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Tree nut allergy

tree nut allergy, tree nut allergy symptoms
A tree nut allergy is a hypersensitivity to dietary substances from tree nuts and edible tree seeds causing an overreaction of the immune system which may lead to severe physical symptoms1 Tree nuts include, but are not limited to, almonds, Brazil nuts, cashews, chestnuts, filberts/hazelnuts, macadamia nuts, pecans, pistachios, pine nuts,2 shea nuts and walnutsnote 1

Tree nut allergies are distinct from peanut allergy, as peanuts are legumes, whereas a tree nut is a hard-shelled fruit


  • 1 Description
  • 2 Prevention and treatment
  • 3 Tree nut alternatives
  • 4 See also
  • 5 Notes
  • 6 References
  • 7 External links


People with tree nut allergy are seldom allergic to just one type of nut,34 and are therefore usually advised to avoid all tree nuts, even though an individual may not be allergic to the nuts of all species of trees

Someone allergic to walnuts or pecans may not have an allergy to cashews or pistachios, because the two groups are only distantly related and do not necessarily share related allergenic proteins The severity of the allergy varies from person to person, and exposure can increase sensitization For those with a milder form of the allergy, a reaction which makes the throat feel like cotton may occurcitation needed Subjects allergic to tree nut can experience asthma, skin rushes, itchy throat, swollen eyes The most severe reaction can lead to anaphylaxis and sensitive subjects may need to carry with them at all times disposable adrenaline injectors prescribed by their GP Less severe reaction can be dealt with by assuming antihistamines tablet The raw nut protein usually causes a more severe reaction than the oil, and extra roasting or processing can reduce the allergic reaction Those diagnosed with anaphylaxis will have a more immediate mast cell reaction and be required to avoid all exposure to any allergen-containing products or byproducts, regardless of processing, as they are prone to even greater sensitivity An allergy test or food challenge may be performed at an allergy clinic to determine the exact allergens New immunotherapy treatments are being developed for tree nut allergy

This allergy tends to be lifelong; recent studies have shown that only about 9% of children outgrow their tree nut allergy5

Hazelnut has been used as a model tree nut in the study of tree nut allergies1

Prevention and treatmentedit

In the United States, the federal Food Allergen Labeling and Consumer Protection Act FALCPA requires that any packaged food product that contains tree nuts as an ingredient must list the specific tree nut on the label5 Foods that almost always contain tree nuts include pesto, marzipan, Nutella, baklava, pralines, nougat, gianduja, and turrón Other common foods that may contain tree nuts include cereals, crackers, cookies, baked goods, candy, chocolates, energy/granola bars, flavored coffee, frozen desserts, marinades, barbecue sauces, and some cold cuts, such as mortadella Tree nut oils especially shea nut are also sometimes used in lotions and soaps Asian and African restaurants, ice cream parlors, and bakeries are considered high-risk for people with tree nut allergy due to the common use of nuts and the possibility of cross contamination

There has been a single documented case of pink peppercorns often used in four-blend peppers causing an allergic reaction in those with nut allergies67 Pink peppercorn is not a true pepper, but dried roasted berries derived from Schinus terebinthifolius, a flowering plant in the family Anacardiaceae, native to South America Common names include Brazilian Pepper, Rose Pepper and Christmasberry Pink peppercorns are used as a spice to add a mild pepper-like taste to foods It may potentially cause an irritating skin effect and has been associated with atopic dermatitis in canines Interestingly, S terebinthifolius is a member of the family Anacardiaceae, which include plants in the genera Anacardium cashew and Pistacia pistachio No allergens from this plant have been characterized but there is potential for cross-reactivity among different members of the Anacardiaceae family

Treatment usually involves an exclusion diet and vigilant avoidance of foods that may be contaminated with tree nuts, nut particles, or oils The most severe nut allergy reaction is anaphylaxis,8 an emergency requiring immediate attention and treatment with epinephrine

Tree nut alternativesedit

Since many people with tree nut allergies also have peanut allergies, and peanut butter is a popular derivative of peanuts and widely used product, especially in the United States, many schools offer peanut-free menu options or implement entirely nut-free policies9 For instance, sunflower seed butter can provide an alternative in schools where peanut butter and peanuts have been banned However, a small number of people with tree nut and/or peanut allergies may also be allergic to sunflower seed butter According to one study a person with a known peanut allergy suffered an acute reaction to a "nut-free" butter containing sunflower seeds10

From a nutritional perspective, sunflower butter contains almost four times as much vitamin E as peanut butter, and about twice as much iron, magnesium, phosphorus and zinc Peanut butter contains higher levels of protein and slightly less sugar and fat11

Sunflower butter, or sunflower seed butter, is a food paste made from the oil of sunflower seeds12

See alsoedit

  • Allergy
  • List of allergies
  • Anaphylaxis
  • Food allergy
  • Asthma
  • Peanut allergy


  1. ^ Many seeds are commonly referred to as "nuts" even though botanists use the term more restrictively to refer to those that come from indehiscent fruits See the article about nuts for more information


  1. ^ a b Birmingham NP, Parvataneni S, Hassan HM, et al 2007 "An adjuvant-free mouse model of tree nut allergy using hazelnut as a model tree nut" Int Arch Allergy Immunol 144 3: 203–10 PMID 17570928 doi:101159/000103993 
  2. ^ "Tree nut allergy" Food Allergy Research and Education 
  3. ^ Goetz, DW July 2005 "Cross-reactivity among edible nuts: double immunodiffusion, crossed immunoelectrophoresis, and human specific igE serologic surveys Abstract" Ann Allergy Asthma Immunol 95: 45–52 PMID 16095141 doi:101016/S1081-12061061187-8 
  4. ^ MD, edited by Scott H Sicherer 2014 Food allergy : practical diagnosis and management 1 ed Boca Raton: CRC Press p 29 ISBN 9781466512689 CS1 maint: Extra text: authors list link
  5. ^ a b National Institutes of Health, NIAID Allergy Statistics "Archived copy" Archived from the original on April 6, 2010 Retrieved December 18, 2011 
  6. ^ "Food Allergy Case Reports: 422 A Rare Case of Food-induced Anaphylaxis to Pink Peppercorns" The World Allergy Organization Journal 5 Suppl 2: S152 PMC 3512604  
  7. ^ Ehlert; et al 2008 "Detection of Cashew Nut in Foods by a Specific Real-time PCR Method" Food Analytical Methods 1: 136–143 doi:101007/s12161-008-9023-6 
  8. ^ National Report of the Expert Panel on Food Allergy Research, NIH-NIAID 2003 http://www3niaidnihgov/about/organization/dait/PDF/june30_2003pdf
  9. ^ Groce, Victoria 2008-06-09 "Why is My Child’s School Nut-Free What food can she bring" foodallergiesaboutcom Retrieved 2011-03-03 
  10. ^ Hsu, Denise 2007 "Is "nut-free" sunflower seed butter safer for children with peanut allergy" The Medical Journal of Australia 198 9: 542–543 
  11. ^ Thomas, RG "Sunflower Seed Butter and Almond Butter as Nutrient-Rich Alternatives to Peanut Butter" PDF USDA Retrieved 2012-11-12 
  12. ^ Peabody, Erin 2005-05-17 "Sunflower Seed Butter Improves As It Spreads Across America" USDA Retrieved 2012-11-12 

External linksedit

  • Tree nut allergy at Food Allergy Initiative
  • "Are Nut Bans Promoting Hysteria" by Tana Parker-Pope at The New York Times 15 Dec 2008
  • Is Peanut Allergy Related to Tree Nut Allergies at PeanutAllergycom

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