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The Ultimate Guide to Living with a Peanut Allergy

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More and more children are being diagnosed with a peanut allergy.  Products routinely change their flavors, sometimes adding peanut butter.  Many children with a peanut allergy have had reactions due to accidental ingestion of products that they thought were safe.

In this article we will discuss facts about a peanut allergy, which ingredients to avoid, and how to stay safe with a peanut allergy.

Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Keep in mind food production can change, always check food labels to be sure products are free of your particular food allergen. For further information please see full Disclaimer.

How Common is a Peanut Allergy?

You may be wondering how common are peanut allergies in children and adults.   If you develop a food allergy sometime before the age of 18, peanuts are considered the most common food allergy in this age group.  

Adults also can develop this allergy and, in fact, peanut is the third most common allergy in adults.

How Likely am I to Outgrow a Peanut allergy?

Unfortunately, children who have a peanut allergy only have a 20% chance of outgrowing the allergy (1).  Most individuals who have a peanut allergy have it for life.

The number of children in the United States with peanut allergies is on the rise, according to a Food Allergy Research and Education (FARE) funded study.   Per this study, the number of U.S. children with a peanut allergy more than tripled between 1997 and 2008 (2).

Peanut Oral Immunotherapy

There is good news! Oral immunotherapy (OIT) is currently used to help desensitize individuals with a peanut allergy.  OIT occurs when small amounts of the food allergen are given to an individual with the hope of increasing the threshold of oral tolerance to the allergen.  

Oral immunotherapy is performed under medical supervision and should never be tried without the direction of a doctor.

While OIT does not cure a food allergy, it may help with reducing chances of  more serious reactions such as anaphylaxis with accidental ingestion of a small amount of an allergen.  Epinephrine auto injectors should still be carried in individuals who are going through OIT.

The Food and Drug Administration (FDA) has approved Palforzia™ as a form of OIT to be used only under medical supervision.

What are the 9 Most Common Food Allergies?

The top 9 food allergies also known as the big 9 allergens in the United States are:

  1. Milk
  2. Egg
  3. Peanut
  4. Soy
  5. Wheat
  6. Tree Nut
  7. Shellfish
  8. Fish
  9. Sesame

I encourage you to click on the links above to learn more about each of these food allergens.

The Top 9 Food Allergens in the U.S. Top 9 Food Allergies. 1. Fish 2. Shellfish 3. Tree Nuts 4. Peanuts 5. Milk 6. Wheat 7. Egg 8. Soy 9. Sesame

It is important to note that you can be allergic to many other foods besides these top nine.

Peanuts Are a Legume

I often wish peanuts were not called “peanuts.” The word “peanut” is a bit of an oxymoron.  Peanuts are not nuts, they are legumes.  Many legumes, like the peanut, grow underground.  Examples of other legumes are beans, green beans, peas, lentils, chickpeas and soybeans.

A peanut allergy is not the same thing as having a tree nut allergy.  Tree nuts and seeds are a different plant family than legumes.

That means, having a peanut allergy does not necessarily mean that you will have a tree nut allergy.  A tree nut allergy is separate from a peanut allergy.  However, it isn’t uncommon to have both a tree nut allergy and a peanut allergy.

Approximately 40% of children with a peanut allergy also have a tree nut allergy (3).

Lupin and Peanut Allergies

Individuals with a peanut allergy typically do not have allergies to other legumes such as peas, lentils, green beans, and other types of beans.  However, sometimes individuals with a peanut allergy have an allergy to lupin, another type of legume.  Another name for lupin is lupine.

A lupin allergy is not as commonly seen in the United States as it is in Mediterranean countries (4).  

However, lupin is becoming more common in food products in the United States.  Lupin flour is sometimes used in vegan products or is used as a flour substitute in gluten free foods.

Work with a Board Certified Allergist to determine your specific food allergies.

What are Symptoms of a Peanut Allergy?

Peanut allergy symptoms can vary from person to person but often reactions can be serious such as anaphylaxis.  Here are some possible symptoms if you have a peanut allergy:

  • Hives
  • Swelling of lips, tongue, throat, face
  • Dizziness
  • Anaphylaxis
  • Itching or swelling of the lips, tongue, or throat
  • Diarrhea
  • Weak pulse
  • Repetitive coughing
  • Difficulty swallowing
  • Abdominal pain and cramps
  • A drop in blood pressure
  • Difficulty breathing
  • Nausea and vomiting
  • Runny nose
  • Congestion (stuffy nose)
  • Digestive problems
  • Coughing
  • Loss of consciousness

An allergic reaction to peanuts can occur minutes to hours after ingestion.  Reactions to peanuts can vary.  Reactions can be mild (requiring only an antihistamine) or they may be a severe reaction such as anaphylaxis.  

Unfortunately, anaphylaxis is not uncommon with peanut allergies.  Severe reactions require epinephrine.

A Food Allergy and Anaphylaxis  Emergency Care Plan is a great tool to use if you or someone you know has a food allergy.  

Foods to Avoid with a Peanut Allergy

Peanuts are commonly found in desserts and candy.  Be sure to check food labels very carefully before eating these types of foods.

