But now, a new study finds that just because you're diagnosed with a nut allergy doesn't necessarily mean you're allergic to it.
For those who do have allergies, an Australian study found that probiotics may be helpful, although the study was conducted using children who were allergic to peanuts, not tree nuts. In such a challenge, they eat increasingly larger amounts of a food suspected to cause an allergic reaction over several hours and are observed by an allergist to gauge their reaction. "The dirty secret of allergy tests is that they're very, very accurate when they're negative, and they're very hard to interpret when they're positive under certain circumstances"-namely, when the patient has never exhibited any allergy symptoms to the food in question or even ever eaten it".
"They take the results at face value and stop eating all tree nuts when they might not actually be allergic", Couch said. They were tested for allergies to other tree nuts they had never eaten before using blood or skin prick tests. "Some of the individuals tested in the study had peanut allergies but never tried tree nuts, and when they tried them, they turned out to be allergic", says Dr. Christopher Couch, an allergist-immunologist and lead author of the study.
Moreover, study results showed nearly none of the people with peanut allergy were actually allergic to almonds, cashews, walnuts and hazelnuts.
Dr. Couch and team came to their findings by analyzing the health records of 109 individuals with an allergy to an individual tree nut.
Nut allergies are common, affecting families across the world - and doctors will tell you to avoid them all to be safe.
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According to the Journal of Allergy & Clinical Immunology, tree nut or peanut allergies affect approximately 3 million Americans.
The study did not include oral food challenges to nuts a person had a documented history of having a reaction to when eaten. Under medical supervision, the participants were fed small amounts of one type of nut every 15 to 20 minutes to see if there was a serious reaction, like hives or trouble breathing, TIME reported.
The ACAAI warns that people should only get oral challenge tests while in the care of a trained, board-certified allergist.
In an analysis of these patients, 91% of 42 patients with sensitivity to a tree nut undergoing 65 tree nut OFCs were successful, leading the researchers to conclude that controlled food challenge in this scenario "might have high utility".
Dr Tariq El-Shanawany, British Society for Immunology spokesperson said: 'A good general piece of advice is that if you are eating and tolerating particular nuts, then don't start avoiding them.
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