Tree Nut Allergy – Everything you need to know

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If you or your child have recently been diagnosed with a tree nut allergy, chances are you feel like life has been turned upside down. Tree nut allergies are one of the nine most common allergies found in children and adults, affecting almost 1% of the U.S. population.

If you’re feeling lost, overwhelmed, or like you don’t even know where to start, then you’ve come to the right place. Below you’ll find Everything You Need To Know About Tree Nut Allergies. From signs and symptoms to tips for managing allergies at home, I’m here to help.

Almonds over a pink surface.

What are tree nuts?

Tree nuts are technically the seeds of certain fruit-bearing trees, such as almonds, cashews, pistachios, hazelnut, walnuts, pecans, and others.

What Is A Tree Nut Allergy?

According to, “Tree nut allergy is a common allergy among children and adults. About 0.5 to 1% of people in the U.S. have a tree nut allergy. A nut allergy is an immune system reaction to nut protein. Tree nuts contain many different proteins. Children with a nut allergy may be allergic to one or several nuts.”

The six tree nut allergies most commonly reported by children and adults are allergies to walnut, almond, hazelnut, pecan, cashew, and pistachio. 

Tree Nut Allergy Symptoms and Reactions

An allergic reaction to tree nuts can be severe and potentially life-threatening. Even just ingesting a small amount can cause a serious reaction, like anaphylaxis.

Anaphylaxis is a very real reaction to tree nuts and should be treated immediately with injectable epinephrine. (EpiPen) You should also call 911 to prevent any possible complications.

Some symptoms of Anaphylaxis are:

  • Hives, itching, skin rash
  • Swelling of the tongue, lips, or throat
  • Shortness of breath
  • Trouble breathing/ wheezing
  • Stomach pain
  • Vomiting
  • Diarrhea
  • Nasal congestion

To know more about this severe allergic reaction, check out my post about What Is Anaphylaxis and How Is Treated.

What Causes A Tree Nut Allergy?

According to, “When a person with an allergy to a particular tree nut is exposed to that tree nut, proteins in the nut bind to specific IgE antibodies made by the person’s immune system. This binding triggers the person’s immune defenses, leading to reaction symptoms that can be mild or very severe.”

The Difference Between Tree Nuts and Peanuts

A lot of times, tree nut allergies and peanut allergies are lumped into the same category. However, this is wrong because peanuts are NOT tree nuts. 

eggless turtle cake

Baking with food allergies does not need to be frustrating! Even if you can’t use certain ingredients, you can produce amazing desserts that the whole family will love.

Peanuts are actually a form of legume, not a nut, although many individuals who are allergic to peanuts also react to at least one tree nut. In order to clear up any confusion about allergies, it’s best to see your doctor or allergist.

Treating Tree Nut Allergies

For many years, the standard of care for food allergies has been allergen avoidance. Nowadays, oral immunotherapy (OIT) holds promise as a treatment option that can potentially improve the quality of life for allergy patients.  OIT involves eating the food allergen, starting with a very small amount, and progressively increasing the amount in an effort to retrain the immune system and raise the threshold amount of food protein that results in an allergic reaction. OIT may not be the right treatment for everyone, so you must carefully discuss it with your allergist. 

Strict avoidance of confirmed food allergens is recommended for the management of food allergies. 

Managing Tree Nut Allergies At Home

The most effective way to manage allergies at home is to completely avoid bringing tree nuts or products containing tree nuts into the house. You should always read labels at the grocery store, inform family members that you may bring food over, and have a solid system set in place in case of an emergency.

If avoiding tree nuts altogether isn’t possible, you can reduce the risk of cross-contamination by using color-coded containers, (I usually do green for safe foods and red for bad), having an allergy-friendly shelf in the pantry where safe foods can be kept, and using different sets of kitchen tools when cooking.

You should also always have a list of emergency numbers to contact in an obvious spot, like on the fridge, so that anyone in the house knows who to contact in an emergency situation.

Check out my 8 Tips to Keeping an Allergy Friendly Kitchen.

Common Foods That Contain Tree Nuts

The most secure way to prevent accidentally ingesting any tree nuts is to read ingredient labels carefully and be aware of the food that contains them. In the United States, food companies must label their products clearly and name any nuts that are in the product.

Some common foods with tree nuts in them are:

  • Nut butters (like almonds, cashew, macadamia, or pistachio)
  • Almond flour
  • Non-dairy alternatives made from nuts
  • Pesto
  • Pralines
  • Candy
  • Ice cream
  • Cereals
  • Energy bars
  • Flavored coffee
  • Coffee creamers
  • Barbecue sauces
  • Salad dressings and marinades
  • Alcoholic beverages

In addition to food, some nut oils have been found in shampoos, lotions, and soaps, so be sure to check the ingredients in them as well.

Ingredients To Avoid

If you’re reading ingredient labels to prevent accidental ingestion, it’s important also to be aware of everything you’ll need to avoid now. Look out for:

  • Almonds
  • Artificial nuts
  • Brazil nut
  • Beechnut
  • Butternut
  • Cashew
  • Chinquapin nut
  • Hazelnut
  • Ginkgo nut
  • Hickory nut
  • Lychee nut
  • Macadamia nut
  • Natural nut extract
  • Nut pieces
  • Nut oils
  • Pecans
  • Pine nuts
  • Pili nut
  • Pistachio
  • Shea nut
  • Walnut

Will My Child Outgrow Their Tree Nut Allergy?

Studies have shown that most tree nut allergies tend to be lifelong allergies. Only about 9% of all children with this allergy have reported outgrowing it.

Frequently Asked Questions

Can I eat coconut if I have a tree-nut allergy?

Coconut is a fruit, not a botanical nut, even though the Food and Drug Administration recognizes coconut as a tree nut. While allergic reactions to coconut have been documented, most people who are allergic to tree nuts can safely eat coconut. However, you must talk with your doctor before consuming coconut with a tree-nut allergy.

Is nutmeg a tree nut?

Nutmeg is a spice that is derived from seeds, not nuts. It may be safely consumed by people with a tree nut allergy.

What is considered a tree nut allergy?

A tree nut allergy is one of the top allergens recognized by the FDA. If someone is allergic to tree nuts, they’re allergic to the proteins found in popular tree nuts such as almonds, cashews, pistachios, walnuts, and others.

What is the most common tree nut allergy?

The 6 most common tree nuts people are allergic to are walnuts, almonds, hazelnuts, pecans, pistachios, and cashews.

Is a tree nut Allergy the same as a peanut allergy?

No, they are not the same allergy. Peanuts are actually legumes, not nuts. 

While a tree nut allergy is a difficult diagnosis to handle at first, there are steps you can take to stay safe. You may be feeling confused, angry, or weighed down with a feeling of loneliness, but if you look in the right spots, there can be an overwhelming amount of support.

Living with a food allergy is totally manageable! Yes, it requires attention to detail, planning, and vigilance. It also means that certain foods must come out of your diet. But it does not mean that life as you know it will end. With some simple safety steps, you can still eat out, travel, go to parties, send your child to school or on play dates, and live a normal life. 

I suggest joining a Facebook group, finding a blog, or listening to podcasts in order to find information and support. A tree nut allergy is not an easy diagnosis to live with, especially because reactions can be so severe, but I have faith that you will handle it well and will come out stronger than ever.

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