Almond allergy
Tree-nut allergy to almonds.
About almond allergy
Almonds are the seed of the almond tree and one of the tree nuts named in UK food-labelling law. Almond allergy is among the more commonly reported tree-nut allergies and can affect both children and adults; while some childhood nut allergies are outgrown, tree-nut allergy often persists for life. In most cases it is an IgE-mediated immediate allergy, in which the immune system mistakenly makes antibodies to almond proteins, and later exposure triggers a rapid release of histamine and other chemicals.
Because it is an immediate-type allergy, symptoms usually begin within minutes and rarely more than an hour or two after eating. Reactions range from an itchy mouth, hives, swelling of the lips and face, and tummy upset, through to wheezing and, at the severe end, anaphylaxis with breathing difficulty or collapse. Some people with birch-pollen hay fever notice mild oral itching to raw almond as part of pollen-food syndrome, though almond can equally cause serious whole-body reactions. There can be cross-reactivity with other tree nuts, so many people are advised about several nuts at once.
Diagnosis is confirmed by an allergy specialist using skin-prick tests or specific-IgE blood tests, sometimes followed by a supervised food challenge. Management centres on strict avoidance, careful label-reading, and awareness of marzipan, praline and nut oils. Anyone at risk of anaphylaxis is usually prescribed an adrenaline auto-injector. A severe reaction is a medical emergency: use the auto-injector and call 999 immediately.
Common triggers
- Almonds and marzipan\nAlmond milk and flour\nBaked goods and cereals
Symptoms
- Itching or tingling in the mouth
- Hives, itching or eczema
- Swelling of the lips, face, tongue or throat
- Stomach cramps, nausea, vomiting or diarrhoea
- Wheezing or trouble breathing
- In severe cases, anaphylaxis
Avoidance & management
- Read ingredient labels every time
- Ask about ingredients and cross-contamination when eating out
- Keep the food out of shared cooking areas
- Carry prescribed antihistamines or an adrenaline auto-injector
- Seek emergency help for any severe reaction
Sources & references
Allergy safety: what everyone should know
Mild-to-moderate reaction signs
- Itching, hives or a raised rash
- Swelling of lips, face or eyes
- Tingling mouth, sneezing, runny nose
- Stomach pain, nausea or vomiting
Anaphylaxis — call 999 (UK) or 112 (EU) immediately
- Difficult or noisy breathing, wheeze, persistent cough
- Swelling of the tongue or tightness in the throat
- Dizziness, collapse, pale and floppy (young children)
- Use an adrenaline auto-injector (e.g. EpiPen) at once if prescribed, then call an ambulance even if symptoms improve
Allergy or intolerance? A true allergy involves the immune system and can escalate quickly; an intolerance (e.g. lactose intolerance) is unpleasant but not life-threatening. The symptoms overlap, so self-diagnosis is unreliable.
Getting tested: home-testing kits based on IgG are not diagnostically valid. If you suspect an allergy, ask a GP for referral to an allergy clinic for skin-prick or specific-IgE testing and a supervised food challenge where appropriate.