Allergic to Nuts? What to Watch Out For

Even a little bit that you swallow or inhale could cause an allergic reaction. You know to avoid the obvious foods, such as almond butter, cookies with walnuts baked in, or oatmeal studded with pistachios.

But other trigger foods, including sauces and gravies, are more surprising.

You need to know what to look for, so you can check before you buy or use a product.

Not Just Peanuts

Peanuts and tree nuts aren’t the same. But if you’re allergic to one, you may also need to avoid the other. Ask your doctor to be sure.

Tree nuts include:

  • Almonds
  • Brazil nuts
  • Cashews
  • Chestnuts
  • Filberts
  • Hazelnuts
  • Hickory nuts
  • Macadamia nuts
  • Pecans
  • Pine nuts
  • Pistachios
  • Walnuts

Check These Foods for Nuts

You may find peanuts or tree nuts in things like these:

  • Baked goods. Cookies, candy, pastries, pie crusts, and others
  • Candy. Chocolate candy especially; also nougat and marzipan
  • Other sweets. Ice cream, frozen desserts, puddings, and hot chocolate
  • Cereals and granola
  • Trail mix
  • Chili and soups. Peanuts or peanut butter are sometimes used as thickeners.
  • Grain breads
  • High-energy bars
  • Honey
  • International foods. Nuts are common ingredients in African and Asian cooking (especially Thai and Indian); also in Mexican and Mediterranean foods.
  • Mortadella. This Italian ham may include pistachios.
  • Veggie burgers
  • Sauces. These may include barbeque sauce, hot sauce, pesto, gravy, mole sauce, glazes, or marinades.
  • Salads and salad dressing

Avoid These Items

Nix them when you cook, and look for them on food labels:

  • Nut butters. Almond, cashew, peanut, and others
  • Nut pastes. Includes products like marzipan, almond paste, and nougat
  • Nut oils. Includes cold-pressed or expressed peanut oil, and others
  • Hydrolyzed plant or vegetable protein. These can have peanuts in them.
  • Peanut flour
  • Nut extracts, like almond extract

4 Tips to Avoid Nuts

1. Ask your server. Foods that don't contain peanuts or tree nuts can get contaminated if they’re made in the same place or with the same equipment. It can also happen in restaurants that use lots of ingredients, and even in ice cream parlors if scoops or other equipment are shared.

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2. Check the label each time you buy a product. Food makers sometimes change the recipe.

3. Look outside the kitchen. Nuts can also be in lotions, shampoos, and pet food. Check labels before you buy or use them.

4. Carry an epinephrine auto-injector. Carry two with you at all times, and know how to inject it. For some people, an allergic reaction to nuts can become life-threatening, so always be prepared.

If it happens, call 911 right away. If you have epinephrine, use it and repeat after 5 to 15 minutes if your symptoms haven’t improved. You’ll still need medical care right after you give yourself the shots -- even if your symptoms seem to stop -- in order to prevent a delayed reaction.

WebMD Medical Reference Reviewed by Carol DerSarkissian on January 23, 2017

Sources

SOURCES:

Food Allergy & Anaphylaxis Network: "Peanuts," Tree Nuts."

Food Allergy Initiative: "Tree Nut allergy."

KidsHealth: "Nut and Peanut Allergy."

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