Basic Information

Q. How common is it?

Current estimates are that it affects 1.8% of children at school entry


Q. Who gets it?

Typically people with peanut allergy are atopic (prone to allergic reactions), and may also have had asthma, eczema, and hayfever.  A tendency to allergy runs in some families.  It isn't known why some people get it and others don't.


Q. Do people outgrow it?

This is rather controversial.  Some studies have found that approximately 20-25% of children may outgrow peanut allergy but others disagree with this.  It is generally accepted that in adults peanut allergy will be lifelong.


Q. How serious can it be?

Peanut allergy can range from anything from mild stomach upset, vomiting, or a rash all the way through to anaphylactic reactions.  Anecdotally, peanut allergy often becomes more serious with repeated exposure. Reactions to peanuts typically occur within minutes, in some people the reaction progresses slowly and in others an anaphylactic reaction begins without warning.


Q. What is anaphylaxis?

In anaphylaxis, the immune system overreacts to an allergen by releasing large amounts of histamine.  This causes swelling of the airways and suffocation.  It also makes blood vessels leaky, so blood doesn't get to the organs but instead enters the tissues.  If untreated then the sufferer can die from respiratory or circulatory collapse.

Symptoms include: rash, itching, hives, swelling of the face, a sensation of impending doom, difficulty breathing, feeling lightheaded and collapse.

This is a very simplified description of anaphylaxis.  For more details, look at the Wikipedia entry for anaphylaxis


Q. How can anaphylaxis be treated?

Administration of adrenalin (for example, through an Epipen) can reverse all the symptoms of anaphylaxis.

Please be aware that a single dose may not be enough, that the effects of adrenalin can wear off over time, and that anyone who experiences an anaphylactic reaction should be taken to hospital.

Some anaphylactic reactions can be 'biphasic' - that is, there is an initial reaction and then another one several hours later.  For this reason, you want to make sure the sufferer is in hospital and under observation.


Q. What about antihistamines?

Giving antihistamine is not guaranteed to prevent the reaction progressing, and may only act to mask the initial symptoms of an allergic reaction.  For this reason I would suggest being  particularly cautious about new food if you are taking antihistamines for another reason (e.g. hayfever)


Q. Can't I just take a tiny taste of food to see if it's safe?

No!  Trivial amounts of peanut are required to set off a reaction, so sampling food in this way is highly dangerous.


Q. I'm only allergic to peanuts.  Should I avoid all nuts?

Peanuts are not actually nuts but legumes.  Some people cross-react with soy.  However, for reasons that are unclear some people with peanut allergy also react to tree nuts, and tree nuts *are* true nuts.

It is prudent to avoid all nuts because of the risk of factory cross-contamination.  Practically, it is also a lot simpler.


Q. I've heard peanut/groundnut oil is safe.  Is this true?

Refined peanut oil (without any fragments of peanuts in it) is theoretically safe.  Unrefined peanut oil isn't.  It is prudent to simply avoid all peanut oil as well.


Q.What should I carry with me?

At a minimum people who suffer from anaphylaxis should carry an Epipen and ideally two.  Some people carry a small allergy kit with them, either in professional kits or assembled in a camera case or bumbag.  If you do want to carry an allergy kit, it should include quick-acting antihistamines (such as Piriton) stored in such a way that it can be easily accessed in an emergency, and corks or something similar to stick the discharged Epipens into.

You may also want to carry a laminated card in the case briefly explaining that you have a life-threatening peanut allergy and 999 should be called, and perhaps contact numbers of relatives on the other side.

If you prefer to just carry Epipens then several companies produce sturdier holders for them so they can survive in jacket pockets and handbags without the yellow outer plastic case becoming damaged!


Q. How can I get my GP to refer me to a specialist?

If you wish to be tested for other allergies then this will usually require specialist referral.  However, if you simply would like to be under the care of an allergist then GPs may be reluctant depending on the allergy provision in your area.

It is best to discuss the reasons behind the refusal with your GP and see what explanation they have - it may be that what you expect to get from a referral would not be provided, for example.

Ultimately, if you are unhappy with the care provided by your GP then for most changing surgery is a relatively straightforward process, but this may not help the underlying problem of difficulty in accessing allergy services.


Q. Where else can I go for information?

For basic information, the Anaphylaxis Campaign have good information on http://www.anaphylaxis.org.uk/information/basic_facts.html

There is also an excellent website on http://www.allerg.qc.ca/peanutallergy.htm that summarises what is known on peanut allergy and keeps up to date with current research.

 

Q. I have other questions that aren't answered here or disagree with the answers above.

Please feel free to join the forum to ask new questions or email me here.  I can't provide medical advice but will try to add any additional questions to this page.

If you think the answers above are wrong, please cite a journal reference or a reputable webpage to substantiate your comments.