What is almond allergy?

Row of delicious almond tarts with a cherry on top – one of the foods to avoid if you’ve got almond allergy

Almond allergy seems to be relatively rare but, like other tree nut allergies, it can be life-threatening. You may have mild to moderate symptoms such as a rash, swollen lips or upset stomach. But almonds can also trigger severe allergic reactions affecting your whole body. So it’s very important to seek medical advice if eating almonds makes you feel at all unwell.

Your healthcare provider will have lots of advice on how to manage almond allergy. They may also prescribe medication for you to carry in case of an emergency.

In the meantime, why not read our simple guide. You’ll find out why some people react to almond and what the possible symptoms are in more detail. We also share ways to avoid almonds if they’re your allergen (that’s the word for something that can trigger allergies).

What causes almond allergy?

Almond allergy happens when your overactive immune system feels threatened by proteins in this type of tree nut. It produces immunoglobulin E (IgE) antibodies, ready to fight off the danger if you ever come into contact with almond again. Now you’re sensitized. Not everyone goes on to develop almond allergy but you could. In which case, eating or drinking anything with almond in it might give you the symptoms we’re about to describe.

Almond allergy symptoms

As with other tree nut allergies, the effects of coming into contact with your allergen can vary. At the milder end, you might get any of these symptoms because of your almond allergy:

  • A raised, itchy red rash (hives) – sometimes the skin can turn red and itchy but not raised
  • Tingling or itching in the mouth
  • Swelling of the face, mouth, throat or other parts of the body
  • Difficulty swallowing
  • Wheezing or shortness of breath
  • Feeling dizzy and lightheaded
  • Feeling sick (nausea) or vomiting
  • Abdominal pain or diarrhea

Almond is a useful ingredient for food manufacturers. The nuts are rich in protein, fiber, vitamins and minerals, and contain healthy unsaturated fat. Almond is also a good replacement for dairy and wheat.

Even a tiny trace of almond could trigger an allergic reaction. You may start to feel unwell in minutes or even seconds after coming into contact with it – and generally within two hours.

Almond allergy and anaphylaxis

You might expect that almond will always give you a rash if that’s what has happened in the past. But allergy isn’t that predictable. A history of milder symptoms doesn’t rule out severe allergic reactions affecting your whole body in the future. Seek medical attention immediately if you recognize these symptoms of anaphylaxis:

  • Skin reactions, including hives and itching and flushed or pale skin
  • Low blood pressure (hypotension)
  • Constriction of your airways and a swollen tongue or throat. This may cause respiratory symptoms like wheezing and trouble breathing
  • A weak and rapid pulse
  • Nausea, vomiting or diarrhea
  • Dizziness or fainting

Anaphylactic shock is shock caused by anaphylaxis. Your blood pressure falls to a critical level which means your body may stop getting enough oxygen. That can damage your organs and even be fatal.

Treatment for almond allergy

Scientists are still working on long-term treatments for most tree nut allergies including almond. At the moment only symptom-relieving medication is available.

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  • Mild to moderate symptoms: The IgE antibodies tell certain cells to release histamine. It’s part of your body’s inflammatory response to the almond allergens and causes many of your milder symptoms. Antihistamine does just what the name suggests; it blocks the uncomfortable effects of histamine. Relatively slow to take effect, it is not the right medication if you think you or someone else could be having anaphylaxis.
  • Severe symptoms: Anaphylactic reactions need fast-acting treatment right away. Epinephrine is another name for adrenaline and it comes in an auto-injector. It's prescribed for you to administer to yourself in an emergency. Carry two doses with you at all times in case one isn’t enough. You should still call an ambulance or go to the hospital even if using the auto-injector makes you feel better. Anaphylaxis can cause a second wave of symptoms a few hours later.

How to avoid getting almond allergy symptoms in the first place

Avoidance is the main tool for managing almond allergy in everyday life. It’s easy when you can see whole nuts in your cereal or bar of chocolate or flakes on an almond pastry. But almond can be a hidden allergen in food and in toiletries too. Being smart about where you might come across the allergens can help lower the risk of accidental exposure and serious allergic reactions.

1. Know your nut: Almond is a useful ingredient for food manufacturers. The nuts are rich in protein, fibre, vitamins and minerals, and contain healthy unsaturated fat. So they can boost the nutritional value of a food. Almond is also a good replacement for dairy. Almond milk adds creaminess to sauces, spreads, dips and (frozen) desserts. Almond butter is a binder in cookies and thickener in drinks and sauces. Gluten-free products often use almond flour instead of wheat.

Food allergy or intolerance?

