10 Surprising Facts About Peanut Allergies

Allergic to peanuts? You’re definitely in good company. Not only is it one of the most widespread food allergies in the United States, but it’s also more difficult to outgrow than milk and egg allergies. Yikes! And, scarily enough, in recent years it’s been gaining momentum, affecting more individuals than ever before. One could even consider it to be an epidemic.

That’s according to a new study by the Jaffe Food Allergy Institute at New York’s Mount Sinai Hospital. Researchers found that from 1997 to 2008, peanut allergies tripled from affecting 1 in 250 children to 1 in 70 children.

“It really is almost an epidemic,” Scott Sicherer, MD, director of the Jaffe Food Allergy Institute, told CNBC’s On the Money. “It’s impossible to deny an increase, even with anecdotal reports from school nurses,” he added, pointing out that “about two (children) per classroom have food allergies. It’s not just our imagination.”

The best and easiest way to keep any members of your family with peanut allergies safe is to be as knowledgeable and aware as possible so that you don’t find yourself in a dangerous situation.

Here and in the video above, 10 surprising facts you may not have known about peanut allergies to help you stay informed.

1. Three million people in the U.S. are allergic to peanuts and tree nuts.

2. Peanuts are not actually nuts but legumes like soybeans and peas. All other nuts (walnuts, cashews, almonds, etc.) are tree nuts.

3. Most people have peanut allergies for life, but 20% of children outgrow them.

4. Peanut allergies are one of the most common food allergies in children, along with milk and eggs.

5. With food allergies, your immune system overreacts to something harmless. The body responds to normal foods and food proteins as if they are dangerous foreign invaders.

6. While the causes of food allergies are not known, they are more common in families with other allergic conditions, like asthma and eczema.

7. When an allergic person comes into contact with peanut proteins their immune system releases histamine and other compounds that can cause breathing trouble, throat swelling, itchy lips, nausea, and vomiting.

8. Food allergies can be life-threatening. Known as anaphylaxis, these dangerous multi-system reactions can cause trouble breathing, a drop in blood pressure, and shock.

9. Rapid treatment with an epinephrine injection can reverse anaphylaxis. This can be done with autoinjectors (like those sold under the brand name EpiPen).

10. There are ways to reduce peanut allergic reactions. Oral immunotherapy involves feeding tiny amounts of peanut protein to patients to help develop tolerance. This can be dangerous, so it must be done under an allergist’s supervision.

Although the National Institutes of Health encourages children around the age of four to six months be introduced to peanut-containing foods, the best way to prevent severe reaction is to avoid any foods that contain peanuts if proven to be allergic. Always be sure to read packaged food labels for red flags, including whether a product was processed near peanuts.

An experimental oral immunotherapy treatment is getting closer to FDA approval.

With no official treatment, the best advice for people with peanut allergies is usually to strictly avoid the offending legume and to keep rescue medications (like an EpiPen) on hand. But an experimental treatment–if approved–could become the first drug to prevent potentially deadly peanut allergy reactions in children.

In new research published in the New England Journal of Medicine and presented at the annual scientific meeting of the American College of Allergy, Asthma, and Immunology, the treatment–called AR101 and manufactured by Aimmune Therapeutics–was shown to increase the amount of peanut protein a child could tolerate before displaying allergy symptoms.

Just under 500 kids and teens between the ages of 4 and 17 were randomized to get a placebo or a peanut powder-filled capsule that was mixed in with their food. Slowly but surely, researchers increased the amount of peanut powder until by the end of the year-long trial, 67% were able to consume 600 mg of peanut protein (about the equivalent of two peanuts) without having a severe allergic reaction. Around half of those kids could tolerate up to 1000 mg of peanut protein. 

This strategy is called oral immunotherapy, Purvi Parikh, MD, an allergist and immunologist with Allergy & Asthma Network, explains to Health. “By introducing small, increasing doses of an allergen,” she says, “the immune system [becomes] less reactive to that specific allergen.”

This type of medication wouldn’t make it so people with peanut allergies could finally enjoy a PB&J. Rather, it would lower their risk of severe or potentially life-threatening reactions to accidental encounters. “It will lessen their chances of life-threatening reactions, which not only will help them from a health standpoint, but will hopefully alleviate their anxiety,” says Dr. Parikh, who was not involved in the new research. “For them, any situation with food can turn deadly if there is accidental exposure.”

However, as you might expect, giving peanut protein to people with peanut allergies wasn’t without incident. “Desensitization was not easy on the patients,” writes Michael R. Perkin, PhD, of the Population Health Research Institute in London in an accompanying editorial published alongside the new study.

More than 11% of the kids and teens originally assigned to get small doses of peanut powder dropped out of the study before the end. Of those who continued on, 14% needed to use epinephrine shots to quiet allergic reactions to the treatment (although most of those reactions were mild). One child experienced a severe allergic reaction, called anaphylaxis. For that reason, experts say, even though peanut powder may sound like something you could DIY, it’s essential not to try oral immunotherapy unsupervised at home.

It’s possible, Dr. Parikh says, that people with worse allergies to begin with might not be the best candidates for oral immunotherapy. “No two patients have the exact same immune system. [For] those who are highly allergic, it may be more difficult to desensitize as they may not tolerate the buildup phase.”

Aimmune Therapeutics plans to submit an application to the FDA in December to bring the new treatment to market. It’s expected that there will be high demand for the drug, and, the New York Times reported, advocates are already asking questions about pricing and insurance coverage.

However, it’s still unclear how long the protection from severe peanut-related reactions would last, Perkin wrote. People may need to literally eat a peanut every day to ensure they won’t react to one in the future. “Sustained, potentially lifelong, regular consumption may be needed to maintain allergen tolerance,” he wrote–although, he added, most parents would probably consider that “a very small price to pay.”

Despite the caveats, the treatment is exciting to experts and parents alike, considering peanut allergies have tripled over the last couple decades. Three million Americans are thought to be allergic to peanuts and tree nuts, and only 20% of kids outgrow their peanut allergies.

In the meantime, the best way to avoid a severe allergic reaction to peanuts is to avoid them altogether. If you or your child has a peanut allergy, you may be cautiously optimistic about the AR101 news, but you’ll also need to keep reading food labels for now.

“Unfortunately, the mainstay of treatment right now is avoidance and carrying an epinephrine auto-injector,” Dr. Parikh says. “Even with careful measures, accidents do occur, and food that is safest is that which you prepare yourself.”

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