Peanut Allergy


What is a peanut allergy?

A peanut allergy is a reaction that occurs when your body mistakenly identifies peanuts as harmful substances. When you eat peanuts or food containing peanuts, your immune system—the body's natural defense system that fights infections and diseases—overreacts and can cause a serious, even life-threatening response.

What causes a peanut allergy?

An allergic reaction occurs when your immune system overreacts and releases chemicals, including histamine, into your blood. These chemicals can affect different tissues in the body, such as the skin, eyes, nose, airways, intestinal tract, lungs, and blood vessels. It's not clear why peanuts trigger this response in some people.

What are the symptoms?

Symptoms of peanut allergy can range from mild to life-threatening. If you have a mild reaction, you may get a stomachache, a runny nose, an itchy skin rash, hives, or tingling in your lips or tongue. If your reaction is worse, you may develop additional symptoms such as a tight throat, hoarse voice, wheezing, coughing, feeling sick to your stomach, vomiting, belly pain, and diarrhea. Your symptoms may start from within a few minutes to a few hours after eating peanuts or peanut products.

People who are allergic to peanuts may have a life-threatening reaction called anaphylaxis. Symptoms of anaphylaxis can include difficulty breathing and swallowing, vomiting and diarrhea, dizziness, dangerously low blood pressure, swelling of the lips, tongue, throat, and other parts of the body, and loss of consciousness. If not treated, death can result. Anaphylaxis usually occurs within minutes but can occur up to several hours after eating peanuts or peanut products.

How is a peanut allergy diagnosed?

Your doctor or allergy specialist will ask you about your previous reactions to peanuts or peanut products, such as how long it took to develop symptoms after eating peanuts, and whether any of your family members have allergies or conditions like asthma. Next, the allergy specialist will do a skin test to see if you have an allergic reaction. During a skin test, a tiny bit of your skin will be pricked and a small amount of peanut liquid will be placed on your skin. If you develop a skin rash or red bumps in that area of your skin, it is likely you are allergic to peanuts.

You may also need to have a blood test that will show whether your body has made proteins called antibodies that would cause an allergic reaction when you eat peanuts. One such test is called an ELISA test, and another is called a RAST test.

How is it treated?

If you accidentally eat a peanut, follow your doctor's instructions. For a mild reaction, you may only need to take an antihistamine, such as diphenhydramine hydrochloride (Benadryl), to reduce your symptoms of a runny nose or itchy skin.

If your allergic reaction is more severe, be sure to follow your doctor's instructions for this type of reaction. If you have had a severe reaction previously, your doctor has probably prescribed a medicine called epinephrine. Give yourself the epinephrine shot, take an antihistamine, and call 911 for further instructions.

For more information on how to give an epinephrine shot, see:

Click here to view an Actionset. Allergies: Giving yourself an epinephrine shot.
Click here to view an Actionset. Allergies in children: Giving an epinephrine shot to a child.

Even if you feel better after giving yourself the shot, symptoms of anaphylaxis can recur or suddenly appear hours later. You need to be observed in a hospital for several hours after your symptoms go away.

If you do not have epinephrine and are having a severe allergic reaction, call 911 immediately.

How can I avoid an allergic reaction?

To prevent an allergic reaction to peanuts:

  • Understand your allergy and know that you need to protect yourself. Read food labels or ask kitchen staff at restaurants if there are peanuts or peanut oils hidden in any of the foods you order. For example, some cooks thicken chili with peanut butter.
  • Understand that no amount of peanut is safe. Some people are so severely allergic to peanuts that being near them or breathing air that contains peanut residue can cause an allergic reaction.
  • Let others know that you or your child has a peanut allergy. Make sure that all caregivers (such as school administrators, teachers, babysitters, and coaches), friends, and coworkers:
    • Know what the symptoms of an allergic reaction look like.
    • Know where the epinephrine shot is kept and how to give the shot.
    • Have a plan to transport you or your child to the hospital.
  • Wear a medical alert bracelet or medallion that lists your peanut allergy. This will alert emergency response workers if you have a severe allergic reaction. Medical alert jewelry can be ordered through most pharmacies or on the Internet.
  • Keep your epinephrine shot with you at all times. Make sure older children know how to give you or themselves the shot. Talk with your doctor or pharmacist if you are unsure how to give yourself the shot.
  • Keep an antihistamine such as diphenhydramine hydrochloride (Benadryl) with you at all times. These medicines can be used in addition to epinephrine and are often helpful in both mild and severe allergic reactions.

If you think you are having an allergic reaction:

  • Get help. Do not minimize the seriousness of the problem.
  • After you give yourself an epinephrine shot, call your doctor immediately or seek other emergency services. You will need to be observed for several hours to make sure the reaction does not recur.


Author Bets Davis, MFA
Editor Susan Van Houten, RN, BSN
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Ruth Schneider, MPH, RD - Diet and Nutrition
Specialist Medical Reviewer Harold S. Nelson, MD - Allergy and Immunology
Last Updated March 9, 2009

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