Allergy to just one sort of nut - common?

[Smithagain]

Just wondering how common it is to be allergic to one sort of nut, but not others?

The background is that DH is allergic to peanuts and all tree nuts (or at least all those he's aware of having tried!). We went down the road of excluding nuts from our children's diets when they were small, which was the advice in place at the time.

The children are now 4 and 7. DD1 has had RAST tests which came up within the normal range of peanuts and a range of tree nuts. We were advised not to treat that as a cast iron result, but to gradually start introducing nuts and monitor for any symptoms. DD2 has never been tested. (DD1 got the tests on the back of an apparent reaction to a bee sting when she was a toddler - although she also seems now to be OK with insect venom, thankfully.)

Both of them have now eaten peanuts, walnuts, hazelnuts and almonds without any apparent reaction. But at the moment, school is still under instruction not to expose them to nuts, while we're in the process of introducing them in a systematic way.

I'm just wondering how many different nuts I need to "try", before we can be reasonably confident of relaxing about their diet when they are out of our immediate care. Having gone down the road of excluding them, it feels really hard just to say anything goes now!!!

I've read somewhere that there are groups of nuts you can be allergic to, hang on a mo and I'll google.

OK, this page is a bit technical but has a lot of info on the most common nut allergies, and which nuts come from the same family (so presumably if you're fine with one you're more likely to be fine with others).

A word of caution though. Unless you're getting nuts directly from the shells, you can't be sure about cross-contamination as the generic word 'nuts' is used on allergy labelling rather than the specific variety. If they were to have a reaction, it would be hard to say for sure what exactly they were reacting to unless you'd shelled the nut yourself. Plus this info is not 100% reliable, not everyone's allergies follow a pattern. So you may find if you want to be sure, you have to try every single nut.

Hope that helps, good luck!

Thanks Lulu - that's really useful. I didn't know they came in families. I'll have a read, and think about whether we can introduce at least one from each of the most-likely-to-be-encountered families before we stop taking precautions at school etc. Then I guess we are no worse off than anyone else who might have an undiagnosed allergy lurking in the background.

It's really scary, getting my head around the idea that they might be able to eat whatever they like, after all these years of vigilance, though!

Ds is allergic to peanuts and hazelnuts. These are in different families of nuts and he can eat other nuts within the same groups without any reaction.

Not sure if that is any help or not!

My dd had RAST tested positive to Hazelnuts and negative to all other types of nuts! Which I was really surprised about. She also has multiple environmental allergies, asthma and milder intolerances to milk and pine nuts.

Hi Smithagain.
My son is allergic to 3 nuts, but not others. The allergist pediatric. explained the importance of introducing the "good" nuts, I mean keep on giving the ones that are ok and he had already had, and introduce (after skin test + RAST) the new ok ones. He said that because he was allergic to some (Pist, Hazel and cashews) it was very important to regularly - one a week - give him the others to decrease the chance of becoming allergic to others.
I am obviously very careful and would only give him the "good nuts" from the supermarket, in shell if possible, and never from a restaurant etc.. where you are not sure if the've been mized with others..
Hope it helps!

That's interesting - hadn't thought about the possibility that we actually should give them nuts. It's all a bit confusing and completely contrary to the way we've lived ever since we got married (nothing with nuts in the house, etc)!

Different consultants seem to say different things.

Ds' just said to be very careful with other safe nuts as they can be contaminated by the ones that cause a reaction (peanuts are apparently ''very dirty nuts'' in that they get mixed in with lots of others). We were not told to actually give him the safe nuts though. Has anyone else been told this?

Madre's suggestion of giving only nuts from their shell is a good idea.

Yes we were told to carry on eating the 'good' nuts, little and often (eg once a fortnight) to keep a bad reaction at bay.

Hi Again,
yes, we'd seen the doctor in June, after my son's first big reaction, he did prick test and asked for a RAST to be then. he told me to keep on giving almonds and walnuts (good nuts) that DS had already had. To be honest I didn't for a while, I was so afraid, and I hadn't understoon the importance then. He just said give them. After 3 months and the RAST results we saw him again (he is a brilliant doctor, allergist pediat. does research on nut allergies) and he asked if I had been giving the good nuts, when I said no, he then explained how important it was to keep the good nuts staying good (as far as I understand someone allergic to some nuts has a bigger chance to becoming allergic to the rest of thenust than someone with no allergies at all, hence the importance of giving the good nuts regularly. So I started giving them, he said slowly, sort of trying a bit on his lips, and then a quarter of a nut, and then half etc... my fear obviously was that when you buy a packet of nust, say almonds, you find in some supermarkets that there is a warning sayind "may contain trace of "other" nuts" and the whole thing becomes nightmare as I would never give my son a chocolate or biscuits or anythign with the warning, but I suppose this is part of managing risk and I think it is better to build My DS good nut inmmunity and risk the trace of other nut that we could find in a packet of almonds...sorry if it is confusing..so, I do try to buy in the shell (Xmas season easier for that) and generally buy from Waitrose, and when they are not in the shell give them a rinse before giving (not sure if that is logic or my madness, my DH says it does not make any difference, I still think it might rinse some bit of other nut..)
Sorry I wrote so much...Hope it helps!

