Board-certified pediatric and adult allergist and immunologist, and Medical Director with Latitude Food Allergy Care, provides important information you need to know about peanut allergies
Peanut allergies have become more common among children and adults. According to recent estimates, nearly 1.6 million children and teens in the U.S. have a peanut allergy. Approximately 20 percent will outgrow a peanut allergy over time, but most will have a persistent one throughout their lives.
Treatments such as Xolair and oral immunotherapy (OIT) have recently made headlines as proven options for making life with peanut allergies more manageable for patients.
As new developments emerge and evolve, here are 10 facts you might not know about peanut allergies.
1. What happens in your body during a peanut allergy reaction?
A peanut allergy develops when the immune system reacts to major proteins found in peanuts as if they are harmful invaders. The immune system fights off the proteins, resulting in a wide range of symptoms, sometimes impacting multiple systems of the body — skin, gastrointestinal, respiratory, or cardiovascular.
2. Peanut allergies are becoming more common.
Cases of peanut allergy have steadily increased in recent history. This may result from many variables in our society, from environmental changes to shifts in our diets over the generations and even decades of (now outdated) recommendations to avoid peanut-based foods altogether in very young children.
3. Accidental ingestion of peanuts
Despite increased awareness, accidental exposures unfortunately continue to occur. Even if a certain food does not intentionally contain peanuts, cross-contact (i.e., accidental contact with peanuts) can still result in an allergic reaction.
4. Symptoms of peanut allergies are varied.
An allergic reaction to peanuts can manifest in a wide range of symptoms, from mild discomfort to severe life-threatening anaphylaxis. Symptoms can include hives; skin redness or swelling; itching or tingling in the throat or mouth; runny nose; red, watery eyes; swelling of the tongue and/or the lips; eye swelling; nasal congestion; stomach cramps and/or abdominal pain; diarrhea; nausea or vomiting; difficulty breathing and/or wheezing.
5. Risk of anaphylaxis for children and adults with peanut allergies.
Peanut allergy is the most common allergy associated with anaphylaxis, which can be a life-threatening allergic reaction. Signs of anaphylaxis can include pale or bluish tint on the skin, throat constriction, shortness of breath (and/or wheezing), difficulty breathing, confusion and/or dizziness, and a weak and rapid pulse.
Although fatalities are very rare, if anaphylaxis occurs, access to immediate medical treatment is critical. Everyone with a doctor-diagnosed peanut allergy should create an emergency anaphylaxis plan to minimize response time, including carrying two epinephrine auto-injectors accessible at all times.
6. When can peanut allergy testing begin?
Peanut allergy testing can begin as early as four months. Testing that includes blood work and skin testing can ensure that diagnoses are as accurate as possible. Blood work may consist of specific IgE tests and component testing that help distinguish which proteins in the peanut a patient might be most likely to react to.
7. Peanuts vs. Tree Nuts
Often confused with a peanut allergy, a tree nut allergy is triggered by proteins found in nuts such as walnuts, almonds, hazelnuts, pecans, cashews, Brazil nuts, pistachios, macadamia nuts, and pine nuts. However, between 25 and 40 percent of those with a peanut allergy are also allergic to at least one type of tree nut. Similar to a peanut allergy, food proteins bind to IgE antibodies during an allergic reaction to a tree nut, triggering an immune system response that results in a wide range of mild to severe reactions. A clinical evaluation with an allergist is advised to determine if the patient is only allergic to peanuts. Once the patient has clarity about which foods are allergies, they should freely eat the foods they are not allergic to, ensuring diversity of diet and reducing the risk of future sensitizations to other foods.
8. An allergic reaction might even be triggered by non-food items.
Peanut proteins can be present in vitamins, medications, skin creams, cosmetics, sunscreen, craft materials, toy stuffing, pet food, bird feed, and even ant baits or mouse traps.
9. Peanut allergies can be outgrown.
If you suspect you’ve outgrown a peanut allergy, follow-up testing with an allergist is recommended. If an allergist suspects through blood work and skin tests that you might have outgrown the allergy, an oral food challenge may be recommended. An oral food challenge is a step-by-step process in which the patient, under the careful supervision of a trained clinician, consumes small amounts of a suspected allergen over 3 to 4 hours. This is done with the expectation that you’ll be able to consume the peanuts safely. Conversely, because peanut allergies can have severe or life-threatening reactions, failing to obtain a clinical diagnosis when there is a suspected history of reaction can present significant health and safety risks.
10. Treatment for peanut allergies
Oral immunotherapy (OIT) is approximately 85 percent effective for single or multiple food allergies and is safe for all ages. Over time, the OIT process continually exposes the patient to increasing amounts of an allergen. As OIT progresses, the body is gradually desensitized and learns to adapt to the allergen. This decreases dietary restrictions and increases protection against severe or life-threatening reactions due to accidental exposure. Some specialized clinics, such as Latitude Food Allergy Care, offer personalized treatment plans for patients with allergies to peanuts and other foods. Palforzia is an FDA-approved drug for peanut allergy treatment, and the FDA also recently approved Xolair (omalizumab) for treating all food allergies, including peanut allergy. It is expected that in the next decade, there will be more treatment options for people with peanut allergies.
About Latitude Food Allergy Care
Latitude Food Allergy Care is the leading network of clinics providing life-changing testing and treatment, including oral immunotherapy (OIT), to help families with food allergies live more freely. Latitude was founded in 2018 by food allergy parents in partnership with world-renowned researchers to provide an exceptional patient experience specifically designed for the needs of food allergy patients of all ages. Led by board-certified allergists, Latitude has provided evidence-based solutions like OIT to more than 6,000 patients with single and multiple food allergies, including those with the most severe food allergies.
Latitude has four clinics in the San Francisco Bay Area, a clinic on the Upper East Side in New York City, and will open a new clinic in Brooklyn in February 2024. Latitude is affiliated with UCSF Benioff Children’s Physicians and Weill-Cornell Medicine, and partners with Columbia University Medical Center and Sean N. Parker Center for Allergy & Asthma Research at Stanford University. Latitude accepts insurance from most major carriers. For more information, please visit latitudefoodallergycare.com and follow Latitude on Instagram, Facebook, and Linkedin.