Peanuts were once a snack-time staple, but these days, they are largely off-limits for a growing number of kids and adults. It’s common now not to serve certain foods at birthday parties or school to keep kids with peanut allergies safe. 

It can seem scary how much damage a little piece of food can do, but you can lower the risk of having a severe reaction if you learn how to spot your symptoms and avoid peanuts.

Who Is at Risk, and Why?

Children -- especially toddlers and infants -- are more likely to develop food allergies.

If you or other family members have other types of allergies, peanuts could be a problem.

Also, if you have eczema, you may also be more likely to be allergic.

If you have peanut allergy, that doesn’t have to mean you are more likely to have a problem with other nuts or legumes. Peanuts grow underground and are different from almonds, cashews, walnuts and other tree nuts.

But recent studies found that 25% to 40% of people who have peanut allergy are allergic to tree nuts, too.

Several Ways to Come in Contact

Most people who are allergic have trouble when they have direct contact with peanuts -- whether eating them by accident or not realizing they are part of a salad or recipe.

It can also happen through skin contact or by breathing in peanut dust or eating something made with gourmet or unrefined peanut oil.

But did you know that if you are very sensitive, indirect contact can trigger a reaction?

It’s called cross-contact. For instance, a chef might be making a meal for you. It contains no peanuts, but they may have used their knife for an earlier task. If the knife touched peanuts and wasn’t washed well, trace pieces could get into your dish.

Make sure any restaurant or dinner host is aware and taking care to avoid cross-contact.

What Problems Can Peanuts Cause?

Symptoms of an allergic response to peanuts will usually start within minutes of exposure, and they can include:

  • Tightening in the throat
  • Shortness of breath or wheezing
  • Skin reaction such as hives or redness
  • Tingling or itching in the mouth or throat
  • Diarrhea, nausea, stomachcramps or vomiting
  • A runny nose

A Severe Reaction: Anaphylaxis

This is a life-threatening allergic reaction and needs emergency treatment. Peanuts are one of the most common causes of anaphylaxis, which can affect several parts of the body all at once.

Your risk may be higher if you have allergies or asthma, a family history of anaphylaxis or if it’s happened to you before. The FDA has recently approved the medication Palforzia for children aged 4 to 17 with peanut allergiies to help minimize any reaction. While they should still avoid contact with peanuts, it helps reduce the risk of them being life threatening.

Certain people with known peanut allergies should carry an injector. You can get one from your doctor. If the symptoms strike, use your epinephrine (adrenaline) injector, such as Auvi-Q, EpiPen, Symjepi or a generic version of the auto-injector..

Call 911 even if you start to feel better. You will still need emergency medical care because you may have a delayed reaction.

The signs of an attack can include:

  • Swelling of the throat that makes it hard to breathe
  • Dizziness or fainting
  • A big drop in blood pressure
  • A rapid pulse
  • Blocked airways

What’s Involved With an Allergy Test?

If you think you are allergic to peanuts, see an allergist. Start a food diary before the appointment and keep track of any reactions.

If you’ve never had a severe reaction, they might suggest what’s called an “elimination diet.” You would cut out peanuts or other suspected foods for a week or longer. Then you would add them back in one at a time to see what might be causing you to react.

Your doctor may also do a skin test, placing a small amount of the food on you and then pricking it with a needle. If you are allergic to peanuts, you will develop a raised bump or reaction.

You may also need a blood test to check to see whether your immune system launches an allergic reaction to peanuts.

How to Avoid Peanuts

Foods that contain peanuts have to say so on the label. That’s the law in the United States. Read all food labels every time, because ingredients can change. There might be nuts in something you didn’t think had them. If you aren’t sure, check with the product’s maker.

There is no easy fix for the allergy. The only way to prevent a bad reaction is to avoid peanuts. But no matter how careful you are, you may still come into contact with them because they’re so common. It is important to know how to act fast in a life-threatening case.

Peanut allergies usually are lifelong for most people. But research finds that about 20% of children who have the allergy outgrow it eventually. For children at risk of peanut allergies, (like those with a family history of it, or with other food allergies, or eczema) the recommendations to do allergy testing and introducing peanut products vary depending on the child's risk.

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