Young woman experiencing common peanut allergy symptoms

Why are peanut allergies so common?

Written on November 23, 2022 by Theresa Vuskovich, DMD. 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.

Table of contents

Peanut allergies are often associated with childhood, but adults can also develop peanut allergies. Peanut allergies affect approximately 4.6 million Americans, with over 800,000 becoming allergic as adults [1]. This article explains the basics of peanut allergies and the reasons why peanut allergies are so common, emphasizing the importance of early detection through a food allergy test.

What are peanut allergies?

Peanut allergies occur when your body mistakenly perceives the proteins in peanuts as a threat. Immunoglobulin E (IgE) is the antibody responsible for activating allergic reactions [2]. During an invasion, your body produces more IgE to defend against the invader.

IgE signals inflammation-causing cells during an allergic reaction to assist with the invasion. These cells produce histamine, which causes the signs and symptoms you see during an allergic reaction.

Although most commonly considered a nut, a peanut is a bean in disguise. As a result, if you are allergic to peanuts, you are not always allergic to nuts such as almonds, cashews, pecans, pistachios, etc., referred to as tree nuts, which are different from a nut allergy to peanuts. So, you might be asking, what specifically triggers tree nut allergies to peanuts?

What causes peanut allergies?

While immunological studies have a firm grasp on the immune system 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 [2]. Furthermore, researchers now believe that infants with a proclivity for developing severe eczema may be at higher risk of developing a peanut allergy [3]. It's crucial to recognize the signs and symptoms of a peanut allergy, as early detection and management can significantly impact one's quality of life.

What are the symptoms of peanut allergies?

Symptoms and signs of peanut allergies vary from person to person, as do their severity and location. Some people react to peanuts from mere skin contact or ingesting tiny amounts, with reactions affecting the skin, mucous membranes, circulation, digestion, and respiration [4]. It's crucial to remain aware of potential peanut exposure and take precautions to avoid accidental exposure, especially considering peanut allergies are a common food allergy that can elicit a severe reaction.

Let’s take a closer look at how peanut allergies can manifest across different systems of the body:

Cutaneous (skin) peanut allergy symptoms

Many people with peanut allergies display a noticeable adverse reaction in their skin, such as acute urticaria (hives) [5]. In some cases, cutaneous reactions may arise from being exposed to peanuts indirectly, even if the food is not ingested [6, 7]. 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 [6]:

  • Abdominal cramping
  • Nausea
  • Vomiting
  • Diarrhea

Circulatory peanut allergy symptoms

irculatory 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 [6]. Other circulatory symptoms include [7]:

  • 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 [6]. During anaphylactic shock, blood pressure plummets, normal breathing becomes extremely difficult, and many peanut allergy sufferers may lose consciousness entirely [6]. 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 [6].

How common are peanut allergies?

Peanut allergies stand out as some of the most prevalent food allergies, especially in Western countries. In the United States, it's estimated that 2% of adults are affected, totaling over 6.6 million individuals [8]. There's growing evidence to suggest that the incidence of peanut allergies is increasing, with some studies indicating a tripling of peanut and tree nut allergies over a span of ten years [9]. This upward trend in allergies prompts a closer examination of specific demographics, particularly the younger population. So, why are peanut allergies especially common in children?

Why are peanut allergies common in children?

Over the past 20 years, food allergies have increased dramatically [10]. Although healthcare providers and scientists recognize the rise in food allergies, the cause is still unclear.

One possible explanation is improvement in hygiene [10]. This is sometimes referred to as the hygiene hypothesis. There is now a consensus among allergy experts that peanut allergies originate from skin contact [11,12,13]. Due to the increase in hygiene, babies may have weaker skin barriers, causing them to overreact to peanut protein [10].

The hygiene hypothesis originates from two concepts. First, children with eczema, a skin condition, have a higher chance of developing peanut allergies compared to children without eczema [4,10]. Additionally, developing countries with less access to hygiene have lower rates of food allergies [10].

Is there a cure for a peanut allergy?

Unfortunately, a cure for peanut allergies does not exist. However, about 20% of children will outgrow their peanut allergy [4]. Rather than a cure, researchers have determined methods to decrease the likelihood of a baby developing a peanut allergy and a medication to decrease the severity of a reaction if one does occur.

The LEAP study

The Learning Early About Peanut Allergy (LEAP) study was a clinical trial designed to establish safe methods for introducing peanuts to infants [11]. The LEAP study evolved from another study of Jewish children living in the United Kingdom (UK) and in Israel.

While Jewish children in Israel are exposed to peanuts early, Jewish children in the UK are often introduced to peanuts later in life. The study found that Jewish children in the UK are significantly more likely to develop a peanut allergy, which indicated early exposure to peanuts might protect against peanut allergies [11].

During the LEAP study, the researchers gave 6 grams of peanuts to 542 infants weekly using Bamba snacks [11]. After 60 months, infants who were introduced to peanuts before 11 months had a 70% to 86% reduction in the likelihood of developing a peanut allergy [11].

Based on the LEAP study, the National Institute of Allergy and Infectious Diseases recommends introducing infants with eczema or an egg allergy to peanuts between 4 to 6 months of age [13]. However, always consult your healthcare provider about introducing peanuts to your baby.

