Table of Contents
Overview | Causes | Symptoms | Diagnosis | Treatment | Prevention
What is a peanut allergy?
“A peanut allergy occurs when your immune system mistakenly identifies peanut proteins as something harmful,” explains Morris Nejat, MD, the medical director of NY Allergy & Sinus Centers.  This triggers an allergic reaction that can sometimes be life-threatening. Some people may experience hives or stomach cramps, while in others, their throat swells up, and breathing becomes labored. 
More than six million Americans have a peanut allergy.  Since 2010, cases of peanut allergy in American children have increased by 21 percent. It’s unknown exactly why this is. Theories include an increase in parents restricting peanuts in infancy (fearing their child would develop an allergy) and an increase in exposure to peanuts throughout life, Dr. Nejat says. Today, about 2.5 percent of children have a peanut allergy. Although some people have a peanut allergy for life, about one in five will outgrow their allergy. 
Meanwhile, some people develop the condition as adults. About 14 percent of people with a diagnosed peanut allergy only began experiencing symptoms as an adult. 
What are the risk factors of a peanut allergy?
It’s unclear why some people develop a peanut allergy. Risk factors include:
Age: Children, particularly infants and toddlers, are more likely to have peanut allergies. “No one is born with a peanut allergy, but exposure when the body is primed to develop the allergy can make a child allergic,” says Dr. Nejat, adding that there’s no way to predict when that time may be. With age, the digestive system often becomes less reactant to peanuts, hence why some people outgrow their childhood peanut allergy.
Other allergies: Food allergies and seasonal allergies (such as hay fever) increase the chance of developing a peanut allergy.
Previous peanut allergy: Some people outgrow a peanut allergy, only to have it come back later. It’s unclear why this happens.
Family history: “Researchers believe genetics likely plays a part,” Dr. Nejat says. If other people in your family have allergies, especially food allergies, you may be at greater risk.
What are the symptoms of a peanut allergy?
Symptoms of a peanut allergy typically begin very shortly after being exposed to peanuts. Reactions may include:
Hives, redness, or swelling of the skin
Stomach cramps or nausea
Shortness of breath, difficulty breathing
Itchy or tingling mouth or tongue
Anaphylaxis: If someone has this life-threatening reaction, their throat swells, making breathing difficult. People may also experience shock (a sudden, severe drop in blood pressure), pale skin or blue lips, rapid pulse, dizziness, or fainting.
And if you believe you’re experiencing anaphylaxis, use an epinephrine aut- injector (sold under the brand names EpiPen, Auvi-Q, Adrenaclick, and Symjepi) and seek emergency care.
If you notice any other symptoms after eating peanuts or dishes that contain peanuts, peanut oils, or traces of peanuts, see an allergist. You should probably avoid anything that contains peanuts until you see a doctor for an evaluation.
How is a peanut allergy diagnosed?
An allergist can diagnose a peanut allergy. Before your visit, keep a food diary and log every time you experience symptoms, suggests Dr. Nejat. Note what you ate (not only peanuts but other foods as well) and how much, when the symptoms set in, what you did to treat yourself, and how long it took for the symptoms to subside.  This will be helpful at your appointment, as your doctor will want to know why you suspect an allergy. They may also ask if you’ve tried anything to improve your symptoms, whether those strategies helped, and if any foods or treatments appear to worsen your symptoms. The doctor may also do the following tests:
None of the tests poses any danger, other than the possible allergic reaction. Your doctor will be there to provide treatment should this occur.
As an alternative to testing, your doctor may recommend an elimination diet. For this, you remove all suspected foods from your diet for a few weeks. Then you add one food back one at a time to identify which food was causing the reaction.
Peanut allergy treatment
A peanut allergy is something you can manage. However, it may take some effort to learn to navigate grocery shopping and use an epinephrine auto-injector.
How to prevent peanut allergy
“Researchers believe that kids who delay eating peanuts have an increased chance of developing a peanut allergy,” Dr. Nejat says. For this reason, some allergists and researchers believe that feeding small amounts of peanuts to young babies, may help their immune systems learn to tolerate the food and reduce the chances of a peanut allergy. 
The National Institute of Allergy and Infectious Diseases (NIAID) recommends that infants identified as being high-risk for a peanut allergy (due to family history or the presence of other food allergies) be introduced to peanuts as early as four to six months.  This early, gradual introduction may reduce the risk of peanut allergy by up to 80 percent.  If you are interested in oral immunotherapy, talk to a pediatrician or allergist, Dr. Nejat recommends.
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