present allergic reactions at first exposure, starting at just a few months, it turns out that “you can develop an allergy at any point in your life.” According to Collins, “Peanut allergies typically present in childhood but you can present an allergy to peanuts at any point.” That’s right. You can develop a peanut allergy at any point in your life. 

When should you go to the doctor or allergist?

“I think any time anybody is having a reaction to a food they should see an allergist or a specialist that can help guide them,” Collins says. So don’t be afraid to take your kid to an allergist, even if you think their allergies are mild. “Sometimes the symptoms patients are experiencing is not a true allergy, so if you have access to an allergist it’s valuable to get an expert opinion,” Collins says. 

Common Myths About Peanut Allergies

While peanut allergies are scary, “peanut allergies and food allergies are generally rising among the population for reasons that we’re not exactly 100 percent clear on,” according to Collins, they’re just not as common as we might think. “Oftentimes parents can be scared to introduce foods that, most of the time, do not cause an allergy. Certainly, the majority of people are not allergic to peanuts,” she says.

It used to be common practice to wait to introduce allergens like milk, fish, and peanuts, but nowadays, it is recommended to introduce them early. Especially for babies who are more likely to develop allergies, like babies with severe eczema, the recommended age of introduction is around 6 months. A 2015 NIAID study found that early exposure to peanuts led to an 81 percent relative reduction in the subsequent development of peanut allergy.

What’s the most important thing to do if your kid has a peanut allergy?

If you suspect your kid has a peanut allergy, Collins’s number one piece of advice is, well, to call an allergist. “There are allergists and immunologists across the country and they are highly trained to help with a lot of these issues and to provide really specific advice about food allergies. Having that conversation is really important. There are a lot of myths about food allergies,” so finding the right doctor and specialist to give you the right advice for your kid’s specific food allergy and help dispel those myths is of paramount importance.