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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. A doctor can go through a reaction, tell a nut allergy from a pollen-related one and plan the next steps; allergy tests and anaphylaxis care are in person.
- What it is: an allergy to peanuts, which are legumes, or to tree nuts such as almonds, hazelnuts, walnuts and cashews, or both.
- How common: about 1 in 50 children and 1 in 200 adults in the UK have a nut allergy, and it can start in adulthood.
- Not tree nuts: coconut, nutmeg, chestnut and pine nuts; if you have never reacted to them, they are likely to be safe.
- Emergency: use an adrenaline auto-injector if you have one and call 112 for throat or tongue swelling, difficulty breathing or feeling faint.
Do not book a video appointment if your lips, mouth, throat or tongue suddenly swell after eating, you are struggling to breathe or swallow, your voice is hoarse, or you feel faint, confused or drowsy. Use an adrenaline auto-injector if you have one and call 112.
Can an online doctor help with a nut allergy?
Partly. A doctor by video can go through a reaction to nuts in detail, work out whether it looks like a true peanut or tree nut allergy or a milder pollen-related reaction, treat mild symptoms, and explain the signs of anaphylaxis and what to do. Confirming the allergy and finding out which nuts are safe needs tests at an allergy clinic, and the doctor arranges the referral.
How an online consultation helps with a nut allergy
- The reaction gone through: Which nut, how much, how quickly, and which symptoms, in the detail a specialist needs.
- True allergy or pollen-related: Mouth itching from raw nuts in someone with hay fever is usually a different, milder problem.
- A plan for next time: Antihistamines for mild reactions, and the signs that mean adrenaline and 112.
- The referral arranged: Tests that find out which nuts you react to and which are safe.
What the doctor checks in an online consultation for a nut allergy
The doctor goes through the reaction in detail, because the history decides which tests are needed. The doctor asks about:
- Warning signs: throat or tongue swelling, a hoarse voice, breathing difficulty or faintness during the reaction.
- The nut: which one, raw or roasted, whole or in a food, and how much.
- The timing: how soon after eating the symptoms started, and how long they lasted.
- The symptoms: itching in the mouth only, or hives, swelling, being sick or wheezing as well.
- Hay fever: especially to birch pollen in spring, which points to a pollen-related reaction.
- Asthma and other allergies: including to sesame and other foods.
- Nuts you eat safely: which ones you have eaten without problems since.
What is a nut allergy?
A nut allergy is the immune system overreacting to proteins in peanuts or tree nuts and releasing chemicals such as histamine. Peanuts and tree nuts come from different plant families: the peanut is a legume, related to peas, beans and lentils, while tree nuts include almonds, hazelnuts, walnuts, cashews, pecans, Brazil nuts, pistachios and macadamia nuts.
About 1 in 50 children and 1 in 200 adults in the UK have a nut allergy, and in UK adults, peanuts and tree nuts are the foods most likely to cause an allergic reaction. Hazelnut is the most common tree nut allergy in Europe, and cashew allergy is becoming more common in the UK.
Can you develop a nut allergy later in life?
Yes. Nut allergies usually start in childhood, but adults can develop new peanut and tree nut allergies, including to macadamia, Brazil nuts and cashews. Around half of adult food allergies start in adulthood.
What are the symptoms of a nut allergy?
Hives, swelling of the face, lips or eyes, tingling or itching in the mouth, mild throat tightness, tummy pain, being sick or diarrhoea, usually soon after eating. Severe reactions affect the airway, breathing or circulation, and are anaphylaxis.
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| Severity | What you notice | What to do |
|---|---|---|
| Mild to moderate | Hives, swelling of the face, lips or eyes, tingling or itching in the mouth, tummy pain, being sick, diarrhoea | Antihistamine, and see a doctor |
| Severe (anaphylaxis) | Throat or tongue swelling, difficulty breathing, wheezing, a sudden drop in blood pressure, feeling faint, collapse | Adrenaline auto-injector, and call 112 |
About 40% of severe nut reactions are caused by tree nuts rather than peanuts, and people with asthma are more likely to have a severe reaction. See anaphylaxis.
