Allergists Get Real About The Best Ways To Manage Your Peanut Allergy

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, 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 have 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 and what are peanut allergy symptoms?

A peanut allergy occurs when your body produces a protein that’s directed towards the peanut protein. This in turn triggers the body to have an allergic inflammation that leads to an allergic reaction.

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

• Rash
• Hives
• Nasal congestion
• Runny nose
• Digestive issues
• Diarrhea
• Abdominal pains
• Nausea
• Vomiting
• Difficulty breathing
• Swelling in lips or tongue
• Itching or tingling in the mouth
• Throat swelling
• Blood pressure drop
• Anaphylaxis

Anaphylaxis is the most serious allergic reaction to peanuts. It’s a severe allergic reaction that usually occurs 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.

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,” she explains, adding, “That’s where really talking to an allergist can help guide you on how to introduce things. An allergist can guide patients and parents on what to look for and the foods that may or may not cross-react with a peanut.

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

As far as spices to avoid if one has a peanut allergy, the biggest culprit seems to be cumin. Some types of cumin have tested positive for undeclared peanut protein in the past, so it’s good to be proactive and skip it if possible.

Peanut allergies in Babies, Toddlers, Kids, and Teens

According to Collins, peanut allergy 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.

In general, food allergies are more common in children than adults. Both peanuts and tree nuts are popular allergies for kids to have, which is why allergists and pediatricians recommend the introduction of allergens like peanuts early. That’s easier said than done, especially if you’re a worried parent. The Children’s Hospital of Philadelphia suggests giving your child a small amount of a peanut product, like peanut butter, in the 4 to 6 months range. Exposure can and should be small. Peanut butter may be a choking hazard, so you don’t want to introduce too much at once.

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,” said 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.

That’s not the only myth about peanut allergies, so we rounded up the most familiar ones below.

• 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. A 2015 NIAID study found that early exposure to peanuts led to an 81 percent relative reduction in the subsequent development of peanut allergy.
• One common myth about peanut allergies is that they’re linked to tree nut allergies. Actually, peanuts are a legume. Despite their name, they’re grown underground and are not linked with walnuts or cashews. While someone can be allergic to peanuts and tree nuts, they are different.
• Another peanut allergy myth is that kids with an allergy can’t be in the same room with peanuts. Many parents have had issues in school lunchrooms due to this. It’s never a bad idea to exercise caution. However, ingestion is the only way symptoms might become deadly. Other reactions may occur, but they won’t be anywhere near as severe.
• It’s also a myth that EpiPens can cause injury. While it’s important for people to know how to use one, EpiPens can and do save lives.

Peanut Allergies and the COVID-19 Vaccine

Getting vaccinated for COVID-19 has been essential in stopping the spread of the deadly virus. But can you get the vaccine with a peanut allergy? According to professionals, the chance of having a severe reaction after getting the vaccine is very minimal. But, it’s something that medical professionals still look for. This is why doctor’s offices and vaccination centers ask patients who get the shot to hang back for 15 to 30 minutes in a waiting area, just in case a reaction happens. If you’ve had an immediate and severe reaction to certain vaccinations before, you have a reason for concern. The best person to ask is your doctor or allergist. While many people with peanut allergies have safely been vaccinated with no issue, any worries should be run by a medical professional.

What is a peanut allergy test?

According to Collins, there are three ways to test for peanut allergies, specifically for kids. The first is mentioned above — small exposures to help kids avoid developing the allergy later. 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, during which a small amount of the protein is put on the child’s arm or back, followed by a prick.

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, nothing has been approved by the FDA as of yet.

Lee says 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 peanut 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.” That’s because some situations 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 have banned peanut packets. There’s a reason for that: A quick inhalation of peanut dust from a newly opened peanut packet can cause an allergic reaction — though as Lee says, that’s a very rare situation.

Can you all of a sudden become allergic to peanuts?

Yes. It’s almost unfair, but it’s true. 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.

Food allergies can develop at any time. But, here’s some good news — in adults, it’s very rare. It’s actually much more common to suddenly become allergic to shellfish than peanuts. Still, you’ll want to be on the lookout for any potential symptoms.

Are there different levels of peanut allergies?

Yes. Some people may be highly allergic to peanuts, while others may only have mild symptoms. But, it’s important to remember that an allergy is an allergy. Your body is a machine at work, so you should fuel it with things that make it run to its best potential.