A peanut allergy is a serious reaction to peanuts that can result in death. Therefore, adults and children need to manage their condition carefully to avoid anaphylaxis.

This article explains what a peanut allergy is and how it develops.

It also looks at the symptoms a person may experience, the treatment options available, and advises on when to see a doctor. Additionally, it looks at what research says about preventing peanut allergies.

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A 2018 article states that peanut allergies affect approximately 1.2% of Americans and are the most common food allergy in children, affecting 25% of those with a food allergy.

When someone becomes allergic to peanuts, their body produces peanut-specific IgE antibodies. If the individual consumes peanuts, it triggers a reaction when it encounters these antibodies. The body then releases inflammatory agents, such as histamine, cytokines, and chemokines, resulting in allergic symptoms.

Some individuals with a peanut allergy can have severe symptoms if they consume even a small amount of peanuts. Moreover, in some people, consuming peanuts could result in death. Therefore, someone with a peanut allergy must know how to manage their condition and treat any symptoms.

Tree nut vs. peanut allergy

Peanuts are legumes belonging to the same family as peas and lentils and growing underground. Therefore, they fall under a different category than other tree nuts, such as walnuts and almonds, which grow on trees.

According to the American Academy of Allergy, Asthma, and Immunology, 30% of individuals with peanut allergies are also allergic to tree nuts. However, having a tree nut allergy does not necessarily mean an individual is allergic to peanuts.

Anyone with a tree nut allergy should talk with a doctor to see if they are also allergic to peanuts.

Symptoms of a peanut allergy include:

  • hives
  • wheezing
  • swelling of the tongue or lips
  • vomiting
  • shortness of breath or breathing difficulties
  • pale or blue coloring of the skin
  • indigestion
  • diarrhea
  • stomach cramps
  • a repetitive cough
  • tightness in the throat or a hoarse voice
  • weak pulse
  • dizziness
  • confusion


Anaphylaxis is a severe allergic reaction requiring immediate medical attention. Anaphylaxis can occur suddenly and worsen quickly, putting a person into shock.

The American College of Allergy, Asthma, and Immunology (ACAAI) advises that early symptoms of anaphylaxis may be mild and include a runny nose, a skin rash, or a strange feeling. However, these symptoms can quickly lead to more serious ones, including:

  • trouble breathing
  • tightness of the throat
  • a hoarse voice
  • nausea or vomiting
  • abdominal pain
  • diarrhea
  • dizziness or fainting
  • hives or swelling
  • low blood pressure
  • rapid heartbeat
  • feeling of doom
  • cardiac arrest

People with a peanut allergy should carry an auto-injector of epinephrine to treat anaphylaxis. Two injections may occasionally be necessary to control symptoms. If someone sees a person experiencing anaphylaxis, they should seek emergency medical attention immediately.

To manage a peanut allergy, individuals should strictly avoid peanuts and any foods that contain them. Additionally, people with peanut allergies should avoid products that have become contaminated through production processes.

The ACAAI advises that many individuals with an allergy to peanuts can safely consume foods containing highly refined peanut oil, which manufacturers have purified and removed the peanut protein from. However, people should avoid cold-pressed or unrefined peanut oil that will cause an allergic reaction.

Another option for those aged 4–17 is a medication called Palforzia that the Food and Drug Administration approved in 2020. A person can continue taking the medication if they are 18 or older.

Palforzia is an oral form of immunotherapy and aims to reduce allergic reactions — including anaphylaxis — if a person experiences accidental exposure to peanuts. The medication is a powder manufactured from peanuts. A person empties the powder into semisolid food that they can eat, such as applesauce.

A person taking this medication should continue to avoid peanuts in their diet. If a person is considering this medication, they should consult an allergist.

Treating a reaction

If someone has a severe reaction such as anaphylaxis, epinephrine is the first-line treatment. Therefore someone with a peanut allergy should carry an injectable dose with them at all times.

Learn more about epinephrine injections.

In the case of anaphylaxis, doctors may also use intravenous fluids and require an individual to stay overnight in hospital until they are stable.

A medical professional may also use antihistamines, corticosteroids, and bronchodilators to manage allergic reactions to peanut. However, these medications do not treat anaphylaxis.

The goal is to prevent a reaction if someone eats peanuts accidentally or to induce tolerance to peanuts so someone can eat them safely. However, people with a peanut allergy should avoid trying this themselves.

Peanuts cause IgE (antibody)-mediated responses in some people, which result in an inflammatory cascade and allergic reactions.

Research suggests that the proteins in peanuts may have evolved into potential allergens as a result of the plant’s defense system.

Infants who have severe eczema or an allergy to eggs are at a higher risk of developing a peanut allergy.

Additionally, Food Allergy Research and Education suggest that younger siblings of children who are allergic to peanuts may be at higher risk themselves.

Experts state that to diagnose a peanut allergy, a doctor may assess a patient’s medical history and examine them physically. They may ask about the type and amount of food they eat and the accompanying symptoms they experience.

A doctor or allergy specialist may perform a skin prick test. To do this, a doctor will apply a drop of peanut extract and prick the skin, usually on the arm or back.

They may also measure peanut-specific IgE antibodies in blood serum. Additionally, for someone whose history of peanut allergy is less clear, a doctor may conduct an oral food challenge. They may ask a person to consume peanut protein and observe them carefully.

Learn more about how professionals diagnose allergies.

If someone experiences anaphylactic shock, it may affect their central nervous system, causing fainting or cardiac arrest.

Experts advise that a peanut allergy may also cause worsening of existing eczema.

If someone suspects a peanut allergy, they should contact their doctor, who can perform testing.

If a person has symptoms of anaphylaxis or a severe allergic reaction to peanuts, they should seek emergency medical treatment immediately, as failure to do so could be life threatening.

A peanut allergy is typically lifelong. However, approximately 20% of people who experience a peanut allergy early in life will eventually develop a tolerance for peanuts.

A peanut allergy can be fatal if a person ingests peanuts. As a result, people should take care to avoid peanuts and ensure that they are carrying an auto-injector of epinephrine.

The National Institute of Allergy and Infectious Diseases suggests that people introduce peanut-containing foods to a person’s diet early in life. This may be particularly applicable to infants that already have eczema or another food allergy, such as egg.

A peanut allergy is a potentially life threatening allergic reaction that results in a range of symptoms from hives to breathing difficulties.

Someone who has anaphylaxis due to consuming peanuts needs urgent medical attention and an epinephrine injection as the first line of treatment.

To manage a peanut allergy, individuals should avoid eating any foods containing peanuts or inhaling peanut particles. A doctor may advise them to carry an injectable epinephrine device.

Children with other allergies are at a higher risk of a peanut allergy, and experts suggest that introducing peanuts from an early age may prevent it from developing.