Allergic reactions to nuts can cause a variety of symptoms and can range in severity from mild local reactions to full-blown anaphylaxis.
Mild reactions can cause itchy eyes and skin, runny nose, sneezing and slight shortness of breath. More severe reactions include swelling of the tongue, throat and lips, as well as generalised symptoms including urticaria (nettle rash), acute asthma, palpitations, anxiety and confusion, dizzyness and fainting (due to low blood pressure), vomitting and in extreme cases, loss of conciousness.
Allergic reactions are driven by antibodies that recognise proteins contained in the sensitising food. A special type of antibody called IgE is responsible for allergies. IgE antibodies circulate in the blood and bond onto special cells called basophils and mast cells. When these “armed” cells next encounter the target protein, they release histamine and other chemicals that cause the symptoms of the allergic reaction.
The most common nuts people are allergic to are:
peanuts
walnuts
brazil nuts
cashew nuts
pecan nuts
almonds
hazelnuts
Nut allergies can be particularly dangerous because nuts are often ‘hidden’ in a variety of foodstuffs such as pre-packed meals, drinks, breakfast cereals, cakes, sweets, sandwich spreads and oils. There is often such a minute trace, however, that it is sometimes not mentioned in the list of ingredients.

Diagnosis
Nut allergies are diagnosed from the history, supported by tests for sensitising antibodies.
Skinprick testing: A very small drop of nut allergen is placed on the skin. A tiny prick is then made through the allergen dose. If the skin is sensitised, a small weal will appear at the test site. Several different nuts can be tested.
Blood test

Management 

• The first mainstay of management is total avoidance of the allergen involved. However, this can be difficult with nut allergies due to inadequate labelling of foodstuffs.
• Accidental exposure is more likely in certain situations e.g. oriental restaurants, pick and mix etc.
• For mild reactions, antihistamine tablets and syrups are available from General Practitioners and Pharmacists.
• All severe reactions should be treated as an emergency and immediate medical attention is necessary. Adrenalin can be carried in a portable ‘pen’ and should be injected as soon after exposure to the allergen as is possible. It is then very important that the patient be taken to a hospital in case further treatment is required. 

For further information and advice contact:

British Allergy Foundation
Deepdene House
30 Bellgrove Road
WELLING, Kent DA16 3BY
Tel: 023 8303 8792

Anaphylaxis Campaign
PO Box 275
Farnborough, Hants GU14 6SX
Tel: 01252 373793
Helpline: 01252 542029
E-mail: info@anaphylaxis.org.uk 

Information on Supermarkets 
Each of the Supermarkets listed below will supply “FREE FROM” Food lists, for example “FREE FROM NUTS”, “FREE FROM MILK”, “FREE FROM GLUTEN” and “FREE FROM EGG”.

ASDA
Customer Services 0113 243 5435

CO-OP
Customer Services 0800 317827

GATEWAY
Customer Services 0115 937 4745

MARKS & SPENCER
Customer Services 0845 6090200

SAFEWAY
Customer Services 01622 712987

SAINSBURYS
Customer Services 0207 921 7075

TESCO
Customer Services 0800 505555

WAITROSE
Customer Services 0800 188 884