Peanut Allergy – Symptoms & Causes Fact Sheet

As one of the more common food allergies, a peanut allergy has the potential to cause a reaction ranging from mild discomfort, all the way to anaphylactic shock. It is an important  health consideration for many, as peanut allergies affect 1 in 50 children in the UK and appears to be increasing in frequency. Let’s explore peanut allergy symptoms, causes, testing methods, daily struggles and management techniques related to peanut allergies.

What are peanut allergies?

A peanut allergy is caused by the immune system overreacting to the specific proteins found in peanuts. The immune system sees the proteins as harmful, even when they are not, and this hypersensitivity can cause a wide range of symptoms. Even trace amounts of peanuts or peanut-derived ingredients can cause allergic reactions.

Food allergies, including peanut allergy account for a significant number  of severe allergic reactions. It usually manifests during childhood and continues on into adulthood. Even when experienced by the same individual, the severity of reactions can vary– so that what previously only caused a mild skin rash, could one day result in difficulty breathing.

What are the symptoms of peanut allergies?

The most common peanut allergy symptoms include:

• Skin reactions – itchy skin; hives; eczema; and swelling of the lips or face.
• Respiratory issues – congestion; sneezing
• Gastrointestinal issues – nausea; cramping; vomiting; or diarrhoea.

• Anaphylaxis – in addition to the features above, anaphylaxis can lead to symptoms of persistent coughing, a hoarse voice, difficulty swallowing, swelling of the tongue, difficult or noisy breathing, wheeze, dizziness, becoming pale or floppy, sudden sleepiness or collapse

What causes a peanut allergy?

The cause of peanut allergies is not fully understood, but a history of eczema or of an egg allergy increases the risk of developing a peanut allergy. However studies have shown that introducing peanut regularly into the diet at an early age, in a safely tolerated form, can prevent peanut allergy from developing.

Peanut Allergy Tests

Due to the intense and potentially fatal reactions that can come from peanut allergies, it’s important that peanut allergy tests are thorough and accurate. If your GP suspects you have a food allergy, including peanut allergies, you may be referred to a specialist, who will potentially use a combination of several diagnostic methods to confirm the diagnosis.

In terms of specific allergy testing, there are two main tests:

• A skin-prick test, where a small amount of allergen is applied to your skin and delivered into it with a lancet to see if it prompts a reaction.
• Blood tests that measure allergen-specific immunoglobin E (IgE) antibodies.

Medical history will be taken into consideration, including a detailed history of symptoms, dietary habits, and potential allergen exposures. This also includes the presence of allergies in the patient’s family.

A physical examination may include a closer examination of the skin, respiratory and gastrointestinal systems.

Management and prevention

Managing a peanut allergy relies on avoiding peanuts and peanut-derived ingredients to prevent allergic reactions. This can be done by:

• Paying close attention to ingredient lists on food packaging, and learning to identify sources that may be more obscure, such as flavourings and sauces.
• Informing any dining establishments that you visit of your peanut allergy, to allow them to prepare your food safely.
• Taking precautions to avoid any cross-contamination within your home. This may involve keeping separate utensils and storage containers for your peanut-free foods.
• Being prepared for what to do in case of an allergic reaction. Carrying antihistamines and an adrenaline auto-injector (eg. EpiPen or Jext in the UK) and making sure that you and the people closest to you know how to administer it should the need arise. Quick use of adrenaline is crucial for reversing severe allergic reaction symptoms.

Immunotherapy

Until recently, avoidance was the usual method of managing a peanut allergy, meaning that anyone diagnosed with this allergy would have to make significant adjustments to their lifestyle for the foreseeable future. However more recently, Peanut Oral Immunotherapy (OIT) has been increasingly adopted. A treatment called Palforzia has now been approved for use in the US and UK.

Immunotherapy involves giving small and steadily increasing amounts of the problem food . This helps to gradually desensitise them to the allergen, meaning that they can tolerate certain amounts of it without developing symptoms. In allergies such as peanut allergies where there is the potential for life-threatening allergic reactions, any reduction of symptoms can greatly improve both peace of mind and quality of life.

Living with a peanut allergy

Living with a peanut allergy can be challenging. Lifestyle adjustments must be made, especially in social, educational and recreational settings. It can make travel difficult, prevent people from taking part in events that occur in environments that cannot be reliably allergen-free, and can take a serious toll on mental health.

Schools and daycare

If you are the parent of a child with a peanut allergy, it’s important to work with schools to implement the necessary allergy management protocols. Schools should be capable of safeguarding children with peanut allergies, but any information you can provide them about your child’s specific peanut allergy symptoms, and the severity of their reactions, will help to ensure they can create the appropriate emergency action plan.

Travelling

Travelling with a peanut allergy requires appropriate research, and planning. Researching destination-specific cuisines can help you understand the prevalence of peanuts in the food you are likely to encounter, and might inform your decisions about where to travel to. It may help to prepare a translation of your allergies into the local language to ensure that you can be easily understood. Always having your emergency medications at hand to treat an allergic reaction, looking at airline policies and identifying medical facilities near to where you’ll be staying, can also help to give you peace of mind. As can bringing allergy-safe snacks, for situations where you don’t feel entirely sure that your food will be peanut-free.

Social impact

Making sure that those you spend time with (e.g. friends, family, coworkers) understand the nature of your allergy is important, and allows them to facilitate accommodations to minimise the risk of any accidental exposure. You might prefer to prepare your own food for gatherings where you want to avoid the risk of any cross-contamination.

As many as 90% of peanut allergy sufferers report feeling frustrated and stressed by their allergy. It can lead to feelings of isolation, and cause anxiety over avoiding triggers. Be confident in asking for any accommodations that will help you to stay safe and feel secure navigating life with your allergy.

Conclusion

To summarise:

• Peanut allergy is one of the more common food allergies and can be associated with severe allergic reactions.
• Reactions do not always present with the same symptoms every time you are exposed to the allergen.
• Symptoms can vary from mild irritation to potentially deadly anaphylactic shock.
• Diagnosis usually involves a clear history of a reaction to peanut, combined with either a skin-prick test, a blood test, or both
• Avoidance is the commonly accepted form of management and you might need to make accommodations to your lifestyle in order to manage a peanut allergy.
• Immunotherapy for peanut allergies is a rapidly advancing field, and is proving to be a successful management strategy.

As the largest provider of Palforzia in Europe, the Allergy Centre of Excellence is on the frontline of managing peanut allergies in children and providing potentially life-saving immunotherapy and desensitisation. If you or your child may benefit from this treatment, find out more about Palforzia and the costs of immunotherapy today.