How do you know if you are allergic to nuts?
Symptoms soon after eating nuts, especially hives, swelling or being sick, point to a nut allergy. Itching only in the mouth from raw nuts, in someone with hay fever, points to a pollen-related reaction. Only allergy tests interpreted with your history can confirm which it is.
Which nuts count in a nut allergy? Coconut, nutmeg, chestnut and more
Peanuts and the tree nuts, such as almonds, hazelnuts, walnuts, cashews, pecans, Brazil nuts, pistachios and macadamia nuts. Coconut, nutmeg, chestnut and pine nuts are not tree nuts, and are likely to be safe if you have never reacted to them.
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| Food | Is it a nut allergen? | Notes |
|---|---|---|
| Peanut | Yes, but a legume | A small number of people with peanut allergy also react to other legumes, such as lupin, soya, peas, chickpeas, beans or lentils |
| Almond, hazelnut, walnut, cashew, pecan, Brazil nut, pistachio, macadamia | Yes, tree nuts | Often more than one: cashew goes with pistachio, and walnut with pecan |
| Coconut | No | Likely safe if you have never reacted to it |
| Nutmeg | No, it is a spice | Likely safe if you have never reacted to it |
| Chestnut | No | Likely safe if you have never reacted to it |
| Pine nuts | No | Likely safe if you have never reacted to them |
| Sesame | No, a seed | More common in people with peanut or tree nut allergy |
| Refined peanut oil | Rarely | Contains little or no peanut protein, and does not cause reactions in most people with peanut allergy |
Can I eat walnuts if I am allergic to peanuts?
Possibly. Peanuts and tree nuts come from different plant families, so many people react only to peanuts or only to tree nuts. But 25% to 40% of people with a peanut allergy are allergic to tree nuts too, so do not try a new nut until a specialist has tested you: testing usually covers a range of nuts to find the safe ones.
What foods are safe with a tree nut allergy?
Foods without tree nuts in the ingredients, and nuts you have been tested for and eat without problems. Nuts are often cross-contaminated in mixed packs, so buy single types, and remember that tree nuts must be highlighted on the label of pre-packed food.
Why am I suddenly allergic to almonds? Pollen-related nut reactions
Adults most often report nut reactions that are linked to pollen. Proteins in some nuts look like proteins in tree pollen, so people with hay fever, especially to birch pollen, can get itching or swelling in the mouth from raw nuts, most often hazelnuts, almonds and peanuts. This is pollen food syndrome, also called oral allergy syndrome, and the reactions are rarely serious.
It can be hard to tell a pollen-related reaction from a true nut allergy from the symptoms alone, so specialists use component blood tests that measure reactions to individual nut proteins. See oral allergy syndrome.
How is a nut allergy diagnosed?
A specialist allergy clinic diagnoses it from your account of the reaction plus:
- skin prick tests or blood tests for specific IgE to the nuts
- component tests, which look at individual nut proteins and help separate a true nut allergy from a pollen-related one, especially in adults with hay fever
- a food challenge under medical supervision, when needed
Can you test for a nut allergy at home?
No. Never test by eating the nut, and do not rely on home kits: blood spot and hair analysis kits sold online are not scientifically proven to diagnose allergy, and can miss a real one. See allergy testing.
Living with a nut allergy
- Read every label: peanuts and tree nuts must be highlighted in the ingredients of pre-packed food. “May contain” labels are voluntary and hard to interpret, so ask your specialist how to treat them.
- Take extra care eating out: more than half of deaths from nut anaphylaxis happened when eating restaurant or takeaway food. Tell the staff about your allergy every time, and ask about cross-contamination.
- Saliva and surfaces: peanut allergen stays in saliva and on household surfaces, so a partner who has just eaten nuts, or an unwiped table, can cause a reaction.
- Carry adrenaline: if prescribed, carry 2 in-date doses at all times, because a second dose may be needed after 5 minutes.
