Tree nut allergy basics

While an tree nut allergy is not the same as an allergy to peanuts, there is some overlap—as many as 30 to 40% of peanut-allergic individuals also have an allergy to tree nuts. The prevalence of tree nut allergies appear to be increasing, now affecting about 0.4-0.5% of the U.S. population. The most common tree nut allergies are to cashew, pistachio, and walnut.

Tree nuts grow on trees, in contrast to peanuts, which are legumes that grow in the ground. Some of the more common tree nuts are listed.

  • Almonds
  • Brazil Nuts
  • Cashews
  • Hazelnuts
  • Macadamia Nuts
  • Pecans
  • Pine Nuts
  • Pistachio Nuts
  • Walnuts

Tree nut allergy begins in childhood, and roughly 50 percent of kids who are allergic to one tree nut are allergic to another. That means if a child has an almond allergy, there’s a good chance he/she also has a walnut allergy (or any other combination). 30% of children with peanut allergy also have a tree nut allergy.  The common severe tree nut allergies are due to cashews, pistachios, walnuts and pecans.  Just like peanut allergy, if a child has has a severe nut allergy there is only a small chance of outgrowing it.

Symptoms of an Allergic Reaction

Tree nut allergy symptoms can be difficult to spot since they’re similar to those you would see with other types of allergies. When you eat anything containing nuts or even foods that come in contact with nuts, you might notice symptoms like:

  • Nausea and vomiting
  • Abdominal pain and cramps
  • Difficulty swallowing
  • Diarrhea
  • Itching or swelling of the lips, tongue, throat, skin, or other areas

The most severe allergic reaction to tree nuts is anaphylaxis—a life-threatening episode that can cause severe hives, wheezing, vomiting, rapid heartbeat, seizing, trouble breathing, and/or chest pain. This is why food allergy testing is so important.

Tree Nut Allergy Testing & Diagnosis

At Allergy Group NJ, our doctors will order a combination of skin tests, blood tests, and component blood testing to gain greater clarity about the risk for severe reactions. Mild and local reactions to tree nuts such as itching of the mouth may be due to cross-reactivity with tree pollens, and are not anaphylactic in nature  All tree nuts are not the same, so a complete evaluation will help us make an accurate diagnosis and inform you what is safe to eat and what is not.

Oral Immunotherapy (OIT): A Promising New Treatment

While there’s no official cure for tree nut allergies, tree nut immunotherapy is the closest thing.

OIT gradually exposes you to small doses of tree nuts over time, desensitizing your body, retraining your immune system, and decreasing allergic reactions to nuts. We’ll work with you one-on-one to determine if tree nut OIT is right for you.