Tree Nut Allergy - Fast Facts

This document has been developed by ASCIA, the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand. ASCIA information is based on published literature and expert review, is not influenced by commercial organisations and is not intended to replace medical advice.         

For patient or carer support contact Allergy & Anaphylaxis Australia or Allergy New Zealand.

ASCIA PC FAST FACTS Tree Nut Allergy 202371.36 KB

1. Tree nuts include almonds, cashews, hazelnuts, macadamias, pecans, pistachios, walnuts and Brazil nuts.
2. If a person is allergic to peanut, this does not always mean they are also allergic to tree nuts. This is because the proteins in peanut are very different to those in tree nuts.
3. Allergic reactions to tree nuts (or other foods), range from mild to severe. Mild to moderate signs of food allergy include swelling of face, lips or eyes, hives or welts on the skin, tingling mouth, abdominal (stomach) pain, and vomiting.
4. Anaphylaxis is the most severe type of allergic reaction and should always be treated as a medical emergency. Anaphylaxis requires immediate treatment with adrenaline (epinephrine), which is injected into the outer mid-thigh. Delayed treatment can result in fatal anaphylaxis. Deaths due to anaphylaxis associated with food allergy can be prevented by avoiding confirmed food allergens.
5. Signs of anaphylaxis include any one of the following; difficult or noisy breathing, swelling of the tongue, swelling or tightness in the throat, wheeze or persistent cough, difficulty talking or hoarse voice, persistent dizziness or collapse. Young children may become pale and floppy.
6. Food labelling laws in Australia and New Zealand require that any product containing peanut, tree nuts or sesame must be clearly labelled. It is important to always check the labels of all foods before purchase.
7. When eating out with food allergy some precautions include; contacting the restaurant, café or home cook in advance to let them know of the food allergy, informing restaurant staff of the allergy on arrival, and not relying on menu descriptions as dips or sauces may have nuts in them.
8. If an adrenaline (epinephrine) injector has been prescribed, the person with allergy should always have it with them. Having an adrenaline injector offers reassurance, but it is not a substitute for strategies to minimise the risk of exposure to allergen triggers.
9. Under the supervision of a clinical immunology/allergy specialist and supportive contacts, people with food allergy can learn to manage the condition.

© ASCIA 2023

Content updated June 2023

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