An allergy to tree nuts is one of the most common allergies among children and adults. It is often linked to anaphylaxis, along with peanut and shellfish allergies. Even a small trace of a tree nut is enough to cause a severe allergic reaction. These allergies are usually long-term with only about 10% of people outgrowing them. Many individuals confuse tree nuts with other nuts such as chestnuts, coconuts, and shea nuts. However, these nuts are not tree nuts. Although the Food and Drug Administration labels coconut as a tree nut, it’s actually a fruit. Many individuals allergic to tree nuts can safely consume coconuts and other nuts. Discuss these exceptions with your NYC allergist to see what nuts will not cause an allergic reaction. Tree nuts are usually cross-reactive. This means that if you are allergic to one type of tree nut, you should try to avoid them all. You may also need to avoid peanuts. Peanuts are legumes and not related to tree nuts, but many people allergic to tree nuts also react to peanuts. An NY allergy specialist can help you decide what is safe for you or your child. Types Of Tree Nuts Almond Brazil nut Beechnut Chestnut Cashew Coconut Filbert Hazelnut Ginkgo nut Hickory nut Lychee nut Macadamia nut Nangai nut Pecan Pili nut Pistachio Pine nut Walnut Foods That Contain Tree Nuts And Should Be Avoided Mixed nuts Almond milk Some chocolates Nut butter Some baked goods Pralines Foods That Could Contain Tree Nuts Mortadella Nut oils Nut extract Breakfast cereals Ice cream Flavored coffee Crackers Marinades & sauces Tree Nut Allergy Symptoms Abdominal pain, cramps, nausea, and vomiting • Skin rash or hives • Difficulty swallowing • Itching of the mouth, throat, eyes, skin or any other area • Swelling of the face and throat • Shortness of breath • Anaphylaxis Tree nuts exhibit many severe allergic reactions. Even the symptoms that are considered mild come with extreme discomfort. These allergic reactions usually start off slow, affecting the skin. You might get a rash before you begin to swell. It’s best to treat these symptoms in the early stages instead of waiting for the reaction to possibly get worse. Mild symptoms are often brought on within minutes while more severe ones can take hours to appear. People who have had a mild allergic reaction in the past are at risk for more severe reactions in the future. So even if your first exposure doesn’t result in anaphylaxis, it can occur later. Diagnosing A Tree Nut Allergy Since tree nuts are responsible for severe allergic reactions, it’s important to get the allergy diagnosed in early childhood. Most people develop the allergy when they’re young, but it’s possible to get it later in life. You should get frequent allergy tests if you’re at risk of developing a tree nut allergy. Those at risk of developing this allergy include individuals allergic to peanuts as well as those with parents or other family members that suffer from food allergies. Visit an allergist for a skin prick test to get your tree nut allergy diagnosed. This form of allergy testing is most commonly used. A skin test diagnoses your tree nut allergy in less than 20 minutes. It involves pricking the skin with the allergen to evoke a reaction. A positive result is indicated by an itchy raised bump on the skin. If a bump or wheal doesn’t appear, there’s a strong possibility that you aren’t allergic to tree nuts. Skin prick tests do produce false results sometimes. In this case, a doctor might suggest a blood test for allergies. They will send you to a nearby lab to have your blood drawn and tested. This method is better for patients who suffer from skin conditions that might skew the results of a skin test. The blood test is also a better option for those that do not want to experience the discomfort of itchy skin from the prick. Tree Nut Allergy Treatment While there are studies focusing on immunotherapy for food allergies, these therapies have not yet been approved by the FDA. Food oral immunotherapy involves eating a small dose of the allergen and gradually increasing the amount over time. This method attempts to desensitize patients to the allergy. Food oral immunotherapy has been a controversial subject among doctors. Many believe that the risks are much greater than the benefits. This treatment could cause many severe allergic reactions in the process, making patients depend on epinephrine more often. Since epinephrine auto-injectors come with a heavy price tag for some people ($600 for a pack of two), it’s not an option for everyone. Until more research is done on eliminating food allergies, the best treatment is avoidance. The allergists at NY Allergy & Sinus Centers have provided a list of tree nuts you need to avoid. We understand that it’s not always possible to avoid to tree nuts, so carry your prescribed EpiPen or Auvi-Q. Frequently Asked Questions Is coconut a tree nut? The FDA labels coconut as a tree nut because they are closely related to palm tree nuts. They raise concern on food labels because they can cause similar or exact symptoms of tree nuts. If I’m allergic to pecans, can I still eat cashews? While tree nuts do often cross-react, it’s possible to be allergic to one tree nut and not the others. Talk to your allergist about which tree nuts are safe for you. Is acorn a tree nut? Acorns are considered tree nuts as they are from oak trees. They are also called oak nuts. How many people with a peanut allergy also have a tree nut allergy? Studies show that up to 50% of those with a peanut allergy are also allergic to at least one tree nut. Is pistachio a tree nut? Pistachio is technically a seed but considered a tree nut because of its hard shell and where it grows. It originates from the pistachio tree in Central Asia and the Middle East. Are peanuts considered tree nuts? Peanuts are not considered tree nuts. They are legumes and grow in the ground not on a tree. Conclusion If you worry that you or your child may have tree nut allergies, the allergists and associates at NY Allergy & Sinus Centers are here to help. NYASC has the latest treatments and testing, and we offer convenient asthma & allergy clinics throughout the NYC metropolitan area. Our NYC allergists can also help you find relief for your nasal and sinus conditions, asthma, & skin problems. Call us today at 212-686-4448.