Medically reviewed by
Richard P. Silton, MD
If you have a peanut allergy, do you also need to stay away from tree nuts? Not necessarily!
While some people are allergic to both peanuts and tree nuts, that’s not the case for everyone. By working with an allergist, you can gain an understanding of what is safe for you.
Peanuts and Tree Nuts: What’s the Difference?
Peanuts and tree nuts like walnuts, cashews and almonds have significant differences. For instance, tree nuts grow on trees, while peanuts grow underground.
Tree nuts and peanuts also come from different families of plants. Peanuts are actually a type of legume — a category that also includes lentils, beans and peas — rather than a true nut.
Can You Be Allergic to Both?
Between 25 and 40 percent of people with peanut allergies are estimated to also have allergies to tree nuts. In many cases, manufacturing and serving processes can bring peanuts and tree nuts into contact with each other, causing cross-contamination.
Because of the risk of allergy to both types of plants and the possibility of cross-contamination, many allergists advise patients with peanut allergies to avoid tree nuts.
Foods That Contain Tree Nuts
If you’re allergic to tree nuts or think you might be, it’s important to know what foods to avoid; some aren’t entirely obvious.
A variety of nuts fall under the category of tree nuts. They may be present in a diverse array of food items, including:
- Salad dressings.
- Candies and sweets.
- Baked goods like pastries and pie crusts.
- Granola and other cereals.
- Mixed grain breads.
- Energy bars.
- Veggie burgers.
- Sauces, including pesto, gravy and marinades.
- International foods, including Thai, Mexican, Mediterranean, African and Asian.
In cooking, you’ll need to avoid items like nut extracts and butters, nut pastes and oils. Always remember to read labels before buying a product, even if you’ve purchased it before; ingredient lists can change.
Nuts also can appear in non-food items, including shampoos and lotions. Always check the label before buying.
As with peanut allergies, individuals who suffer from tree nut allergies should carry an epinephrine auto-injector at all times and understand how to use it if needed. Allergies to tree nuts can be severe and life-threatening. If you do have a reaction, call 911 and use your auto-injector. You should be seen by a medical professional even if your symptoms improve.
Should You Avoid Tree Nuts?
Just because you have a peanut allergy doesn’t mean you’re allergic to tree nuts. However, many people with peanut allergies also suffer from other nut allergies, and reactions can be severe. If you’re allergic to peanuts, don’t just assume that tree nuts are OK.
Your allergist can perform comprehensive testing to determine if you need to avoid tree nuts. To schedule an appointment with a board-certified allergist, please contact Carolina Asthma & Allergy Center.
