Peanut allergy is one of the most common food allergies.
Peanuts are not the same as tree nuts (almonds, cashews, walnuts, etc.), which grow on trees. Peanuts grow underground and are part of a different plant family, the legumes. Other examples of legumes include beans, peas, lentils and soybeans.
Being allergic to peanuts does not mean you have a greater chance of being allergic to another legume.
Peanuts can cause a severe, potentially life-threatening allergic reaction (anaphylaxis). Allergic reactions can be unpredictable, and even very small amounts of peanut can cause one.
Casual skin contact is less likely to trigger a severe reaction. But casual contact can become a problem if the affected area then touches the eyes, nose or mouth. For example, if a child with peanut allergy gets peanut butter on her fingers and rubs her eyes, she can have a reaction.
If you have a peanut allergy, keep an epinephrine auto-injector (such as an EpiPen®, Auvi-Q™ or Adrenaclick®) with you at all times. Epinephrine is the first-line treatment for anaphylaxis.
To prevent a reaction, it is very important that you avoid peanut and peanut products. Always read food labels to identify peanut ingredients.
If you are allergic to peanuts, you have a 25 to 40 percent higher chance of also being allergic to tree nuts.1 Also, peanuts and tree nuts often touch one another during manufacturing and serving processes. Discuss with your allergist whether you need to also avoid tree nuts.
Peanuts are one of the eight major allergens that must be listed on packaged foods sold in the U.S., as required by federal law. Download this resource about how to identify peanut ingredients on food labels.
Avoid foods that contain peanuts or any of these ingredients:
- Arachis oil (another name for peanut oil)
- Artificial nuts
- Beer nuts
- Cold-pressed, expelled or extruded peanut oil*
- Ground nuts
- Lupin (or lupine)—which is becoming a common flour substitute in gluten-free food. A study showed a strong possibility of cross-reaction between peanuts and this legume, unlike other legumes.
- Mandelonas (peanuts soaked in almond flavoring)
- Mixed nuts
- Monkey nuts
- Nut meat
- Nut pieces
- Peanut butter
- Peanut flour
- Peanut protein hydrolysate
*Highly refined peanut oil is not required to be labeled as an allergen. Studies show that most people with peanut allergy can safely eat this kind of peanut oil. If you are allergic to peanuts, ask your doctor whether you should avoid peanut oil.
But avoid cold-pressed, expelled or extruded peanut oil—sometimes called gourmet oils. These ingredients are different and are not safe to eat if you have a peanut allergy.
Peanuts can be found in surprising places. While allergens are not always present in these food and products, you can’t be too careful.
Remember to read food labels and ask questions about ingredients before eating a food that you have not prepared yourself.
- African, Asian (especially Chinese, Indian, Indonesian, Thai and Vietnamese), and Mexican restaurant food—even if you order a peanut-free dish, there is high risk of cross-contact
- Alternative nut butters, such as soy nut butter or sunflower seed butter, are sometimes produced on equipment shared with other tree nuts and, in some cases, peanuts. Contact the manufacturer before eating these products.
- Candy (including chocolate candy)
- Egg rolls
- Enchilada sauce
- Glazes and marinades
- Ice creams
- Pet food
- Sauces such as chili sauce, hot sauce, pesto, gravy, mole sauce and salad dressing
- Specialty pizzas
- Sunflower seeds (which are often produced on equipment shared with peanuts)
- Sweets such as pudding, cookies, baked goods, pies and hot chocolate
- Vegetarian food products, especially those advertised as meat substitutes
Also, peanut hulls (shells) can sometimes be found in compost, which can be used as lawn fertilizer. Before you hire a contractor, ask whether they use peanut hulls in their compost so you can make an informed decision.
Allergy to peanuts appears to be on the rise in children. According to a FARE-funded study, the number of children in the U.S. with peanut allergy more than tripled between 1997 and 2008.2 Studies in the United Kingdom and Canada also showed a high prevalence of peanut allergy in school-aged children.
Peanut allergies tend to be lifelong, although studies show that about 20 percent of children with peanut allergy do eventually outgrow their allergy.
Younger siblings of children who are allergic to peanuts may be at higher risk for allergy to peanuts. Your doctor can guide you about testing for siblings. Introducing infants to peanuts early on may help prevent them from developing this food allergy.
1 Ibid (same as previous reference); see also Sicherer SH, Munoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol 2003; 112(6):1203-7.
2 Sicherer SH, Munoz-Furlong A, Godbold JH, Sampson HA. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J Allergy Clin Immunol 2010; 125(6):1322-6. [LINK to ADVANCING A CURE>FARE Research Grants>Selected Completed Studies > Sicherer, Prevalence of Peanut and Tree Nut Allergy in the United States]
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In early January, the National Institute of
Managing life with a food allergy means reading packaged food labels—every time you purchase that food.
We were distraught and unsure how to make all of the changes needed to keep him safe. FARE has been our primary resource from the day of diagnosis and still is today, four years later.