Top 8: Peanuts

Receiving a diagnosis of a peanut allergy can be frightening, especially with the prevalence of peanut butter in our society! Our son had a contact reaction to a peanut butter sandwich at the age of 9 months. He didn’t even eat anything – he just touched it.

Check out “Allie the Allergic Elephant: A Children’s Story of Peanut Allergies“, a children’s book that tells a heartwarming story of an elephant learning to live with peanut allergies. “Allie” has been used to educate friends, families, schools, administration, and even religious leaders. Find out more information here.

According to the Center for Disease Control (CDC) in 2007, approximately 3 million children under age 18 (3.9% of the population or almost 4 out of every 100) were reported to have a food or digestive allergy in the previous 12 months. From 1997 to 2007, the prevalence of reported food allergy increase 18% among children under age 18. Researchers aren’t currently certain why the prevalence has increased. In 2010, research reported in the Journal of Allergy & Clinical Immunology reported that the prevalence of peanut allergy in the United States was about 0.6% of the population (adults and children included).

There is the thought that roasting peanuts, as we do in the USA makes them more highly allergenic versus boiling them as China does. There’s also the possibility that pregnant and nursing women who eat peanuts are passing the proteins on to their infants which increases the likelihood of the child developing a peanut allergy. Yet other research studies have found the opposite to be true! Lastly, there is the supposition that our too clean houses don’t challenge our immune systems to fight off parasites, and instead they turn on themselves viewing a peanut protein as the enemy.

The main problem with a peanut allergy is the severity of the reaction. In fact, studies by Scott H. Sicherer, M.D., associate professor of pediatrics at the Mount Sinai School of Medicine and a researcher in the Jaffe Food Allergy Institute, suggest that 80% of people with a peanut allergy have had a reaction that involves a breathing problem or have experienced a reaction that affected multiple areas of their body. He further estimates that 100 to 150 people in the USA die each year from peanut allergies.

These types of statistics are frightening for those of us with peanut allergic children! The peanut allergy was once considered life long, yet research has determined that up to 20% will actually outgrow the allergy by school age. This is especially true if your child has few, if any, other food allergies; doesn’t have other allergic issues such as asthma or eczema; and has a low peanut IgE on a RAST blood test.

Peanut is in the legume family, along with peas, lima beans, lentils and soybeans to name just a few. Just because your child is allergic to peanuts does not mean an allergy to any of these other legumes will also be present. An allergy testing can be completed on each of these foods separately. Some children will test allergic to other foods in the legume family, yet be able to tolerate them. Apparently the proteins are so similar on an allergy testing that the body may react solely because of this.

My son is severely allergic to peanuts, and mildly allergic to soy, peas and green beans! He doesn’t tolerate eating anything in the legume botanical family. Other children may be able to tolerate eating one item and not another. An allergy testing is the only way to determine exactly what your child is allergic to. If your child has been eating green beans without issue, an allergist will probably not suggest ceasing to eat them because of a positive allergy test.

There has been some exciting new research recently in regard to finding a cure for food allergies, especially to the peanut allergy. Dr. Wesley Burks, chief of Pediatric Allergy and Immunology at Duke Medical Center, is part of a potentially groundbreaking study aimed at finding out whether children with peanut allergies can be desensitized to peanuts and eventually cured of the allergy altogether.

The study has children ingesting tiny, precise amounts of peanut flour every day, and gradually increasing the dose every two weeks. Known as OIT – Oral Immunotherapy – the research is very promising, but being done on a very small basis currently. Patients are becoming increasingly less sensitive as the study continues. This would NOT be a study to take on in your own home! Patients receiving the peanut flour are closely monitored for hours after each dose, and an abundance of emergency medical care provisions are available should a severe reaction ensue.

Dr. Burks said the therapy works by depleting the body of chemicals that cause allergic reactions. If successful, desensitization therapy should be able to help all different kinds of food allergies.

Dr. Kari Nadeau of Stanford is also working on this desensitization protocol. The NY Times wrote an article about her endeavors, and Dr. Nadeau wrote a response about this ongoing research that is in its infancy stages.

Clinical trials of the drug Xolair for peanut allergy were halted early in 2006 after two children experienced anaphylactic reactions. The children hadn’t yet been given the drug, but reacted to an oral challenge of peanuts to determine their level of tolerance. The establishment of tolerance levels was required in the enrollment process of the FDA (Food & Drug Administration). The manufacturer of Xolair, Genentech and two others companies, remain committed to continuing the trials, however oral challenges may not be included in the future. The use of Xolair in combination with desensitization protocols is occurring in research around the USA currently.

Researchers at the Mt. Sinai School of Medicine in New York have been working with two Chinese herbal formulas – one to treat asthma and one to prevent anaphylaxis to peanuts. Participants in the asthma study had results from the Chinese herbs similar to the control group taking the corticosteroid Prednisone. The herb to prevent peanut anaphylaxis has only been studied on mice, yet the herbs completely blocked anaphylaxis for up to six months. Dr. Xiu-Min Li, a leader of the project, has applied to the FDA for human trials, which will hopefully begin soon.

Until a cure is found, the only “cure” for the peanut allergy is to stay away from all peanuts and peanut products.  Read labels of EVERY food that your child eats, and all foods in your house.  Re-read the labels each time you purchase a product, because manufacturing processes change continuously. Peanuts and peanut products show up in the most unsuspecting foods.

Need help reading labels for peanut allergies? Click here.