Q. What are the symptoms of a peanut allergy? And how is it treated?
As in all allergic reactions, the symptoms can range from mild (sneezing, itching, localized swelling) to severe (anaphylaxis, a reaction affecting the body as a whole, including a drop in blood pressure and fainting, swelling of the airway, nausea, vomiting, diarrhea, and hives over the entire body). It's very important to create an anaphylaxis action plan with your doctor, and always carry two epinephrine auto-injectors (EpiPen, Auvi-Q). Epinephrine must be given as soon as possible after the ingestion of peanuts. Strict avoidance of peanuts or items that could potentially contain peanuts is the best treatment. If you suspect that you or someone you know is having an anaphylactic reaction to peanuts call 911 immediately.
Q. How many people are allergic to peanuts?
Recent statistics suggest that approximately 3 million people in the U.S. alone are allergic to peanuts. According to FARE, the number of peanut allergic children had tripled between 1997 and 2008.
Q. How much peanut protein can trigger a reaction?
It depends on the person, however some people can react just to peanut molecules picked up through cross-contact on contaiminated surfaces - or even to airborne peanut molecules. As with all allergies, it's very important to work with a board-certified allergist, who can test for your specific level of IgE antibodies, which will give you some indication of your likely level of sensitivity to the allergen. She will also be able to give you guidance on the levels of precautionary measures that are right for you.
Q. How do I know if a product is safe?
Read the label. Read it every single time you purchase a product. Even if you've used a product safely in the past, manufacturing practices may change. While labeling laws require that the top 8 allergens to be listed in plain English (in other words, if "Arachic oil" is listed on the ingredient label, the word "peanut" must be there as well), there is not yet a law requiring companies to include a "may contain" statement on their products. That means that trace exposures to the allergen may be introduced through the manufacturing process. Many companies include this statement voluntarily, but not all do. When in doubt, call or email the company to ask about their allergen policy.
Q. Do I need to avoid products that have a "may contain" statement?
As mentioned above, a very small amount of peanut protein can trigger a potentially fatal reaction, so most health care providers recommend avoiding any products with labels that state: "may contain" peanuts, "are produced in the same facility" as peanut products, or products that are "made on shared equipment." In addition, some allergists recommend that those with a peanut allergy also avoid treenuts (including pecans, walnuts, almonds and hazlenuts, among others), because they are commonly processed in shared manufacturing facilities. Again, speak with your allergist about which precautions are right for you.
Q. Is it safe to consume peanut oil?
It depends on your sensitivity level, and on the way the oil was processed. Peanut oil is extracted by one of two methods. The first is by expeller pressing (also called "cold pressing") at very low temperatures. This is the preferred method for gourmet cooks, as it keeps the flavor and integrity of the oil intact. However, with cold-pressed oils, the peanut protein also remains within the oil and can therefore cause a reaction in allergic individuals. The second method involves chemically extracting the oil using very high temperatures (300 F+). Studies have found that the amount of peanut protein remaining in oil treated this way is negligible, however some individuals may still have a reaction. All in all, it's safestto use one of the many other cooking oils available on the market and skip the peanut oil, but speak to your doctor about the risks of consuming peanut oil.
Q. Can a child outgrow his or her peanut allergy?
Unlike milk, egg, and soy allergies, which many children outgrow, the majority of peanut allergies tend to be life long. There have been many studies showing that approximately 20% of young children diagnosed with a peanut allergy early in life (before age 3) will outgrow their allergy. This number declines steadily as the age of diagnosis increases. Please speak with your doctor about the possibility of your child outgrowing his or her allergy.
Q. What is an "airborne" peanut allergy?
An airborne reaction can occur when the peanut protein is ground (as when making peanut butter), becomes vaporized (through cooking at high temperatures), or when peanut dust is released into the air (as when peanut shells are cracked open, or when peanuts are served in the closed air system of an airplane). Symptoms of an airborne peanut allergy are similar to those of hay fever and include itchy eyes and runny nose. Most people with peanut allergies are unlikely to experience an anaphylactic reaction just from airborne exposure, but unfortunately many do. Speak to your allergist about whether you are likely to be at risk for airborne reactions, and whether it is safe for you to fly. And even if not, help support those who are by letting your airline know that you appreciate a peanut-free flight!
Q. What is lupine and do I need to avoid it?
Lupinus is a genus of flowering plant that is very closely related to the peanut. Lupine seeds are commonly used in the cuisine of the Mediterranean regions of Europe and North Africa, as well as on the coastal regions of the Middle East. According to FARE, "A recent study showed that unlike other legumes, there is a strong possibility of cross-reaction between peanuts and lupine." It should be avoided by those with peanut allergies, unless your doctor advises otherwise.
Q. How is a peanut allergy different from a tree nut allergy?
Tree nuts (almonds, cashews, walnuts, etc.) grow on trees and are fruits, while peanuts grow underground and are part of the legume family (including peas, beans and lentils). Food Allergy Research and Education (FARE) states that "Based on recent studies, an estimated 25-40 percent of people who have a peanut allergy also are allergic to tree nuts. In addition, peanuts and tree nuts often come in contact with one another during manufacturing and serving processes. For these reasons, allergists usually tell their patients with peanut allergies to avoid tree nuts as well."
Q. I'm allergic to peanuts, but is it possible that might lead me to react to other legumes as well?
As noted above, peanuts aren't actually "nuts" at all - they're legumes, like peas, beans, lentils and chickpeas. Most people who are allergic to peanut can eat these without any problem, but not all. And, as the specialty food industry seeks to find new plant-based proteins, oils and dairy substitutes, pea protein is turning up in more and more surprising places. Thus, it's important to speak with a board-certified allergist about whether you need to take any precautions about other legumes.
Q. I'm allergic to peanuts. What foods should I look out for?
Check out our Peanut-free Cheat Sheet to learn the common and not-so-common sources of peanuts in both food and non-food items.
Q. Where can I find out more?
Check out these links to learn more about peanut allergies.
FARE - Peanut Allergy
Kids with Food Allergies - Peanut Allergy Avoidance List
Mayo Clinic - Peanut Allergy
ACAAI - Peanut Allergy