Two of the most widespread food allergies in the world are tree nuts and peanuts. It is estimated that twenty percent of Australians suffer from some form of allergy and anaphylaxis. The erratic weather also aggravates allergies. Both of these allergy types can be life-threatening and require immediate medical attention if they are detected.
Are Tree Nut and Peanut Allergies The Same?
Tree nuts are a group of nuts that include but are not limited to almonds, Brazil nuts, cashews, hazelnuts, pecans, pistachios, macadamia nuts, pine nuts, walnuts and chestnuts. These are high in protein and rich in vitamin E.
Peanuts are completely unrelated to tree nuts mainly because the protein composition of the two differ. Despite the misleading moniker, peanuts belong to the legume family e.g. peas and lentils.
Generally speaking, those who are allergic to tree nuts will experience a hives-type reaction, while those who are allergic to peanuts will experience a severe, life-threatening allergic reaction called anaphylaxis if left untreated.
What Happens With a Tree Nut or Peanut Allergy?
When food containing nuts is consumed, the body interprets the proteins as dangerous invaders and mobilises all of its resources to repel the intruder. An allergic reaction is then provoked and the cells of the body release chemicals like histamine. These chemicals then cause the person’s symptoms.
Signs and Symptoms
Allergy symptoms to tree nuts, seeds or peanuts can range from minor to severe, which is anaphylaxis. But keep in mind that not all mild allergic reactions will probably lead to anaphylaxis.
Tree Nut Allergy Symptoms
An estimated 3.1% of babies and young children suffer from tree nut allergies in Australia. Some of the symptoms include:
- itching in the mouth or throat
- tingling in the lips or tongue
- swelling of the lips, tongue, face, or throat
- flushed skin or rash
- wheezing, trouble breathing, or coughing
- abdominal pain, nausea, vomiting, or diarrhoea
The most severe reaction is anaphylaxis, which can be life-threatening. If you have a tree nut allergy, it’s important to carry an epinephrine auto-injector with you at all times in case you have a reaction.
What is cross-reactivity?
“Cross-reactivity” is when a person who is allergic to one type of tree nut has a reaction after eating another type of tree nut. For example, someone with a walnut allergy may also be allergic to almonds, hazelnuts, or walnuts.
Peanut Allergy Symptoms
Children and teens commonly suffer from peanut allergies. Some people may experience a life-threatening reaction (anaphylaxis) even after ingesting or breathing even extremely little amounts of peanuts. Common symptoms include:
- itching or tingling in the mouth
- swelling of the lips, tongue, and throat
- hives or welts on the skin
- wheezing or difficulty breathing
- stomach cramps, nausea, or vomiting
- dizziness or lightheadedness
Signs of Severe Allergic Reaction to Nuts or Peanuts
In severe cases, anaphylactic shock may occur. Anaphylactic shock is a potentially life-threatening reaction characterised by a strong and sudden drop in blood pressure and a high heart rate. Serious cases must be given medical attention immediately. The following signs are:
- loud difficult breathing
- swollen tongue
- throat swelling or tightness
- the difficulty of speaking thus producing a raspy voice
- wheeze or a chronic cough
- continual fainting or collapsing
- a child’s paleness and floppiness.
How does asthma complicate an allergic reaction?
Asthma is an exaggerated reaction of a sensitive airway to a stimulus. It constricts the big airways and fills the bronchial tubes with mucus making breathing difficult. Thus, it complicates the hypersensitivity reaction.
Severe asthmatic attacks may follow a slight difficulty in breathing in people having an allergy. An asthmatic attack may come in slow but in most cases during an allergic reaction, it comes in very fast. Management of asthma is included in the emergency or first aid treatment of a hypersensitivity reaction.
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Common Risk Factors for Peanut or Nut Allergies
The risk factors for peanut allergy are not entirely clear. Nonetheless, understanding the why and how can help allergy sufferers manage their condition. The following risk factors have been identified.
Food allergies are most common in children, especially toddlers and infants. When they grow older, the digestive system matures and is not as reactive to allergens as before.
Peanut Allergy in the Past
Some kids who are allergic to peanuts grow out of it but it may recur when they are older.
Other Forms of Allergies
An allergy to one food may increase the risk of becoming allergic to another. If you have an additional allergy such as hay fever, this may increase the likelihood of developing allergies to food.
Family Members with Allergies
There is an increased risk of peanut allergy if other allergies are present and experienced by at least one family member.
Food allergies can also occur in people with skin conditions like atopic dermatitis (eczema).
Emergency Response for a Severe Allergic Reaction
- Do not allow the person to stand or walk. Instead, lay them flat.
- Inject adrenaline into the outer mid-thigh with an injector (such as EpiPen® or Anapen®).
- If there is no response after 5 minutes, more doses of adrenaline may be administered.
- In case of a medical emergency, always contact triple zero (000) for an ambulance.
- In case of need, provide adrenaline before puffing an asthma medication.
- Call a family member or an emergency contact.
Advice Given to Those Who are At Risk of Having Anaphylaxis Due to Nut Allergies
- Have a plan of action for anaphylaxis approved by ASCIA. (Australasian Society of Clinical Immunology and Allergy)
- Carry a prescription for an adrenaline injector which may be lifesaving.
- Always keep an adrenaline injector on hand.
- Wear jewellery with medical identification which can improve the chance of receiving adrenaline in an emergency.
- Avoid using drugs like beta-blockers that could worsen the difficulty of breathing.
- Avoid eating food that is known to cause allergic reactions.
- When dining out, let the wait staff know if you have a food allergy.
- Learn to read food labels so you can avoid foods that cause allergic reactions.
- Remember that the best way to manage a peanut, tree nut and seed allergy is to avoid all products containing substances a person is allergic to.
First Aid for Allergic Reaction: What can be done at the moment
Give oral antihistamines?
Sneezing, itching, a stuffy or runny nose and watery eyes can all be alleviated by antihistamines.
Give Corticosteroid Nasal Sprays
Nasal problems are improved with corticosteroids. Cromolyn sodium nasal spray, for example, helps prevent stuffy nose together with oral decongestants.
Help your healthcare provider or doctor diagnose your food allergies properly by
- keeping a record of nut allergies
- keeping a diary that describes symptoms and answering questions about what, where and when
- Where symptoms are felt, inside or outside the house or both?
- Duration – How long does a particular symptom occur?
- When – Do symptoms appear at night or daytime or upon waking up? upon lying down just before going to sleep at night?
- Do symptoms appear after taking a particular food or drink?
Food to Avoid That Have Tree Nuts or Peanuts
The best way to prevent an allergic reaction is to avoid eating foods that contain tree nuts or peanuts. These nuts are often used as ingredients in other foods such as baked goods and cereals.
If you have a tree nut or peanut allergy, always read the ingredient labels on food products before eating them. Be sure to look for any mention of tree nuts or peanuts, as well as any ambiguous terms such as “natural flavours” or “spices.”
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