Oh, nuts! They sure can cause you trouble if you're allergic to them — and a growing
number of kids are these days.
So what kind of nuts are we talking about? Peanuts, for one, though they aren't
truly a nut. They're a legume (say: LEH-gyoom), like peas and lentils. A person also
could be allergic to nuts that grow on trees, such as almonds, walnuts, pecans, cashews,
hazelnuts, Brazil nuts, and pistachios.
When you think of allergies,
you might picture lots of sneezing and runny noses. But unlike an allergy to spring
flowers, a nut or peanut allergy can cause difficulty breathing and other very serious
health problems. That's why it's very important for someone with
a nut or peanut allergy to avoid eating nuts and peanuts, which can
be tough because they're in lots of foods.
What Happens With a Tree Nut or Peanut Allergy?
Your immune system normally
fights infections. But when someone has a nut allergy, it overreacts to proteins in
the nut. If the person eats something that contains the nut, the body thinks these
proteins are harmful invaders and responds by working very hard to fight off the invader.
This causes an allergic reaction.
What Are the Signs & Symptoms of a Nut Allergy?
When someone with a peanut or tree nut allergy has something with nuts in it, the
body releases chemicals like histamine (pronounced: HISS-tuh-meen).
Reactions to foods, like peanuts and tree nuts, can be different. It all depends
on the person — and sometimes the same person can react differently at different times.
In the most serious cases, a nut or peanut allergy can cause anaphylaxis
(say: an-uh-fuh-LAK-sis). Anaphylaxis is a sudden, life-threatening allergic reaction.
A person's blood pressure can drop, breathing tubes can narrow, and the tongue can
People at risk for this kind of a reaction have to be very careful and need a plan
for handling emergencies, when they might need to use special medicine to stop these
symptoms from getting worse.
What Will the Doctor Do?
If your doctor thinks you might have a nut or peanut allergy, he or she will probably
send you to see a doctor who specializes in allergies. The
(allergy specialist) will ask you about past reactions and how long it
takes between eating the nut or peanut and getting the symptoms, such as hives.
The allergist may also ask whether anyone else in your family has allergies or
other allergy conditions, such as eczema or asthma. Researchers aren't sure why some
people have food allergies and others don't, but they sometimes run in families.
The allergist may also want to do a skin test. This is a way of seeing how your
body reacts to a very small amount of the nut that is giving you trouble. The allergist
will use a liquid extract of the nut that seems to be causing you symptoms.
During skin testing, a little scratch on your skin is made (it will be a quick
pinch, but there are no needles!). That's how just a little of the liquid nut gets
into your skin. If you get a reddish, itchy, raised spot, it shows that you may be
allergic to that food or substance.
Skin tests are the best test for food allergies, but if more information is needed,
the doctor may also order a blood test. At the lab, the blood will be mixed with some
of the food or substance you may be allergic to and checked for antibodies.
It's important to remember that even though the doctor tests for food allergies
by carefully exposing you to a very small amount of the food, you should not
try this at home! The only place for an allergy test is at the allergist's
office, where they are specially trained and could give you medicine right away if
you had a reaction.
How Is a Tree Nut or Peanut Allergy Treated?
There is no special medicine for nut or peanut allergies and many people don't
outgrow them. The best treatment is to avoid the nut. That means not eating that nut,
and also avoiding the nut when it's mixed in foods. (Sometimes these foods don't even
taste nutty! Would you believe chili sometimes contains nuts to help make it thicker?)
Staying safe means reading food
labels and paying attention to what they say about how the food was produced.
Some foods don't contain nuts, but are made in factories that make other items that
do contain nuts. The problem is the equipment can be used for both foods, causing
"cross-contamination." That's the same thing that happens in your own house
if someone spreads peanut butter on a sandwich and dips that same knife into the jar
After checking the ingredients list, look on the label for phrases like these:
"may contain tree nuts"
"produced on shared equipment with tree nuts or peanuts"
People who are allergic to nuts also should avoid foods with these statements on
the label. Some of the highest-risk foods for people with peanut or tree nut allergy
cookies and baked goods
Asian and African foods
sauces (nuts may be used to thicken dishes)
Talk to your allergist about how to stay safe in the school cafeteria. Also ask
about how you should handle other peanut encounters, like at restaurants or stadiums
where people are opening peanut shells. People with nut allergies usually won't have
a reaction if they breathe in small particles. That's because the food usually has
to be eaten to cause a reaction.
Have an Emergency Plan
If you have a nut or peanut allergy, you and a parent should create a plan for
how to handle a reaction, just in case. That way your teachers, the school nurse,
your basketball coach, your friends — everyone will know what a reaction looks like
and how to respond.
To immediately treat anaphylaxis, doctors recommend that people with a nut or peanut
allergy keep a shot of epinephrine (say: eh-puh-NEH-frin) with them.
This kind of epinephrine injection comes in an easy-to-carry container. You and your
parent can work out whether you carry this or someone at school keeps it on hand for
you. You'll also need to identify a person who will give you the shot.
You might want to have antihistamine medicine on hand too for mild reactions. If
anaphylaxis is happening, this medicine is never a substitute for
epinephrine. After getting an epinephrine shot, you need to go to the hospital or
other medical facility, where they will keep an eye on you for at least 4 hours and
make sure the reaction is under control and does not come back.
What Else Should I Know?
If you find out you have a nut or peanut allergy, don't be shy about it. It's important
to tell your friends, family, coaches, and teachers at school. The more people who
know, the better off you are because they can help you stay away from the nut that
causes you problems.
Telling the server in a restaurant is also really important because he or she can
steer you away from dishes that contain nuts. Likewise, a coach or teacher would be
able to choose snacks for the group that don't contain nuts.
It's great to have people like your parents, who can help you avoid nuts, but you'll
also want to start learning how to avoid them on your own.