Some Possible Food Sources which Do Contain Peanut or Are Likely to Contain Peanut

  • Arachidic acid
  • Arachis oil (this is another name for peanut oil)
  • Artificial nuts, 
  • Beer nuts
  • Cacheuta
  • Earth nuts
  • Goober nuts
  • Ground nuts
  • Hydrolyzed plant protein or hydrolyzed protein
  • Hydrolyzed vegetable oil
  • Kernel Paste
  • Lupin (also known as lupine)
  • Mandelonas (these are peanuts that have flavorings added to them)
  • Mani
  • Mixed nuts
  • Monkey nuts
  • Nut meat or nut meal
  • Nu-Nuts
  • Nut pieces
  • Ontjom or Onchom
  • Peanuts
  • Peanut Butter
  • Peanut Dust
  • Peanut Flour
  • Peanut Oil (cold-pressed, expeller pressed, extruded peanut oil)
  • Peanut Products
  • Peanut protein hydrolysate
  • Valencias
Foods to avoid or investigate with a Peanut Allergy.  The Food Allergy Advisor.

Is Peanut Oil Okay if I Have a Peanut Allergy?

Most individuals with a peanut allergy can safely consume highly refined peanut oil.  The FDA does not consider highly refined peanut oil to be a major food allergen.  Therefore restaurants are not required to label foods cooked in highly refined peanut oil as containing peanuts.

Popular restaurants like Chick-fil-A use highly refined peanut oil.

Talk with your Board Certified Allergist to find out if you need to avoid highly refined peanut oil.

If you have a peanut allergy you will need to avoid cold pressed peanut oil, expeller pressed peanut oil, gourmet peanut oil, or extruded peanut oil.  Unlike highly refined peanut oil, these oils tend to contain enough peanut protein to invoke an allergic reaction.

Other Foods and Non-Food Items which May Contain Peanuts:

  • Ant Traps
  • Asian-style dipping sauces
  • BBQ Sauce
  • Bird Food
  • Candy
  • Chili
  • Chocolate
  • Cookies
  • Compost
  • Curry Sauce
  • Desserts
  • Dog Food
  • Dressings 
  • Egg Rolls
  • Enchilada sauce
  • Granola
  • Ice Cream
  • Marinades
  • Marzipan
  • Muesli Cereal
  • Nougat
  • Nut butters 
  • Sauces (especially szechuan sauce)
  • Spring Rolls
  • Trail Mix
  • Vegetarian products

Be sure to think of things like dog foods which may contain peanuts as these food sources often get overlooked.

Peanuts may also be found in personal care products such as make up and soaps.  

Peanuts in Arts and Crafts

Arts and Crafts supplies may also contain peanuts.  I have seen sensory bins with peanut shells, not something you want to see when peanut allergies are so prevalent with children.

Be sure to ask questions if you have a child with a peanut allergy who will participate in arts and crafts.  Crafts such as bird feedings may contain ingredients such as peanut butter.  

Be sure to help educate daycare teachers, elementary teachers and other community members about the risk of food allergies in arts and crafts.

You may want to share this article, Allergens in Arts and Crafts, with others.

Food Allergy Labeling.  About FALCPA

The Food Allergen Labeling and Consumer Protection Act (FALCPA) was created in 2004.  FALCPA identified the following foods as major food allergens:  milk, eggs, fish, shellfish, peanuts, tree nuts, wheat, and soy.

Effective January 1, 2023, the FASTER Act  (the Food Allergy Safety, Treatment, Education, and Research Act) was signed into law, adding sesame as the 9th major food allergen recognized in the U.S. 

FALCPA  requires that foods or ingredients that contain major food allergens have labeling with the name of the allergen source.   

FALCPA states that major food allergens arelisted in one of three ways:

  1. In the ingredient list, using the allergen’s common name. 
  2. By  citing the word “Contains” followed by the name of the major food allergen—for example, “Contains peanuts”
  3. In the ingredient list in parentheses after a less common name of ingredient that may contain an allergen.  

Again, discuss with your provider which foods you should avoid with a peanut allergy.

Made in a Facility/Cross Contamination Statements for Peanut

Food manufacturers may use equipment to produce multiple products.  This may lead to cross contamination of allergens.  Some manufacturers disclose this information and others do not.  This is true for both FALCPA and non-FALCPA allergens.

Cross contamination statements are not required in the U.S.  Call the manufacturer to learn about their manufacturing practices.

Cross contamination is a particularly important concern with a peanut allergy.  Items that contain tree nuts may have come in cross contact with peanuts.

Nut butters, like sunflower seed butter or soy nut butter, may also have risk for cross contamination.  Be sure to check with the manufacturer about risk for cross contamination.

Be sure to ask a lot of questions when dining out.  The risk of cross contamination may be high at certain restaurants.

It is imperative to check the food label every time!  Companies may release new products that contain things like peanut butter.  A child may recognize the package (which may look similar to the product that does not contain peanuts) and think it is safe to consume.  

Teach your children that a trusted adult needs to read the food label every time before they eat.  At schools, this may involve the school nurse.

Peanut Allergy Treatment

  1. Always read food labels closely and look for ingredients that indicate peanuts.
  2. Avoid all foods related to your allergy.  Learn less common names for your particular food allergy.
  3. Become familiar with labeling laws.
  4. Talk to your Board Certified Allergist
  5. Be mindful of risk for cross contamination
  6. Treat your peanut allergy in the case of accidental ingestion.  Be sure to have not one, but two doses of epinephrine available when eating.  Always call 911 if epinephrine is given.
  7. Talk to your doctor about how to treat symptoms of an allergic reaction and visit www.foodallergy.org for more detailed information about treating food allergies.  

Final Thoughts

Peanut allergies are becoming more common in children.  Oral immunotherapy treatments for peanut continue and peanut allergies are among the most researched of the food allergies.

Special attention needs to be paid to reading food labels as well as considering risk of cross contamination of peanuts.

If you think you may be allergic to peanuts see a Board Certified Allergist.

Like this post?  Make a comment.  Stay in touch by subscribing to my email list.  

Last Updated on March 17, 2023 by Amber DeVore, RD, CSSD, CLT

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