- Keep asthma controlled: asthma raises the risk of a severe reaction.
- Know your safe nuts: finding out which nuts you tolerate makes life easier, and strict avoidance of everything has been linked to more anxiety.
Can you outgrow a nut allergy?
Sometimes, mostly in childhood: about 1 in 5 to 1 in 10 children are thought to outgrow a nut allergy, usually by the age of 4 or 5. In adults it is usually lifelong, but regular specialist reviews check whether anything has changed.
What might the doctor recommend after a reaction to nuts?
What happens next depends on the reaction, the nut and your other allergies. This is the framework the doctors use:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Throat or tongue swelling, breathing difficulty, or feeling faint after nuts | Adrenaline and emergency treatment | No | Call 112 now |
| Hives, swelling or being sick after nuts, with normal breathing | Antihistamine, strict avoidance and a referral | Yes, to assess | Allergy tests at a specialist clinic |
| Itching only in the mouth from raw nuts, with hay fever | Assessment for pollen food syndrome | Yes | Tests if symptoms go beyond the mouth |
| A peanut allergy, wondering about other nuts | Avoid untested nuts, and ask for testing | Yes | Testing of a range of nuts |
| A diagnosed nut allergy, needing a review | A check of your plan and auto-injectors | Yes | Regular specialist reviews |
Reacted to nuts? A doctor can go through it and arrange the right tests in one consultation.
See available times →Special situations
Sesame and other seeds
Sesame is the most common seed allergy, is more common in people with a peanut or tree nut allergy, and can cause anaphylaxis. It usually starts in early childhood but can start in adulthood. Sunflower, pumpkin and mustard seeds can also cause allergy.
Pregnancy and breastfeeding
Speak to a doctor or pharmacist before taking an antihistamine: loratadine is usually recommended if you need one in pregnancy.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When a nut allergy is treated online, and when you need in-person care
Treated online: going through a reaction to nuts, telling a nut allergy from a pollen-related reaction, antihistamines for mild reactions, a plan for next time, and referral to an allergy specialist.
In-person care: anaphylaxis, skin prick, blood and component tests, food challenges, and regular specialist reviews.
When to get in-person care
Use an adrenaline auto-injector if you have one, and call 112 now for:
- sudden swelling of the lips, mouth, throat or tongue
- difficulty breathing or swallowing, wheezing, or a hoarse voice
- feeling faint, dizzy or confused, or collapsing
- skin, lips or tongue turning blue, grey or pale
Get medical advice the same day for:
- hives, itching or swelling after eating nuts, with normal breathing
- a first reaction to a nut you had eaten before without problems
- a reaction after which you have no auto-injectors left
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the reaction: say which nut, how much, how quickly the symptoms started, and whether you have hay fever or asthma.
- Leave with a plan: what to avoid, what to do if it happens again, which tests to have, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s a nut allergy? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call. If you have an emergency sign listed on this page, call 112 instead.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Oral Allergy Syndrome can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about nut allergy
Is coconut a nut allergy?
No. Coconut is not a tree nut, and if you have never reacted to it, it is likely to be safe with a nut allergy.
Is nutmeg a nut?
No. Nutmeg is a spice from the seed of a tropical tree, not a tree nut, and it is not related to peanuts or to the nuts that cause nut allergy, so it is likely to be safe if you have never reacted to it. The same is true of coconut, chestnut and pine nuts, though anyone can be allergic to any food, so a reaction to one of these needs its own assessment.
Is chestnut a nut allergy?
No. Chestnut is not counted as a tree nut for nut allergy, so most people with a peanut or tree nut allergy can eat chestnuts if they have never reacted to them. Chestnut allergy exists on its own, and is linked to latex allergy rather than to nuts, so a reaction to chestnut in someone who reacts to latex or bananas needs a separate assessment.
Is almond a tree nut?
Yes. Almonds are tree nuts for the purposes of nut allergy, along with hazelnuts, walnuts, cashews, pecans, Brazil nuts, pistachios and macadamia nuts, and products such as marzipan, almond milk and almond butter contain them. A reaction to almonds can be a true tree nut allergy or a milder pollen-related reaction in people with birch hay fever, which a doctor can tell apart.
