Hazelnut allergy is one of the most common nut allergies. Symptoms can include any of the usual symptoms of food allergies (from the mild to the severe) and can occur within two hours of consuming hazelnuts or food containing them.
Symptoms may include:
- Skin: Hives or eczema
- Eyes: Allergic conjunctivitis
- Gastrointestinal system: Nausea, abdominal pain, vomiting or diarrhea
- Airways: Wheezing, coughing or runny nose
- Mouth: Angioedema (swelling of lips, tongue or face)
- Anaphylaxis: A severe allergic reaction that requires immediate medical care
Oral Allergy SyndromeOral allergy syndrome (OAS) is a form of Ig-E-mediated food allergy in which people who are sensitive to pollen react to certain foods that are related to those pollens. In the case of hazelnuts, many people with birch pollen allergies also react to hazelnuts.
Symptoms of hazelnut OAS are usually confined to tingling, itching or swelling of the lips, tongue and throat. These symptoms may be treated with an over-the-counter antihistamine such as Benadryl. After taking an antihistamine, a person with OAS should be monitored for the next few hours to make sure that more serious allergic symptoms do not develop.
Occasionally, some people with OAS have more severe reactions that may include rashes, delayed gastrointestinal symptoms such as abdominal cramps and diarrhea, or, very rarely, anaphylaxis. More severe, full-body reactions require immediate treatment with the drug epinephrine.
Treatment of Hazelnut AllergyThere is no cure yet for hazelnut allergy. Management of your hazelnut allergy involves avoiding hazelnuts and being prepared for future reactions.
Talk to your doctor or allergist if you have any symptoms after eating or touching hazelnuts. You may need allergy testing to determine the severity of your reaction and to determine if you have allergies to other nuts.
Do You Need an Epinephrine Auto-Injector?Some people with OAS have only localized reactions that have been successfully treated with antihistamines. However, your doctor may prescribe an epinephrine auto-injector (commonly referred to by the brand name EpiPen) for you just in case of a more severe reaction. You will need to carry your auto-injector with you at all times.
Living with a Hazelnut AllergyNuts are one of the eight most common food allergies in the United States, and so are covered by the current food allergy labeling law (FALCPA). Food manufacturers are required to list nuts on their ingredient labels in plain English. A hazelnut allergy warning on an ingredient label should look like this: "Contains: Nuts (hazelnuts)."
Some foods, such as those in restaurants or at someone's home, will not have convenient ingredient lists on them. You should learn to recognize foods that commonly contain nuts. When ordering food in a restaurant, always ask questions of your server or ask to speak to the chef about your hazelnut allergy.
Food Allergy Initiative. Tree Nut Allergy. Accessed online 10/2/2010 http://www.faiusa.org/?page=treenuts
Geroldinger-Simic, M, et al. Birch pollen-related food allergy: Clinical aspects and the role of allergen-specific IgE and IgG4 antibodies. J Allergy Clin Immunology. Vol. 127, No. 3
NIAID-Sponsored Expert Panel. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel. The Journal of Allergy and Clinical Immunology. Volume 126, Issue 6, Supplement, Pages S1-S58, December 2010
Webber, Christopher and Ronald W. England. Oral allergy syndrome: a clinical, diagnostic, and therapeutic challenge. Ann Allergy Asthma Immunol. 2010;104:101-108