Are you peanuts?

Dear Dr. Mo: Why are some people allergic to peanuts? What is it about that allergy that makes it so dangerous?

Peanuts are healthy but could cause dangerous allergic reactions

Peanuts are healthy but could cause dangerous allergic reactions

Dear reader: Allergy to peanuts is a fairly common one among us humans.

In fact, when it comes to severe allergy attacks, this one is among the most common causes. There are even some anecdotal stories about strange ways people have come into contact with traces of peanuts and died almost instantly – these in fact may have been based on real life events.

This allergy exists in both adults and children and at times can really be very dangerous – for some people, even very small amounts of peanuts can cause a life-threatening reaction called ‘anaphylaxis’.

If you’ve had a mild reaction to peanuts previously, do not think you are in the clear – you may develop a more serious one at any time in the future. This is why even the smallest reaction to peanuts should be taken seriously every time and checked out by a doctor; this is especially valid for children.

To answer your question directly – it is not known why some individuals develop an allergy to peanuts and others don’t and why is it so severe in some people and only mild in others. What is known however is that for some reason, the immune system of allergic individuals sees peanuts as something harmful and dangerous and reacts to it by releasing symptom-causing chemicals into the blood stream.

I’ve heard people confusing food intolerance (i.e. intolerance to peanuts) with food allergy (i.e. allergy to peanuts).

Food intolerance and food allergy are two different, unrelated things.

Intolerance does not involve your immune system and you could still eat small amounts of that food with only mild digestive symptoms (or none at all).

Allergy on the other hand, deploys an immune response and the tiniest of amounts can cause very serious reactions (the most serious being Anaphylaxis, which can at times lead to death).

Signs and symptoms

Allergy to peanuts shows quickly – within minutes of exposure and varies in symptoms and signs from mild irritation to severe. These include:

  • Redness, hives or swelling on your skin
  • Tingling and itching sensations in and around your mouth and throat
  • Runny nose
  • Nausea, vomiting, cramps and diarrhea
  • Shortness of breath and wheezing sounds
  • The feeling that your throat is tightening

These signs and symptoms may at times quickly progress to the most severe and life threatening complication – Anaphylaxis.

What is the dreaded Anaphylaxis?

Anaphylaxis is a medical emergency, which requires an adrenalin shot (Epi Pen) and an immediate trip to the emergency room.

Anaphylaxis usually includes all of the above symptoms and signs in addition to:

  • Very rapid pulse
  • Significant drop in blood pressure (state of shock)
  • Constriction of airways
  • Edema (swelling) of the throat, which makes it very difficult to breathe
  • Dizziness and loss of consciousness

Exposure

Now, all of the symptoms I’ve listed can occur in any allergic reaction to anything so there is nothing too special about peanuts in that sense – what makes peanuts so important is our daily exposure to it, sometimes even without knowing it.

We can be exposed to peanuts directly, which is the most common way, by eating peanuts or peanut-containing food. Even skin contact can be enough to trigger a response in allergic individuals.

Cross-contact is unintentional introduction of peanuts into other foods during processing and handling – always read labels as they will have such information.

We can become exposed through inhalation of dust and aerosols containing peanuts (peanut flour, peanut oil).

Just the other day, I’ve seen a child walking around in a playroom with a peanut butter sandwich and it gave me chills. Allowing your kid to carry such a potent allergen while playing with other children is both reckless and dangerous as even peanut traces on the floor or a toy can send an allergic child into an anaphylactic shock. Dear parents – please be cautious about these things and mindful of potential consequences of your actions.

Be aware of the facts about peanut allergy and make sure you understand the gravity of that condition – just in case you find yourself in a situation where someone might depend on your prompt assistance: in such cases look for an Epi Pen (adrenalin shot) if available on site or on the allergic person (this automatic syringe should be injected in a thigh muscle or another available muscle) and immediately call your local emergency number.

For people who are not allergic, peanuts provide a source of healthy nutrients and should by all means be present in a diet.

Yours in health,

Dr. Mo