PEANUT ALLERGY

Peanut allergy is one of the most common and potentially serious food allergies in the UK. Reactions can range from mild oral symptoms to life‑threatening anaphylaxis. Because peanut allergy often persists for life and can be unpredictable, specialist assessment is essential.

What Is Peanut Allergy?

Peanuts contain multiple proteins, and allergic individuals react to one or more of these. Modern molecular allergy testing (such as ALEX³ or ISAC) can identify exactly which peanut proteins are involved, helping to assess risk and guide management.

Peanut allergy affects approximately 4% of school‑aged children in the UK, and many continue to have symptoms into adulthood.

How common is peanut allergy

The prevalence of peanut allergy has been increasing over the last two decades and at present affects about 4% of school children in the UK.  In majority of individuals peanut allergy is a lifelong condition.

Symptoms of Peanut Allergy

Symptoms usually appear within minutes of exposure and may include:

• tingling or itching of the mouth and throat
• hives or swelling
• abdominal pain, vomiting
• coughing, wheezing or shortness of breath
• dizziness, fainting or collapse

Severe reactions involving breathing difficulty or circulatory collapse are known as anaphylaxis, a medical emergency.

Avoiding Peanut in Food

Peanut can appear under several names, including groundnut, earthnut, and monkey nut. It may be present in:

• breakfast cereals and cereal bars
• chocolates, biscuits, cakes
• Asian cuisine (Chinese, Thai, Indonesian, Indian)
• sauces, marinades, desserts
• nut pastes, praline, nougat

Cross‑contamination is common in takeaway and restaurant settings. Spicy foods may mask early warning symptoms.

Food labels to avoid

• “Contains peanuts”
• “May contain peanuts”
• “May contain traces of nuts”

Peanut oil

• Refined peanut oil is generally safe because proteins are removed.
• Cold‑pressed/unrefined peanut oil may contain allergenic proteins and should be avoided.

Where Peanut May Be Hidden

Peanut can be found in:

• muesli and granola
• flaked nuts
• chocolates (e.g., Snickers)
• some cakes and pastries
• nut butters
• bird feed (risk of environmental exposure in children)

Always check ingredient lists carefully and ask about preparation methods when eating out.

Always be aware of food that may be cross contaminated with other food containing peanuts e.g. Chinese, etc takeaway.  When eating out in restaurants it is not always guaranteed that the staff would know if the food contains peanut.  The usual warning sensation in the mouth such as tingle or sore throat may be masked by the spices in the food.  Therefore it is advisable not to eat spicy foods in restaurants.

Can You Eat Other Nuts if you have peanut allergy?

Many people with peanut allergy also react to tree nuts such as:

• almond
• cashew
• pistachio
• walnut
• hazelnut
• Brazil nut
• macadamia
• pine nut

Reactions may be due to:

• true co‑sensitisation
• cross‑reactivity
• cross‑contamination with peanut

A small number of peanut‑allergic individuals also react to peas, chickpeas, lentils, beans or soya.

Specialist testing can help determine which nuts are safe.

Travelling abroad with peanut allergy

When travelling:

• learn key phrases to ask about nuts/peanuts
• carry written allergy information in the local language
• identify the nearest emergency department
• ensure you have up‑to‑date emergency medication (e.g., adrenaline auto‑injector)
• discuss travel plans with your GP or allergy specialist. Our clinic can help with any aspects of management peanut allergy.

Can Tests Predict the Severity of Future Reactions in case of peanut allergy?

No test can reliably predict how severe a future reaction will be.

However, molecular allergy testing (e.g., Ara h 1, Ara h 2, Ara h 3, Ara h 6) provides valuable information:

• Ara h 2 is strongly associated with more severe reactions
• Ara h 8 is linked to milder, pollen‑related oral symptoms

This helps clinicians tailor advice and risk assessment.

Is Peanut allergy Desensitisation Available?

Oral immunotherapy (OIT) can reduce sensitivity to peanut, but:

• it is not a cure
• ongoing daily exposure is required
• reactions can still occur
• it is currently available mainly in specialist paediatric centres

Adult OIT is still under investigation.

Why Choose Our Clinic for Peanut Allergy Assessment?

• Consultant‑led allergy service
• Access to ALEX³ and ISAC molecular allergy testing
• Detailed interpretation of peanut components (Ara h 1–9)
• Personalised risk assessment
• Clear dietary guidance
• Emergency action plans
• Paediatric and adult allergy specialists
• Remote and in‑clinic appointments available

Our goal is to provide accurate diagnosis, clear advice, and safe long‑term management.

References (2021–2025)

1. Turner PJ et al. Epidemiology of food allergy in the UK. Lancet. 2022.
2. EAACI Food Allergy Guidelines. European Academy of Allergy & Clinical Immunology. 2021.
3. Hourihane JO et al. Peanut oil safety in peanut allergy. BMJ. 2021.
4. Sicherer SH, Sampson HA. Peanut and tree nut allergy. New England Journal of Medicine. 2023.
5. Klemans RJ et al. Component‑resolved diagnostics in peanut allergy. JACI. 2022.
6. Vickery BP et al. Oral immunotherapy for peanut allergy. NEJM. 2022.

The page’s content updated  May 2026