General Information

  • Reactions to food are common and can be divided into two categories, those caused by food allergy and all other reactions
  • Food allergies develop when the body's immune system has an abnormal reaction to one or more proteins in a food that can lead to serious allergic reactions
  • Other food reactions are not caused by the immune system but can cause unpleasant symptoms (examples include lactose intolerance, heartburn, food poisoning, and sensitivities)
  • Peanut allergy is one of the most common food allergies
  • Peanuts grow in the ground and are from the legume family (also includes beans, peas, lentils, soybeans, lupine bean)
  • Peanuts are different from tree nuts (ex almond, hazelnut, pecan, walnut, cashew, pistachio, Brazil nut, macadamia nuts, pine nuts, chestnuts, hickory nuts, shea nuts) which grow on trees
  • Around 30% of patients with peanut allergy are also tree nut allergic

Peanut Avoidance

  • Tell anyone with regular contact with you or your child about the allergy and avoidance of peanut
  • Read labels every time you buy something. Manufacturers can change products at any time
  • Be aware of cross contamination (transfer of peanut to a food that does not normally have peanut as an ingredient)
  • Food ingredients that indicate or may indicate the presence of peanut protein:
    • Arachide
    • Goober nuts
    • Nut meats
    • Arachis oil
    • Goober peas
    • Nut pieces
    • Beer nuts
    • Ground nuts
    • Peanut butter
    • Cacahouete
    • Kernels
    • Peanut flour
    • Cacahouette
    • Mandelonas
    • Peanut protein hydrolysate
    • Cachuete
    • Monkey nuts
    • Valencias
  • Some foods that contain or may contain peanut protein:
    • Almond paste
    • Energy bars
    • Nut substitutes
    • Baked goods (cake, cookies)
    • Glazes
    • Pastries
    • Candy
    • Granola bars
    • Peanut oil (cold pressed)
    • Cereals
    • Hazelnut paste
    • Satays
    • Chili
    • Hydrolyzed plant protein
    • Sundae toppings
    • Chinese food
    • Hydrolyzed vegetable protein
    • Szechuan sauce
    • Chocolate / Candy bars
    • Ice cream / frozen yogurt
    • Thai food
    • Curries
    • Icing
    • Trail mix
    • Dried salad dressing
    • Marzipan
    • Vegetarian meat substitutes
    • Egg rolls
    • Nougat
    • Vietnamese food

Allergic Reactions

  • Symptoms often occur within minutes up to 2 hours of exposure to peanut
  • Outside Symptoms
    • Face: Redness, itchy eyes / nose, swelling
    • Skin: Itching, redness, hives, swelling
  • Inside Symptoms
    • Face: Swelling lips and tongue, itchy mouth
    • Throat: Itching, tightness, hoarse voice, cough
    • Lungs: Trouble breathing, shortness of breath
    • Stomach: Vomiting, nausea, stomach pain, diarrhea
    • General: Dizzy, unsteady, drowsy, fainting
  • Not every reaction will look the same, a person can have different symptoms each time
  • Symptoms range from mild to life threatening, there is no way to predict if the reaction will be mild or severe
  • Anaphylaxis is a severe life threatening reaction with more than one body system affected (skin, breathing, stomach, general) and can occur WITHOUT skin symptoms such as hives

Treatment of Reactions

  • Antihistamines such as Benadryl will NOT stop severe reactions
  • An epinephrine auto-injector such as Allerject or EpiPen MUST be available at all times
  • If you are visiting an area without access to a hospital you should have 2 auto-injectors available
  • A medical identification device such a Medical Alert bracelet should be worn to outline the food allergy and that an epinephrine auto-injector is carried
  • Give epinephrine in the outer thigh if there are any of the following symptoms (listed in the table on the previous page)
    • General symptoms
    • Severe outside symptoms
    • Any inside symptoms
    • If you are in doubt, give the epinephrine
  • After epinephrine is given
    • Lie down / lie your child down
    • Call local emergency service and tell them someone is having an allergic reaction
    • If the reaction continues or worsens, give a second dose of epinephrine in 5 - 15 minutes (there is only 1 dose of epinephrine in each auto-injector, a second dose requires a new autoinjector)
  • Go to the nearest emergency room even if the symptoms are gone because the reaction can worsen or come back
  • Stay in the hospital for at least 4 - 6 hours of observation

Outcomes for Peanut Allergic Patients

  • About 20% of people outgrow the peanut allergy
  • Repeat skin testing and blood work every 1 - 2 years will help determine if the allergy is outgrown
  • An oral food challenge (eating peanut products in small steps ONLY in the doctors office) will be offered if your doctor feels it is safe
  • Peanut products should NEVER be tried outside of a doctors office to see if the allergy is outgrown

Additional information: www.anaphylaxis.ca or www.foodallergy.org