Introduction
A peanut allergy is one of the most common causes of food allergies, which can sometimes lead to a severe allergic reaction known as anaphylaxis. Anaphylaxis is a life-threatening symptom of an allergic reaction. Anaphylaxis can occur in some people with peanut allergies even after ingesting very small amounts of peanuts.
A peanut allergy occurs when your body identifies peanuts as a harmful substance, and your immune system starts to overreact to them. Although there is no cure for a peanut allergy, some children outgrow it.
In children, peanut allergies have been increasing. There is still a risk of a more serious future reaction. It's crucial to consult your doctor even if you or your child has only experienced a minor allergic reaction to peanuts.
Symptoms of a Peanut Allergy
Symptoms of a peanut allergy usually occur within minutes of consuming peanuts. However, it can also occur within two hours. The severity of the symptoms of a peanut allergy can range from mild to severe allergic reactions known as anaphylaxis. Mild to moderate symptoms of the allergic reaction are:
- Skin reactions such as hives and redness
- Itching
- Diarrhea
- Stomach cramps
- Nausea or vomiting
- Runny nose
- Cough
Anaphylaxis is a life-threatening, severe allergic reaction that needs immediate treatment. The symptoms associated with anaphylaxis are:
- Narrowing of the airway
- Swelling of the throat
- Difficulty in breathing
- Wheezing
- Hoarse voice
- Swelling of the lips and face
- A sudden drop in blood pressure
- Increased heart rate
- Dizziness
- Confusion
- Pale or bluish coloration of the body.
Causes of a peanut allergy
A peanut allergy occurs when a protein content of a peanut is mistakenly identified as harmful by the body's immune system and starts attacking these proteins, releasing various chemicals into the bloodstream, resulting in symptoms of an allergic reaction.
This occurs due to exposure to peanuts in a number of different ways.
- Direct contact: This occurs by directly eating a peanut or a peanut-containing food. Occasionally, an allergic reaction also occurs when your skin is exposed to peanuts.
- Cross contact: This occurs when a food item or any product is unintentionally exposed to peanuts during manufacturing, processing, or transport.
- Inhalation: A peanut allergy might also occur when you inhale any dust, powder, or aerosol containing peanut protein. It can be made from peanut flour or peanut cooking oil.
It is not clear why some people get allergies while some do not and why some have only mild reactions while others have severe ones. However, there are risk factors that have a greater chance of developing a peanut allergy.
The risk factors for peanut allergy include:
- Age: Children, particularly infants and toddlers, are most likely to develop food allergies. Your digestive system develops more as you age, and your body is less likely to react negatively to allergen-inducing foods.
- Past allergy history: Some people outgrow their allergies to peanuts. Even if you appear to have grown out of a peanut allergy, it could return.
- Other allergies: If you develop an allergic reaction to another food, like a nut allergy, your risk of developing a peanut allergy increases. Furthermore, if you have any other type of allergy, such as hay fever, the risk of a peanut allergy increases.
- Family history of allergies: If any of your family members have a peanut allergy or any other type of food allergy, it increases the risk of you developing a peanut allergy.
- Atopy: Atopy can be defined as an exaggerated immunoglobulin E (IgE) response to a potentially harmless stimulus. People with atopic conditions such as atopic dermatitis or atopic rhinitis have an increased risk of developing a peanut allergy.
Diagnosis
The symptoms of an allergic reaction may not be the same for everyone, and the severity also varies from person to person. You need to see your health care provider if you suspect having a peanut allergy or your child is developing symptoms. They might ask a few questions regarding your experience.
The doctor might ask you the following questions:
- What were the symptoms you developed?
- What and how much did you eat?
- When did the symptoms start? (after exposure to suspected food)
- What did you do to relieve your symptoms?
- How long did the symptoms last?
- Did you have any other allergies?
- Do you have a family history of food allergies?
Based on the history taken by your doctor, they can order certain tests.
- Blood Test: A blood test can determine how your immune system reacts to specific foods by examining the concentration and type of allergy-causing antibodies in your blood. A higher number of immunoglobulin E (IgE) indicates an allergy. This test is known as immunocap radioallergosorbent (RAST).
- Skin test: A skin test can help to diagnose various types of allergic reactions. While performing a skin test, your doctor might make a few needle pricks on your arm or back and apply a small dose of different suspected allergens. After 15 minutes of allergen exposure, they interpret the results. An allergy to a particular allergen is diagnosed when there is redness and itchiness over the skin patch.
