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Kraig W. Jacobson, M.D.

Allergy, Asthma & Immunology

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Living with a peanut allergy

Posted by on in Allergy
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140609OSMpeanutallergy finalWhen it comes to food allergy awareness, peanut allergy is most commonly known because of its prevalence and symptom severity, which can include death.

About 1 percent of the United States population has peanut allergy. Among children with food allergies, youngsters have the highest allergic reaction to peanuts, followed by milk and shellfish. Peanut allergy is estimated to affect about 400,000 school-aged children in the United States, and it is one of the food allergens most commonly associated with severe reactions, such as anaphylaxis.



You may have a peanut allergy if you suffer these symptoms immediately after ingesting peanuts or peanuts included in foods. Symptoms may range from mild to severe and varies among patients. They include:

  • Swelling or itching of the lips, face and throat
  • Digestive problems, such as vomiting, diarrhea and acute abdominal pain
  • Skin reactions, such as hives, flushing or swelling
  • Respiratory symptoms, such as tightness, wheezing, nasal symptoms, cough, runny nose and congestion


Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. Anaphylaxis requires immediate medical treatment and epinephrine (adrenaline). Epinephrine is the only available treatment for a severe peanut allergy reaction.

Anaphylaxis signs and symptoms include:

  • Skin reactions, including hives along with itching, flushed or pale skin (almost always present with anaphylaxis)
  • A feeling of warmth
  • The sensation of a lump in your throat
  • Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
  • A feeling of impending doom
  • Drop in blood pressure
  • A weak and rapid pulse
  • Nausea, vomiting or diarrhea
  • Dizziness or fainting

Peanut allergy foods to avoid

The U.S. Food and Drug Administration requires major food allergens to be identified on product labels. Individuals with peanut allergies should become familiar with food labels and should avoid products with labels indicating that they contain peanuts. In addition, caution should be taken with foods that have labels bearing precautionary statements such as “may contain peanuts.” We also suggest that those with peanut allergy be vigilant at restaurants and find out what is in your food. Remember, most people with an allergy to peanuts can safely eat processed peanut oil, but not cold-pressed, expelled or extruded peanut oil that has peanut protein in it. Generally, the processed oil is clear and contains no particles or sediment.

Unexpected sources of peanut allergy

The Food Allergy & Anaphylaxis Network lists a number of unexpected sources of peanut allergy. The website explains that the list is not intended to imply that peanuts are always present in the following foods, but that it should serve as a reminder to read the labels and ask questions about food you have not prepared yourself.

  • Sauces, such as chili sauce, hot sauce, pesto, gravy, mole sauce and salad dressing
  • Sweets, such as pudding, cookies and hot chocolate
  • Egg rolls
  • Potato pancakes
  • Specialty pizzas
  • Asian and Mexican dishes
  • Some vegetarian food products, especially those advertised as meat substitutes
  • Foods that contain extruded, cold-pressed or expelled peanut oil, which may contain peanut protein
  • Glazes and marinades


People with peanut allergy should avoid foods that contain whole peanuts, peanut particles or peanut protein. Additionally, those allergic to peanuts should carry an EpiPen, which is an adrenalin auto-injector that Oregon Allergy Associates prefers, because it can improve outcomes for those who’ve inadvertently consumed or been exposed to peanuts.

Our recommendations

Peanut allergies can be treated. If you or a loved one has a peanut allergy, we recommend you do the following:

  • See your doctor.
  • Establish a Food Allergy Action Plan with you doctor and have it filed at the patient’s workplace or school.
  • Keep an EpiPen or adrenalin auto-injector with you.
  • Learn more about food allergies on the Food Allergy Anaphylaxis Network website and become a member, if you wish.
  • Wear a medical alert bracelet so that medical emergency care workers can quickly respond if you have an emergency.

Exciting research

In future blog posts we will be discussing some exciting research about peanut allergies and new forms of treatment and diagnosis.

An energetic problem solver, Dr. Kraig Jacobson has spent his career treating patients and teaching about the complexities of allergy, asthma and immunology. He has practiced medicine in Eugene since 1979. The bigger the challenge, the more he enjoys his work.