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Allergic to peanuts = allergic to pecans?

Dear Alice,

I am allergic to peanuts. Does that mean that I am allergic to pecan nuts as well?

Dear Reader,

Being allergic to peanuts doesn't necessarily mean being allergic to tree nuts (and vice-versa). Being allergic to peanuts also doesn't automatically mean being allergic to other members of the legume family, such as lentils and soybeans. Similarly, being allergic to one kind of tree nut doesn't automatically result in being allergic to other tree nuts. However, most health experts recommend that people with peanut and/or tree nut allergies avoid all peanuts and tree nuts, just in case. A little introduction to peanuts and tree nuts might clarify this.

Peanuts are not actually nuts, but legumes, which are beans and peas. Peanuts, peanut products, and peanut by-products are found in many foods and in many variations, such as peanut flour, peanut oil, and peanut butter. The presence of peanuts in foods is tricky to identify; they can even be a hidden, unlabeled ingredient, such as hydrolyzed plant or vegetable protein. Also, cross contamination during manufacture of food products is another source of exposure to peanuts that can elicit allergic reactions, so some non-nut items are labeled as "may contain nuts."

Unlike peanuts, pecans are part of the tree nut family, which also includes almonds, walnuts, cashews, hazelnuts, pistachios, macadamia, chestnuts, and brazil nuts. Tree nuts are also present in a variety of foods and even in some bath and beauty products.

Allergy to peanuts and tree nuts, usually life-long, are two of the most common food allergies. Fortunately, many people with these allergies experience mild responses to the proteins found in peanuts and tree nuts, such as sneezing and/or itching. However, what is worrisome about these allergies is that some people experience severe enough reactions from miniscule amounts that can be life-threatening (e.g., difficulty breathing, loss of consciousness). In fact, about 100 people in the United States die each year from their peanut allergy. The most intense responses tend to be from ingesting food containing peanuts, tree nuts, or their derivatives, but inhaling air contaminated with peanut or tree nut dust, having skin or eye contact with something containing these items, and even kissing someone who recently consumed peanuts or tree nuts also can produce allergic responses. In particular, the sensitivity of peanut allergies and the prevalence of peanuts in our food supply and elsewhere have made peanuts a source of heated controversy for schools, camps, airlines, and restaurants concerning whether or not to ban them in these places.

What is in your control to prevent peanut and tree nut allergies is avoiding all peanuts and tree nuts (though accidental exposure could still happen no matter how vigilantly you avoid nuts). Educating oneself about the allergy (i.e., always asking about ingredients and reading food labels carefully) and preparing oneself for accidental exposure (i.e., always keeping epinephrine nearby) are other keys to managing a peanut or tree nut allergy. If you are uncertain about whether or not you can eat pecans safely, your health care provider may be able to refer you to an allergist. S/he can administer a skin prick, blood, and/or medically supervised food challenge test.

For more information about peanut, tree nut, and other food allergies, check out the Food Allergy and Anaphylaxis Network website.

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Last updated Apr 09, 2015
Originally published Jan 17, 2003