Peanut Allergy: What You Need to Know

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Peanut allergy is one of the most common and severe food allergies. It affects about 1.2% of Americans and can cause life-threatening reactions, such as anaphylaxis. In this article, we will explain what peanut allergy is, what causes it, what the symptoms are, how to diagnose it, how to treat it, and how to prevent it.

What is peanut allergy?

Peanut allergy is a type of food allergy that occurs when your immune system mistakenly identifies peanut proteins as harmful and produces antibodies to fight them. When you eat peanuts or peanut-containing foods, these antibodies trigger the release of chemicals, such as histamine, that cause allergic symptoms. Peanuts are not true nuts, but legumes that grow underground. They belong to the same family as peas and lentils. However, some people who are allergic to peanuts may also be allergic to tree nuts, such as almonds, cashews, walnuts, and others. Tree nuts grow on trees and are different from peanuts in terms of their structure and proteins.

What causes peanut allergy?

The exact cause of peanut allergy is not fully understood, but it may involve genetic and environmental factors. Some risk factors that may increase the chance of developing peanut allergy include

  • Age: Peanut allergy is more common in children than in adults. Some children may outgrow their peanut allergy, but others may have it for life.
  • Family history: Having a parent or sibling with peanut allergy or any other food allergy may increase the risk of having peanut allergy.
  • Other allergies: Having other allergies, such as eczema, asthma, or hay fever, may also increase the risk of having peanut allergy.
  • Exposure: The timing and amount of exposure to peanuts may also influence the development of peanut allergy.Some studies suggest that early introduction of peanuts to infants may prevent or reduce the risk of peanut allergy while others suggest that avoiding peanuts during pregnancy and breastfeeding may reduce the risk of peanut allergy in children.

What are the symptoms of peanut allergy?

The symptoms of peanut allergy can vary from person to person and depend on the amount and type of exposure to peanuts. The symptoms can range from mild to severe and can occur within minutes or hours after eating peanuts or peanut-containing foods. Some common symptoms include

  • Skin reactions: Hives, redness, swelling, itching, or eczema
  • Respiratory reactions: Runny nose, sneezing, coughing, wheezing, shortness of breath, or asthma attack
  • Gastrointestinal reactions: Nausea, vomiting, diarrhea, stomach pain, or cramps
  • Oral reactions: Itching, tingling, swelling, or tightness in or around the mouth or throat
  • Cardiovascular reactions: Low blood pressure, rapid heartbeat, dizziness, fainting, or shock

Anaphylaxis is a severe and potentially fatal allergic reaction that involves multiple organ systems. It can cause difficulty breathing, swelling of the throat, loss of consciousness, and cardiac arrest. Anaphylaxis requires immediate medical attention and treatment with an epinephrine auto-injector (EpiPen) and a trip to the emergency room.

How is peanut allergy diagnosed?

If you suspect that you or your child has a peanut allergy, you should consult your doctor for a proper diagnosis. Your doctor will ask you about your medical history, family history, symptoms, and exposure to peanuts. Your doctor may also perform some tests to confirm your diagnosis. These tests may include

  • Skin prick test: A small amount of peanut extract is placed on your skin and pricked with a needle. If you are allergic to peanuts, you will develop a raised bump or wheal at the site of the prick within 15 minutes.
  • Blood test: A sample of your blood is sent to a laboratory to measure the level of peanut-specific IgE antibodies in your blood. A high level of these antibodies indicates that you are allergic to peanuts.
  • Oral food challenge: This is the most accurate but also the most risky test for peanut allergy. Under medical supervision, you are given increasing doses of peanuts or peanut-containing foods until you develop an allergic reaction or tolerate a certain amount without any reaction.

How is peanut allergy treated?

There is no cure for peanut allergy. The only way to prevent an allergic reaction is to avoid peanuts and peanut-containing foods completely. You should read food labels carefully and avoid any products that contain peanuts or may have been contaminated with peanuts during processing or handling. You should also inform your family members, friends, school staffs, and restaurant staffs about your peanut allergy and ask them to help you avoid any accidental exposure.

If you have a peanut allergy, you should always carry an epinephrine auto-injector (EpiPen) with you and know how to use it in case of an emergency. Epinephrine is a medication that can reverse the symptoms of anaphylaxis and save your life. You should inject epinephrine into your thigh as soon as you notice any signs of anaphylaxis and you can call local emergency number for further assistance.

There are some experimental treatments for peanut allergy that are currently under research. These include oral immunotherapy, sublingual immunotherapy, epicutaneous immunotherapy, and biologic therapy. These treatments aim to desensitize your immune system to peanuts and reduce the severity of your allergic reactions. However, these treatments are not yet widely available and may have some risks and side effects. You should consult your doctor before trying any of these treatments.

How can you prevent peanut allergy?

The best way to prevent peanut allergy is to avoid exposure to peanuts and peanut-containing foods. However, some studies suggest that early introduction of peanuts to infants may prevent or reduce the risk of peanut allergy in some cases. The American Academy of Pediatrics (AAP) recommends that parents introduce peanuts to their infants as early as 4 to 6 months of age, after they have started eating other solid foods, if they have a high risk of developing peanut allergy. A high risk is defined as having severe eczema, egg allergy, or both.

The AAP advises parents to consult their doctor before introducing peanuts to their infants and to follow these steps.

  • Check with your doctor if your infant is ready to try peanuts and if they need any testing or evaluation before doing so.
  • Choose a smooth peanut butter or a peanut powder and mix it with water, breast milk, formula, or pureed fruit until it is thin enough to be easily swallowed by your infant.
  • Give your infant a small amount of the peanut mixture on a spoon and wait for 10 minutes to see if they have any allergic reaction. If they do not have any reaction, continue feeding them the rest of the peanut mixture gradually over the next 20 minutes.
  • Do not give your infant whole peanuts or chunky peanut butter, as they can cause choking.
  • Feed your infant peanuts at least three times a week and at least 6 grams per week until they are 5 years old.
  • Monitor your infant for any signs of allergic reaction and seek medical help if needed.


Peanut allergy is a serious condition that can cause life-threatening reactions. It is important to know what causes it, what are the symptoms, how to diagnose it, how to treat it, and how to prevent it. If you have a peanut allergy, you should avoid peanuts and peanut-containing foods completely and always carry an epinephrine auto-injector with you. If you have an infant who is at high risk of developing peanut allergy, you may consider introducing peanuts to them early under medical guidance.


1Peanut Allergy | Causes, Symptoms & Treatment | ACAAI Public Website 2Peanut allergy – Symptoms and causes – Mayo Clinic 3Peanut and Nut Allergies: Common Foods, Items to Avoid and 4 Tips – WebMD 4: Peanut Allergy Prevention | American Academy of Pediatrics 5: Peanut consumption in infancy prevents peanut allergy, study finds – Harvard Health Blog – Harvard Health Publishing


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