Palforzia

Despite the lack of a cure for peanut allergies, a new medication can help those who have them experience less severe allergic reactions. An oral medication called Palforzia helps a child's immune system fight an allergic reaction if they are accidentally exposed to peanuts [14]. Nevertheless, even if a child is taking Palforzia, they must follow a peanut-free diet and carry medication in case of an acute reaction [14].

What are the best ways to manage and diagnose peanut allergies?

Since a cure does not exist for peanut allergies, the best way to manage a peanut allergy is to avoid peanut-containing foods, including peanut butter, peanut oil, and other products that may contain traces. However, trace amounts of peanuts can exist in unexpected products and places. Therefore, it's essential to remain vigilant and attentive to an allergy alert and read the food label to prevent exposure to peanut containing foods or peanut flour, which could trigger a severe allergic reaction.

Medication

For people with peanut allergies, a prescription for self-injectable epinephrine is necessary and must be accessible at all times [4]. Antihistamines, corticosteroids, and a bronchodilator are often used along with epinephrine [4].

Awareness

The primary way to manage a peanut allergy is awareness [4]. Especially at work or school, it is essential to inform everyone of your peanut allergy. When buying packaged food products, it is crucial to read the labels.

Testing

Testing is crucial to determine whether you have a peanut allergy. A study in the Journal of the American Medical Association (JAMA) using self-reported data determined more adults think they have a food allergy than actually do [15]. It is essential to note food allergies and food sensitivities are different conditions. While food allergies are life-threatening, food sensitivities can cause inconvenient physical symptoms such as stomach cramping.

Although a healthcare provider must diagnose you, food testing can provide insights into how your body reacts to certain foods. Using the Everlywell food allergy test can help you. Visit the Everlywell products page to learn more about our at-home lab tests.

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How to test for peanut allergy at home: a quick guide

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Sudden egg allergy in adults: causes and more

References

  1. Warren C, Lei D, Sicherer S, Schleimer R, Gupta R. Prevalence and characteristics of peanut allergy in US adults. J Allergy Clin Immunol. 2021;147(6):2263-2270.e5. doi:10.1016/j.jaci.2020.11.046. Medical Citation URL. Accessed June 14, 2022.
  2. 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. Al-Ahmed N, Alsowaidi S, Vadas P. Peanut allergy: an overview. Allergy Asthma Clin Immunol. 2008 Dec 15;4(4):139-43.
  3. Patel R, Koterba AP. Peanut allergy. In: StatPearls [Internet]. StatPearls Publishing; 2022. Medical Citation URL. Accessed June 14, 2022.
  4. Peanut Allergy. StatPearls [Internet]. Medical Citation URL. Accessed June 14, 2022.
  5. Peanut allergy. Mayo Clinic. Medical Citation URL. Accessed June 14, 2022.
  6. Peanut. American College of Allergy, Asthma, & Immunology. Medical Citation URL. Accessed June 14, 2022.
  7. 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.
  8. Sicherer SH, Muñoz-Furlong A, Godbold JH, Sampson HA. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J Allergy Clin Immunol. 2010 Jun;125(6):1322-6.
  9. Platts-Mills TA. The allergy epidemics: 1870-2010. J Allergy Clin Immunol. 2015;136(1):3-13. doi:10.1016/j.jaci.2015.03.048.
  10. Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy [published correction appears in N Engl J Med. 2016;375(4):398]. N Engl J Med. 2015;372(9):803-813. doi:10.1056/NEJMoa1414850.
  11. Maleki, S.J., Teuber, S.S., Mustafa, S.S., 2021. Adult peanut allergy: What we know and what we need to learn. Journal of Allergy and Clinical Immunology 147, 2069–2072.. doi:10.1016/j.jaci.2021.03.031.
  12. Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for preventing peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. J Allergy Clin Immunol. 2017;139(1):29-44. doi:10.1016/j.jaci.2016.10.010.
  13. PALFORZIA [Peanut (Arachis hypogaea) Allergen Powder-dnfp]. Aimmune Therapeutics. Medical Citation URL. Accessed June 14, 2022.
  14. Gupta RS, Warren CM, Smith BM, et al. Prevalence and severity of food allergies among US adults. JAMA Netw Open. 2019;2(1):e185630. doi:10.1001/jamanetworkopen.2018.5630.
  15. 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.
  16. Al-Ahmed N, Alsowaidi S, Vadas P. Peanut allergy: an overview. Allergy Asthma Clin Immunol. 2008 Dec 15;4(4):139-43.
Theresa Vuskovich, DMD is a dentist and public health expert with over 10 years of experience. Vuskovich has written, edited, and reviewed health content for the Accreditation Council for Medical Affairs (ACMA), Everly Health, and other organizations, and has a decade of experience practicing dentistry. Dr. Vuskovich is skilled in patient education, medical affairs, sleep medicine, stroke prevention, medications, and other health and wellness topics. Theresa holds a BS, MPH, and DMD, and recently returned to the University of Florida to complete her master of Pharmaceutical Sciences studies (MSPharm).
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