Was my GP's advice bonkers or is this right? (re poss peanut allergy)

[TheHelpfulHiker]

DS2 is four and we suspect he has a peanut allergy. When he was a toddler he had a severe reaction to peanut butter (ended up in A&E although was over pretty quickly). On another occasion we were at a party with a bowl of peanuts on the table and he came out in hives, although he didn't touch them, others around him did so there would have been traces on the table etc. We have subsequently done a skin test with some peanut butter and again his skin reacted. Now he is starting school so we need to formalise it and find out how severe it is, what we need to do to manage it etc. I know we should have done it sooner, but I took him to our GP this morning and the general consensus is that we can't be sure it's peanuts as there are many ingredients in peanut butter and even peanuts have salt and other preservatives(?) on them. SO my GP told me to go home, give him 2-3 peanuts (after boiling them so there is nothing else on them), have some piriton to hand and call 999 if he has a bad reaction. Is it me or is that nuts? (pun intended). In the end we gave him half a nut, his face went blotchy and came out in hives so I dosed him up with piriton and it subsided. We have another appointment on Thursday. Fingers crossed we get further! If any allergy parents have any tips on what to say and how to make some progress I'd be so grateful.

That is so ridiculous I cant even type straight. He could have ended up anaphylactic. You had significant evidence that he did have a peanut allergy and to suggest that it might be salt or sugar rather than peanuts is just stupid considering the number of kids with a peanut allergy versus the number of kids with a salt or sugar allergy (hint I have never even heard of the later). Your son needs allergy testing by an allergist, and a proper treatment/risk management plan

New GP time!!!

I switched GPs after mad allergy advice (eat cheese instead of the dairy he’s allergic to...) and never regretted it

@Clovko don't worry, we are changing ASAP! Worryingly the doctor I saw today is usually the one that I've found most helpful in the past!

www.nice.org.uk/guidance/cg116/chapter/1-Guidance

Children with a suspected IgE mediated allergy (hives or urticaria) should have skin prick testing.

I don’t often say this but if story is as You say it might be worth a complaint as sounds like GP has an educational need.

That was hugely dangerous advice. When my daughter had only a suspected non-ige allergy I was told not to give it to her for TWO years, not to go home and try it myself. Jesus Christ, that’s shocking.

Glad your son is ok - but ime many gps know little about allergy.

I'm a GP. I would have advised you to avoid peanuts and possibly other nuts if any suggestion of allergy to them and referred to allergy clinic for testing. Also carry piriton in case you unwittingly ingest peanuts.
I think this GP may be getting confused with gradual reintroduction we use for other things eg dairy or egg intolerance.
Worth highlighting to the GP as really important they are aware.

Did you post this twice?

That is absolutely ridiculous advice. Our GP in contrast explained to us that after one a&e visit with a 7month old we needed to log any further reactions with the GP or a&e so we could be referred to the allergy clinic. There we had multiple skin prick tests followed by a detailed ige blood test which showed which specific protein in peanuts our child is allergic too (there are at least 3 and they have differing severity and prognosis) and over repeat visits has shown that she is vanishingly unlikely to grow out of her allergy. While our GP at the first visit at 4 months (massive skin reaction to touch after I’d been eating nuts) was sceptical that the cause was nuts and said it was more likely to be milk - true, but he also recommended nonetheless that we steer clear of nuts etc till more was clear.

Some consultant allergists have given this advice re go home and try a bit, it will be fine.. to people I know including family members BUT generally after either a blood test showing v low risk OR after taking a detailed history suggesting a pattern of quickly self-resolving reactions.

When you say you’ve done a skin test, do you mean an actual skin prick test at a clinic? Because only that is a reliable skin test. Our allergy clinic said it is absolutely pointless rubbing products on skin at home as you can get a false positive - or worse, a false negative.

Also, fwiw, roasted peanuts (as in PB, or salted nuts...) are much more likely to cause a big reaction than raw peanuts, because of the effect of heat on the proteins.

That does sound like worrying advice. I won’t even try penicillin because it seems to run in the females in close family so it was never tried on me. I know it’s different but I wouldn’t think suggesting to try the possibly allergic to item is wise.