Is a peanut a nut?
No. The peanut is a legume, related to peas, beans and lentils, but peanut allergy is usually managed alongside tree nut allergy as a nut allergy.
Can you develop a nut allergy later in life?
Yes. Adults can develop a new nut allergy at any age, including to peanuts and to tree nuts such as macadamia, Brazil nuts and cashews, even after eating them for years. A first reaction in adulthood needs proper assessment, because a sudden reaction to a nut can also be a pollen-related reaction in someone with hay fever, which is milder and limited to the mouth.
Why am I suddenly allergic to almonds?
In adults, itching in the mouth from raw almonds, hazelnuts or peanuts is often pollen food syndrome, linked to hay fever. A true almond allergy is also possible, so a specialist test is needed.
Can I eat walnuts if I am allergic to peanuts?
Possibly, but do not try until you have been tested. 25% to 40% of people with a peanut allergy are allergic to tree nuts too.
Can you outgrow a nut allergy?
About 1 in 5 to 1 in 10 children are thought to outgrow a nut allergy, usually by the age of 4 or 5. In adults it is usually lifelong.
Does a nut allergy last for life?
Usually, yes. Only about 1 in 5 children outgrow a peanut allergy and fewer outgrow a tree nut allergy, and a nut allergy that starts in adulthood is almost always lifelong, so most people need to avoid the nut permanently. Specialists can retest over the years, and a supervised food challenge is the only safe way to find out whether a nut allergy has gone; never test it at home.
Can you test for a nut allergy at home?
No. Never test by eating the nut, and do not rely on home kits. Skin prick, blood and component tests at an allergy clinic are needed.
How can I prevent a nut allergy reaction?
Avoid the nuts you are allergic to completely: read every label, since peanuts and tree nuts must be highlighted, ask about ingredients and shared fryers or utensils when eating out, be careful with Asian food, pesto, baked goods and sweets, and do not rely on 'may contain' warnings being absent. Carry 2 adrenaline auto-injectors if one has been prescribed and a non-drowsy antihistamine for mild reactions, keep asthma well controlled, and make sure the people around you know what a nut allergy reaction looks like.
How common is nut allergy?
About 1 in 50 children and 1 in 200 adults in the UK have a nut allergy, which makes it one of the most common food allergies in children and the most common cause of severe food reactions. Peanut allergy is the most frequent, and many people who react to one tree nut can eat others, which is why testing by a specialist is worth having.
Is it a nut allergy or pollen food syndrome?
A true nut allergy causes hives, swelling, tummy pain or anaphylaxis however the nut is prepared, and can be severe. Pollen food syndrome is different and milder: proteins in some nuts look like proteins in tree pollen, so people with hay fever, especially to birch pollen, get itching or swelling in the mouth from raw nuts, most often hazelnuts, almonds and peanuts. A doctor can usually tell a nut allergy from a pollen-related reaction from your story, and tests settle any doubt.
Can an online doctor help with a nut allergy?
Partly. A doctor can go through a reaction, tell a nut allergy from a pollen-related reaction and arrange tests. Anaphylaxis and allergy tests are in person.
- Peanut and tree nut allergy, Anaphylaxis UK, factsheet, accessed 15 October 2026.
- Peanut, tree nut and seed allergy, BSACI, British Society for Allergy and Clinical Immunology, accessed 15 October 2026.
- Around 6% of the UK adult population have a food allergy, Food Standards Agency (UK), updated 16 May 2024.
- Food allergy and intolerance advice for consumers, Food Standards Agency (UK), updated 7 August 2026.
- Food allergy, NHS, National Health Service (UK), reviewed 20 August 2026.
- Evidence-based versus non-evidence-based allergy tests and treatments, ASCIA, Australasian Society of Clinical Immunology and Allergy, March 2024.
- Antihistamines, NHS, National Health Service (UK), reviewed 16 May 2023.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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