Woman holding her sore stomach with a glass of milk on the table in front of her. Lactose can cause food intolerance

2. Read food labels carefully: Tree nuts are one of the major allergens which must be highlighted on food packaging by law. If you have almond allergy, avoid almond extract, essence or natural almond flavoring. But “artificial almond flavoring” is just what it says, artificial, and not made fromthe nut.

Almond alcoholic drinks may or may not be made from the nut, even amaretto. Read the label if you can; if not, say no thanks. Less obviously, almond may be one of the flavors in some spirits, including gin. The infusing process makes it unlikely that proteins are left behind. But do ask your healthcare provider if you should avoid them.

3. Scan your skincare: Personal care products like body lotion, shampoo and conditioner, and soap may use almond oil. Refining tends to alter the allergenic proteins but more artisan brands may use cold-pressed oil.

Again, your healthcare provider can give you advice on what not to use. Almond may be written in Latin on the non-food labels. Sweet almond is Prunus dulcis or Prunus amygdalus dulcis. Bitter almond is Prunus amara or Prunus amygdalus amara.

You can find lots more practical tips on how not to spread or pick up food allergens here.

Almond allergy symptoms from other foods

Six almond proteins have made it onto the official global list of allergy triggers. Depending on which is your trigger, similar proteins in other foods may cause unwelcome symptoms too. This cross-reactivity happens because your overenthusiastic immune system can’t tell the difference easily. Common cross-reactions with almond include peanut, hazelnut, walnut, chestnut, peach, mahleb (a Middle-Eastern spice made from cherry seeds) and maize.

Dangling birch flowers called catkins release millions of pollen grains in spring which give some people hay fever

Birch pollen can give
you hay fever

Almond belongs to the same branch of the rosaceae plant family as stone fruit such as peach, cherry and apricot. It’s not a nut at all but the seed inside the kernel of a peach-like fruit or drupe (pronounced droop). So it’s not surprising they share similar proteins. One of them is a type called lipid transfer protein (LTP).

Lots of plant-based foods contain LTPs, mostly in the skin, pips and seeds. Adults can develop lipid protein transfer allergy, which behaves like a food allergy. You may react to a few or several fruit, vegetables, nuts and cereals. Other common culprits include apples, grapes, walnuts, dried fruit and tomatoes. It seems to be rare in children, unlike tree nut allergies which commonly start in childhood.

Hay fever and almond allergy

You might be wondering why we’ve matchmade these two conditions. It’s also to do with cross-reactions. Proteins in certain pollen are like those in almond. You could be allergic to birch pollen, plane or mugwort and react when you eat almond.

It’s called oral allergy syndrome (OAS) or pollen food syndrome (PFS). Symptoms are often mild and local such as an itchy mouth. And you may get them at the same time of year as birch pollen gives you hay fever symptoms like a runny nose.

Get yourself checked out as soon as you can anyway. If it's a food allergy and not OAS, that can be life-threatening.

Getting a diagnosis of almond allergy

Your healthcare provider will ask you to describe your symptoms, when they last happened and what you think the cause was. Your medical history is important too and so is your family’s. A child is more likely to react to tree nuts including almond if a parent or sibling does too. The risk also goes up if you have egg allergy or severe eczema.

Allergy testing can help confirm the diagnosis.

An itchy rash could
be skin allergies

Man applying cream to the backs of his hands to ease skin allergy symptoms. Food allergies like almond can cause a rash

Testing for peanut and tree nut allergies

Up to 40% of kids with a tree nut allergy have peanut allergy too. Also, being allergic to one tree nut makes it more likely you’ll react to another. That’s why the advice is often to avoid all nuts if you’re allergic to one. Also why your healthcare provider may suggest testing for peanut and tree nuts other than almond at the same time.

Skin prick tests tend to be the first choice. You may need an allergy blood test too. This can either look for whole allergens or for specific proteins. The latter is called a component blood test and can help assess your risk of anaphylaxis. That's because some proteins are more likely to trigger severe systemic allergic reactions. A component blood test can also distinguish a peanut or tree nut allergy from oral allergy syndrome (OAS).

If the diagnosis is still unclear your healthcare provider may ask you to do an oral food challenge at their clinic.

You eat tiny amounts of almond while medical staff monitor closely you for allergic reaction. This is a more definitive test because it shows you almond allergy in action – or rules it out.

Almond allergy summary

Almond allergy can cause mild to potentially life-threatening symptoms. Call an ambulance if you feel faint and have trouble breathing. This could be an anaphylactic reaction. You must avoid almond completely and, once diagnosed, possibly some related foods too. You may also have to carry emergency medication.

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