- Home kits: Various home testing kits are available to diagnose food allergies. These kits usually test blood samples. However, a hair sample test is also available for those who do not want skin pricks. One such kit in which tests can be done using a hair sample is the Advanced Food Intolerance Lab (AFIL), a food & drink sensitivity testing kit for adults & kids.
- Food Diary: Your doctor might also ask you to keep a food diary record, including your food intake, symptoms, and medications.
- Elimination diet: Your doctor may advise an elimination diet if it is unclear whether the symptoms are due to a peanut allergy or if they suspect you may be reacting to more than one kind of food.
You might be instructed to cut out peanuts or other questionable foods for a week or two before gradually reintroducing them to your diet. This method can be used to connect symptoms to particular foods. This method cannot be used if you have had a severe reaction to food.
Treatment, Prevention, and Cure
If you have symptoms of a peanut allergy, your doctor might prescribe certain medications to treat the symptoms of an allergic reaction. Here is the list of medications used for treating symptoms of allergy.
- Epinephrine: This is an emergency life-saving treatment that immediately helps to reverse the symptoms associated with anaphylaxis. Many people carry an epinephrine autoinjector, which the patient or their caretaker can use. When you press this device against your thigh, a single dose of medication is injected using a syringe and a hidden needle.
So, if you have a history of anaphylactic reactions, you need to know how to use the epinephrine autoinjector.
- Antihistamines: This medicine helps reduce symptoms such as itching, congestion, or a runny nose. However, the medicine can make you drowsy, so you need to avoid driving and operating heavy machinery while taking medicine.
- Corticosteroids: Corticosteroids help to control delayed symptoms such as swelling and also help to open the airway for breathing.
The mentioned treatment options are for treating allergic symptoms once exposed. But it would help if you avoided exposure to peanuts as much as possible to avoid symptoms. You can follow a few tips to prevent exposure, such as:
- Pay close attention to what you eat and always check the label.
- Watch for phrases like "may contain peanuts" and "made in a factory on machinery that may also have been used to process peanut products."
- Always ask about the ingredients of any food when you are going out to eat.
- Always be prepared for an allergic reaction and carry two epinephrine autoinjectors with you.
Cure and Prevention.
There is no cure for a peanut allergy, but children could outgrow it. A new treatment that uses peanut protein powder may provide additional protection for your child, who is between the ages of 4 and 17. The FDA has only approved one oral immunotherapy product, called Palforzia, to treat peanut allergies at this time. This type of treatment is called oral peanut immunotherapy.
A child who is allergic to peanuts is gradually exposed to them, which reduces the likelihood that their immune system will react if they accidentally consume a peanut product. This does not imply that your child can eat peanuts at any time, though. Your child still needs to avoid peanuts and carry two epinephrine autoinjectors even after receiving this treatment.
For high-risk infants who have already begun solid foods, a recommendation has been made to introduce peanut-containing foods as early as 4-6 months after determining that it is safe to do so.
Final Takeaway
A peanut allergy is a fairly common condition affecting children. However, some of them outgrow the condition by adulthood.
Peanut allergies can occur even with a small amount of exposure and can sometimes lead to a life-threatening condition called anaphylaxis.
Therefore, if you have a peanut allergy, you should strictly avoid peanuts and seek medical help from your health care provider.
References:
Togias, A., Cooper, S. F., Acebal, M. L., Assa'ad, A., Baker, J. R., Beck, L. A., ... & Boyce, J. A. (2017). Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases–sponsored expert panel. World Allergy Organization Journal, 10(1), 1-18.- Burks, A. W. (2008). Peanut allergy. The Lancet, 371(9623), 1538-1546.
- Sampson, H. A. (2002). Peanut allergy. New England Journal of Medicine, 346(17), 1294-1299.
- Hourihane, J. O. B., Kilburn, S. A., Dean, P., & Warner, J. O. (1997). Clinical characteristics of peanut allergy. Clinical & Experimental Allergy, 27(6), 634-639.
- Hourihane, J. O. B., Berger, A., Roberts, S. A., & Warner, J. O. (1998). Resolution of peanut allergy: case-control studyScience commentary: Why do some children grow out of peanut allergy?. Bmj, 316(7140), 1271-1275.
