Nut Allergies

Peanut and tree nut allergies are two of the most common food allergies in the UK, with the former affecting about 1 in 55 children. Allergic reactions range from mild to extremely severe symptoms. On rare occasions, patients can even experience life-threatening symptoms.

Although some children can outgrow peanut and tree nut allergy, others can retain  the allergy into adulthood. In some cases, patients even report a higher sensitivity as they grow older.

London Allergy Care and Knowledge helps patients manage the symptoms of peanut and tree nut allergy so they can live happier and more fulfilling lives.

Peanut Allergy vs Tree Nut Allergy

A nut allergy refers to either a peanut allergy or a tree nut allergy. A peanut allergy is a heightened sensitivity to peanuts, which are legumes grown underground. Technically, therefore, peanuts are not classified as nuts.

Tree nut allergy, on the other hand, is an extreme sensitivity to nuts that grow on trees, which include: Brazil, Hazelnut, Almond, Walnut, Cashew, Pine Nuts, Macadamia, Pecan and Pistachio.

If you have an allergy to one tree nut, it’s likely that you are allergic to other tree nuts as well.

Can a Patient Have Both Types of Allergies?

Having a peanut allergy does not necessarily mean a patient has a tree nut allergy as well. Some patients are allergic to peanuts but are perfectly fine eating tree nuts (and vice versa).

However, allergy to both peanuts and tree nuts simultaneously is not uncommon. Those with an existing peanut allergy have a 30-40% higher chance of developing a tree nut allergy due to the fact that these food items have similar types of proteins. Some patients who are allergic to one avoid the other just for good measure.

At LACK, we can provide definitive assessments to ensure that our patients have exact knowledge about their allergies and which food items to avoid, or indeed, reintroduce. We highly recommend visiting our allergy clinic to determine your specific allergies if you are unsure about your ability to eat certain types of food.

In a Nutshell

Food allergies occur when the body’s immune system overreacts to a certain kind of food. These substances, although harmless, are seen as a threat, so the body fights them off and causes different allergic reactions.

In the case of peanuts and tree nuts, the immune system overreacts to the proteins found in the nuts. The most common symptoms are raised red bumps of the skin, called hives. Some patients experience anaphylaxis, a dangerous and severe allergic reaction that requires immediate medical intervention.


Patients experience a range of allergic reactions with variable severities due to the fact that each individual’s immune system and level of sensitivity varies too.

Immediate allergic reactions usually occur between 20 minutes and 2 hours from exposure.

Mild Allergic Reactions

Mild reactions include: Hives (also known as urticaria), itchiness and tenderness of the skin, rashes, tingling of the throat and mouth, swelling of the lips, runny nose, cramps, stomach pain, nausea/ vomiting or diarrhoea.

In some cases, these mild symptoms may develop into severe symptoms.Severe Allergic Reactions

Severe reactions include: difficulty breathing, wheezing, swelling of the tongue, swelling or tightness of the throat, difficulty talking, dizziness or collapse.


Anaphylaxis is the most severe form of allergic reaction. Anaphylaxis can be dangerous, or even fatal, and patients require urgent medical attention. Symptoms include: the throat and airways become swollen, which leads to extreme difficulty in breathing—sometimes it’s even impossible to breathe. In some cases, the face swells, blood pressure drops, and the heart rate becomes irregular.


There are proteins in tree nuts and peanuts that remain intact even if they are cooked and processed. When a patient’s body detects these allergens, it releases a chemical called histamine, which facilitates many of the allergic reactions.

Risk Factors

Some people are more likely to have peanut and tree nut allergies than others:

  • Children (like infants and toddlers) run a higher risk of food allergies compared to adults.
  • A family history of food allergies could make you more vulnerable to one.
  • People with eczema are more likely to be allergic.

To properly manage a nut allergy, you have to confirm a peanut allergy or determine the specific tree nut the patient is allergic to. When you visit an allergist, the patient will undergo certain tests :

  • Skin Prick Test – This test checks allergic reactions. The nurse applies a drop of an allergen onto the skin and then uses a lancet to prick the extracts into the skin’s surface. The test is not painful and takes about 15 minutes.
  • Blood Test – This test checks the immune system’s response to peanuts or tree nuts by measuring the allergy-related antibody known as immunoglobulin E (IgE). The clinic will take a sample of your blood and send it to a laboratory.
    Your allergist will explain these tests in full detail during your consultations.

The treatment plan for allergies is decided on a case-to-case basis. Nevertheless, treatments are likely include:

  • Avoiding the allergen – Patients allergic to peanuts and tree nuts should exercise caution choosing food. This is more difficult than other food allergies, as peanuts and tree nuts are common ingredients in food, beverages, and even non-edible items.

As such, patients and the people they live with have to check for nuts in baked goods, desserts, sauces, soups and stews, salads, lotions and soaps, and more.

  • Taking medication – Some patients would be prescribed antihistamines to mitigate mild symptoms should they arise. This also includes the proper intervention for an anaphylactic shock.
  • Creating a safe environment – If a child has a nut allergy, the family need to inform all care-givers or people in authority in the child’s life, such as care providers, coaches, teachers and parents of friends.

A more medical approach is food desensitisation. This treatment must only be conducted under the supervision of a medical professional. Please contact LACK to discuss this option.

Is There a Way to Prevent Nut Allergies?

The LEAP study concluded that food allergies are preventable when infants are weaned onto high risk allergens from 3 months of age whilst either being breastfed or bottle fed.

Currently in the UK, the Department of Health guidelines recommends exclusive breastfeeding until six months, followed by complementary feeding of potentially allergenic foods including peanuts and tree nuts. Meanwhile, current European and American infant guidelines suggest feeding complementary foods as early as four months.

Professor Lack and our specialist allergy nurse will guide you through safe food introduction as part of your appointments and ongoing care.

Managing Allergies for a Higher Quality of Life

Even if the patient doesn’t experience extreme allergic reactions, an allergy can impair the quality of their life. An allergy can limit the food you are able to safely eat.

London Allergy Care and Knowledge will help you manage your allergies in a friendly and patient-centric environment.