Woman with peanut allergy experiencing symptoms

Peanut allergy symptoms explained

Medically reviewed on June 14, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Peanut allergies are one of the more common food allergies in the US. While immunologists and researchers have a grasp on the physical symptoms that accompany peanut allergy reactions, the root cause of the condition remains unknown.

Nevertheless, knowing which symptoms point to a mild, moderate, or severe peanut allergy is key to protecting yourself or a loved one who lives with an allergy. In addition to familiarizing yourself with the symptoms, food allergy testing can be a beneficial measure of how reactive your body may be to this type of food.

Below, we’ve outlined the most salient symptoms in play when a peanut-related allergy arises, as well as what the research has to say about peanut allergies and their treatment today.

What is a peanut allergy?

Peanut allergies are a type of food allergy, a reaction to proteins in peanuts that triggers an immune response in the body [1].

During an allergy attack, IgE antibodies—a protein responsible for identifying peanut antigens—trigger a deluge of histamines and other proteins that communicate distress signals between the body’s cells [2].

When histamines flood the bloodstream, it can induce a cascade of inflammatory responses that may affect [3]:

  • Skin
  • Eyes
  • Breathing passageways
  • Lungs
  • Blood vessels
  • Intestinal tract

Part of the danger for many people with peanut allergies lies in the immediacy of the allergic response. Peanut allergy symptoms tend to set in acutely, sometimes within minutes of exposure.

Often, an individual with a peanut allergy does not need to ingest peanuts to be affected. In severe cases, even trace amounts of peanuts can propel an individual into a life-threatening allergic reaction. Trace amounts of peanuts may result from:

  • Indirect exposure (e.g., if someone unpacks a peanut butter & jelly sandwich in your vicinity)
  • Cross-contamination (e.g., if you ingest M&Ms included in a bag of trail mix containing peanuts)
  • Food supply chains (e.g., if a food item was manufactured in a factory that also processed peanut-containing foods)

Symptoms of a peanut allergy

Peanut allergies usually manifest as a complex of symptoms that affect multiple physical systems at once. Four areas of the body tend to bear the brunt of the impact: the skin and mucous membranes, circulation, digestion, and respiration.

Cutaneous (skin) peanut allergy symptoms

Many people with peanut allergies display a noticeable adverse reaction in their skin, such as acute urticaria (hives) [2]. In some cases, cutaneous reactions may arise from being exposed to peanuts indirectly, even if the food is not ingested [1, 4].

Cutaneous symptoms may include:

  • Runny nose
  • Swelling, especially of the lips
  • Pins-and-needles sensation around the mouth
  • Itching
  • Rash
  • Hives

Digestive peanut allergy symptoms

While not always the most pronounced symptom, it’s not uncommon for the body to exhibit digestive distress during a peanut allergy response.

The digestive upset may involve [1]:

  • Abdominal cramping
  • Nausea
  • Vomiting
  • Diarrhea

Circulatory peanut allergy symptoms

Circulatory symptoms can be one of the most disruptive and even lethal symptoms of peanut hypersensitivity. Shock, or a severe decline in blood pressure, is one of the first signs of peanut-related anaphylaxis [1].

Other circulatory symptoms include [4]:

  • Weak pulse
  • Rapid heartbeat
  • Dizziness
  • Sweating
  • Lightheadedness
  • Pale or bluish-colored skin
  • Fainting

Respiratory peanut allergy symptoms

Respiratory distress is one of the most dangerous ways peanut allergies may manifest, limiting the affected individual’s ability to breathe.

People with a peanut allergy may experience:

  • Coughing
  • Wheezing
  • Difficulty breathing
  • Shortness of breath
  • Constriction of the airways
  • Loss of consciousness
  • Mild nausea

Peanut allergies and anaphylactic shock

People with a severe peanut allergy could be at a high risk of entering a state of anaphylactic shock [1].

During anaphylactic shock, blood pressure plummets, normal breathing becomes extremely difficult, and many peanut allergy sufferers may lose consciousness entirely [1].

Anaphylaxis is a medical emergency and is usually treated with an injection of epinephrine (adrenaline), often administered with an EpiPen. Epinephrine works by softening and dilating the breathing passageways while restoring blood pressure through constriction of the blood vessels. This helps restore the individual’s normal breathing patterns so that they can receive treatment and make a steady recovery [1].

Peanut allergy FAQs

If you’re concerned about yourself or a loved one’s peanut allergy, getting tested for food allergies is a great step to take to staying healthy and protected.

Stay informed about what the most current science has to tell us about peanut allergies and other food allergies. To that end, we’ve put together some FAQs to help tackle some of the most common questions related to peanut allergies.

How common are peanut allergies?

Peanut allergies are among the most dominant food allergies in Western countries. In the US alone, research suggests they affect 2% of American adults—more than 6.6 million people [5].

Some epidemiologists believe that peanut allergies are on the rise [5]. In one nationwide study, peanut and tree nut allergies tripled in just one decade [6].

Fortunately, the increasing prevalence of reported peanut allergies is initiating some significant developments in peanut allergy treatments. In recent years, the European Academy of Allergy and Clinical Immunology (EAACI) has endorsed a novel therapeutic modality called oral immunotherapy, which has benefited many peanut allergy sufferers as an effective form of treatment [5].