and our GP that we still see, also quite good as she has a daughter with allergies so does take it very seriously, said the same. She said to always make sure you give the whole good nut and not ground nuts where they could be mixed with bits of other, or never ins a cafe or restaurant, just at home where you see what you are giving...

sorry a bit more, maybe important to point out that mi friend saw the same doctor (before we became friends) for her DS allergic to peanuts and a bit allergic to other nuts but not that much, and the doctor didnt tell her to keep good nuts going, we believe it's because there weren't any really good nut for him, some were bad, others not so bad (I don't actually know what the RAST results were for him)... I mean it's worth making sure how good is your child with the "good" nuts, as they have to be perfectly "good" I understand, I mean no reaction at all...mybe it was because her son was a lot younger (under 2).. not sure tbh

Hi there

Just to cloud the waters a little more (like that's necessary!), my ds who is 4, has only ever had a reaction to brazil nuts, and only comes up with a positive skin prick to that nut. He was clear on peanuts, almonds, hazlenuts, pistachios, cashews, and pine nuts. However, as he is still little, our advice was to avoid all nuts in order that he doesn't develop an allergy to them at this stage!
After reading the previous posts, I am now totally confused! Perhaps this advice is because he is below 5?

Also confused. We were told to avoid all nuts until DS1 was 7. Apparently allergies can go in 7 year cycles. They really don't know the answer yet - our Doc admitted as much. So we have to keep DS2 off nuts too, even though he has shown no allergy to anything we have given him, but family history does play a large part. Both DH nad I have allergies - (not to nuts) hayfever, cats, dogs. DH1 had anaphlatic reaction to egg but has since been tested and has outgrown this. Therefore we have to be careful as we have obviously passed on the allergy gene, although the doc said the allergy may change in the next generation.

So yes, all very confusing.

Hi my dd2 is allergic to peanut and it appears to be only peanuts. She has been tested for Peanuts, hazelnuts, brazil nuts, almonds and walnuts and all were negative except for peanuts. I was told she could have the other nuts if I shelled them myself to avoid contamination.

I have a question though, what is a RAST test? And I have just got a letter today from the paediatrician confirming her results, saying her positive control was 4mm and her peanut reaction was 6mm - does this mean she is very allergic or mildly allergic to peanuts or does it not work like that? This is a whole new world for me!- sorry if this is a bit of a hijack.

Hi All again, yes quite confusing, lots of doctors and lots of research going on ... I understand that the advice on keeping the good nuts going is related to building/keeping immunity... but obviously have no idea why some children are told to have the good nuts and others not. Might be age, might be specific RAST results, family history, having asthma or not (aparently this makes a massive difference in being high or low risk to An. reaction) .... Obviously wouldn't try anything at home that your doctor hasn't told you to do. Each patient is different and what's right for on it's wrong for the other. I think policies are changing now about what to do during pregnancy reg. nuts in the diet...they are all doing so much research now as the number of children with allergies is massively increasing... best thing ask your doctor. About RAST, is a blood test for allergens, pur doctor did Skin Prick test, then RAST and then asked about things my DS has had and then put it all together I understand... when we first saw him (right after first attack) he told me to keep on giving only the good nuts he has already had. then after RAST he told me to introduce the new good nust that he had never had (very slowly, and weekly).

sorry bit more, my DS had 6 mm to cashew and 7 mm to pistachio and 9 mm to hazelnut. We were given an Epipen immediately. Not sure what those exactly mean...it really depends on the child and other related things (breathing, excema etc..)

Yes, my ds skin prick was 6mm for brazils only. He doesn't have any other allergies nor did he have any breathing difficulties or swelling round the mouth when he had his one and only reaction, yet we were given epipens immediately and told to avoid all nuts. We have never had the RAST done.

I suspect the knowledge base across the NHS and elsewhere is just not that great, and until it gets better and more consistent, the advice is going to vary massively from patient to patient. Not very helpful right now!!

Yes I agree.
If I was looking for a doctor I'd go to St Thomas (Evelina's, that's where the An Campaing suggested in the first place), Adenbrook in Cambridge or Portland Hospital in London if you can afford private. As far as I understand and have read so far those are doing the research, so doctors in those teams should be updated...I imagine some GP s are great, mine is very good again because of her daughter (or maybe she would be anyway? who knows...) but my previous GP did't even know you had to carry 2 Epipens, I was so shocked ... (on the other hand the NHS paramedics that came to save my DS when reaction happened were incredibly amazing and knew so much about this!!)