How are peanut allergies diagnosed?

Peanut allergies tend to present within the first four years of life, sometimes in children as young as four months of age. Only 20% of children with a peanut allergy grow out of their allergy by the time they reach adulthood, and researchers estimate that 2% of American adults still live with a peanut allergy from childhood [2, 5].

To diagnose peanut allergies, healthcare providers typically begin by administering a physical exam and assessing medical family history [3]. Some evidence points to a link between peanut allergies and genetics, suggesting that children of people with peanut allergies may be more likely to develop one themselves [7].

Because the severity of peanut allergies varies widely between affected individuals, the next diagnostic stage is to evaluate the specific traits accompanying a suspected peanut allergy.

Healthcare professionals will assess [2]:

  • Type of food that initiates an allergic response
  • The amount of peanuts or trace peanuts that induce an allergic response
  • Timing of symptom onset
  • Duration of symptoms

Are peanut allergies the same as other nut allergies?

In public discussions pertaining to health matters, peanut allergies and other nut allergies often get conflated. However, the two stem from entirely different species of plants.

Peanuts are legumes. They’re a type of seed that sprouts from the ground in the company of other legumes such as lentils, kidney beans, and black-eyed peas.

Tree nuts, in contrast, are the seed of a fruit. Tree nuts include:

  • Almonds
  • Brazil nuts
  • Cashews
  • Hazelnuts
  • Pecans
  • Pistachios
  • Walnuts

Like peanut allergies, tree nut allergies tend to present in very young children and usually persist into adulthood. Interestingly, some research suggests that nut allergies correlate with geographic location. For instance, while peanut allergies far outpace tree nut allergies in the US, Northern Europeans have fewer instances of peanut allergies and a higher rate of hazelnut allergies [8].

While peanut allergies and tree nut allergies stem from different antigens detected by the immune system, they often present similar symptoms. Like a peanut allergy, many tree nut allergies can cause swelling of the tongue and face, abdominal pain, and, in severe cases, anaphylaxis [8].

How are peanut allergies treated?

The most critical lines of defense against peanut allergies are to avoid exposure to peanuts and to carry an epinephrine injector. These two protective measures can be lifesaving in the event of peanut-induced anaphylaxis. In mild to moderate cases of a peanut allergy, antihistamines may also be a helpful way of lowering harmful immune responses [2].

Aside from adapting your lifestyle to stay safe and healthy, two newer therapeutic treatment modalities may serve to mollify allergy symptoms in some individuals [2]:

  • Oral immunotherapy – During oral immunotherapy, individuals are asked to ingest tiny amounts of peanuts to familiarize their immune system with peanut antigens. These sessions are closely monitored by medical professionals who can swiftly provide emergency assistance in the event of an allergic attack. The objective of oral immunotherapy is to desensitize the affected individual, incrementally building up a tolerance to peanut proteins and thereby reducing their risk of severe symptoms.
  • Sublingual immunotherapy – Sublingual immunotherapy is like oral immunotherapy. Instead of swallowing a small amount of peanut protein, a purified version of peanut protein powder is administered below the tongue and removed after two minutes. After a sequence of treatment sessions, some individuals exhibit a higher tolerance and less aggressive allergy symptoms to peanut proteins.

What causes peanut allergies?

While immunological studies have a firm grasp on the physical reactions associated with peanut allergies, the root cause is not well understood.

That said, there are some studies that indicate an exposure to peanut proteins during perinatal development may be advantageous in promoting food tolerance. In one study, people who consumed peanuts during pregnancy saw a lower incidence of peanut hypersensitivity after their children were born [9]. Furthermore, researchers now believe that infants with a proclivity for developing eczema may be at higher risk of developing a peanut allergy [10].

Check for potential peanut allergy with the Everlywell Food Allergy Test

Peanuts are one of many common allergens that affect the 32 million Americans living with a food allergy today [11]. The Everlywell at-home Food Allergy Test checks IgE reactivity to common food allergens, including peanuts. If your test results show increased reactivity that may indicate a food allergy, you will receive a call from a nurse to help with next steps.

How to know if you have a food allergy

Food allergy, food sensitivity, and celiac disease: An expert explains the key differences and how to test

Meet our first at-home Food Allergy and Celiac Disease Screening tests


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5. Lieberman JA, Gupta RS, Knibb RC, Haselkorn T, Tilles S, Mack DP, Pouessel G. The global burden of illness of peanut allergy: A comprehensive literature review. Allergy. 2021 May;76(5):1367-1384.

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8. Kuźmiński A, Przybyszewski M, Przybyszewska J, Ukleja-Sokołowska N, Pałgan K, Bartuzi Z. Tree nut allergy. Postepy Dermatol Alergol. 2021 Aug;38(4):544-549.

9. Frazier AL, Camargo CA Jr, Malspeis S, Willett WC, Young MC. Prospective study of peripregnancy consumption of peanuts or tree nuts by mothers and the risk of peanut or tree nut allergy in their offspring. JAMA Pediatr. 2014 Feb;168(2):156-62.

10. Al-Ahmed N, Alsowaidi S, Vadas P. Peanut allergy: an overview. Allergy Asthma Clin Immunol. 2008 Dec 15;4(4):139-43.

11. Facts and Statistics. Food Allergy Research & Education. URL. Accessed June 14, 2022.

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