Symptoms, what to avoid and more

Although technically seeds, cashew nut are generally classified as tree nuts. They are found in the drupe (fleshy fruit) of tropical tree species known as Western anacardium.

Cashew nut allergies occur when a person’s immune system reacts to the proteins found in cashew nuts, causing allergy symptoms. A cashew nut allergy is a common nut allergy. About 20% of all people with nut allergies in the United States are allergic to cashews.

This article discusses cashew allergy symptoms, risk factors, and treatments.

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Cashew nut allergy symptoms

Cashew allergy symptoms are the same as those that occur with other types of food allergies. They include:

  • Urticaria, or a similar skin reaction known as angioedema
  • Gastrointestinal symptoms, such as upset stomach, nausea, vomiting, and diarrhea
  • Itchy skin
  • Respiratory symptoms, such as shortness of breath, cough, and wheezing
  • To sneeze
  • Hoarseness or tightness in the throat
  • Itchy, swollen or watery eyes
  • Swelling of the face or throat
  • Drop in blood pressure

Complications

Allergic reactions can sometimes be serious and lead to more serious symptoms that require immediate medical attention.

When severe symptoms appear, anaphylaxis (a life-threatening allergic reaction) may occur.

Symptoms of Anaphylaxis

Anaphylaxis is a severe allergic reaction that is manifested by symptoms such as:

  • Difficulty breathing
  • Feeling lightheaded, dizzy, or fainting
  • Wheezing
  • rapid heartbeat
  • feeling anxious or confused
  • Faint

Risk factors

There are several risk factors associated with developing a cashew nut allergy. They include:

  • Allergy to another type of nut: Nuts often have high cross-reactivity, which is when two different foods contain enough similar proteins to cause allergic reactions. Pistachios, in particular, are cross-reactive with cashews.
  • Peanut allergy: Since peanuts contain proteins similar to those of cashews, a person allergic to peanuts will probably also be allergic to cashews.
  • Hereditary factors: In some cases, having immediate family members with a nut allergy can increase your risk of developing an allergy yourself.

Diagnostic

Diagnosing a cashew nut allergy involves the same diagnostic parameters as other types of food allergies, including other tree nuts.

Typically, diagnosis begins with collecting symptoms or medical history of allergic reactions after consuming cashews.

Other tests for cashew allergy include:

  • Radioallergosorbent test (RAST): The RAST test is a blood test that looks for specific antibodies produced in response to allergens (substances that cause allergic reactions).
  • Skin test: The skin test is performed by a healthcare professional. The test uses a comb-like tool to prick the skin of the upper back or forearm. The allergen is then introduced into the bitten area to see if there is a reaction.
  • Oral food challenge: The oral food challenge involves a person with suspected cashew allergy eating cashews in a controlled environment to see if there is a reaction. This challenge is performed under direct medical supervision in the event of a severe allergic reaction.

How common are severe allergic reactions with cashew nut allergies?

Cashew allergies are often associated with more severe reactions than other types of food allergies. Studies show that up to 74% of people with tree nut allergies experience anaphylaxis, even if the exposure was minimal.

Treatment

The first-line option for treating a cashew nut allergy is complete avoidance. This means that cashews and potentially any other cross-reactive food should be completely avoided to prevent symptoms.

Antihistamines can be taken for mild symptoms as soon as a potential allergic reaction has occurred. However, treatment of severe allergic reactions should be carried out at all times in an emergency.

Treating a Severe Allergic Reaction

In the event of anaphylaxis, people with cashew allergies will need powerful forms of treatment. These may include:

  • An injection of epinephrine (EpiPen)
  • Steroids
  • Oxygen in the hospital
  • More antihistamines

What to avoid

In addition to cashews, you may need to avoid consuming other types of nuts. This is especially true for pistachios, as they have a high cross-reactivity with cashews.

Many food products contain hidden ingredients which could include cashews. Beware of pre-packaged foods that don’t carry a “nut-free” label.

Nut butters, as well as oils and extracts, should also be avoided as they likely contain the protein allergen that causes symptoms in someone allergic to cashews.

You should also steer clear of products with a nut allergy warning label. These often include things like cookies, cakes, ice cream and sauces.

Food alternatives

While it can be difficult not being able to eat cashews and other nuts, there are other food items that are safe to eat and taste just as good. These can include seeds, soy, chickpeas, and pretzels. These snacks provide the crunchy, salty flavor profile often found in cashews and other nuts without the risk of an allergic reaction.

Roast legumes as an alternative to nuts

Legumes such as chickpeas and soybeans can be roasted and salted, giving them a good crunch and flavor. This makes it a great alternative to cashews.

When to See a Health Care Provider

If you experience mild symptoms of an allergic reaction after consuming cashews, you should contact your health care provider. They will be able to perform the appropriate tests to determine if cashews are the cause of your symptoms.

You may be referred to an allergist (an allergy specialist) to help determine if cashews were the cause of your symptoms.

When to call 911

If you consume cashews and start to feel confused, pass out, are unable to breathe, or have a sense of impending doom, you should call 911 or go to the emergency room immediately. You could have a serious allergic reaction and need immediate medical attention.

Summary

Cashews, although technically a seed, fall into the category of tree nuts. When a person is allergic to cashews, they may experience symptoms such as hives, swelling, difficulty breathing, and wheezing when consuming them. In severe cases, which often occur with cashew allergies, a life-threatening allergic reaction known as anaphylaxis can occur. This causes symptoms such as confusion, dizziness or difficulty breathing.

Generally, if you are allergic to peanuts or another type of nut, you are also likely to be allergic to cashews. Not being aware of a cashew nut allergy puts you at risk for serious symptoms, so it’s important to get diagnosed and receive a prescription for an emergency epinephrine auto-injector (EpiPen) when you feel serious symptoms.

Avoiding all nuts, peanuts, and products that may contain traces of nuts is the best way to avoid an allergic reaction. You should read all your food labels before eating and look for alternatives.

A word from Verywell

Having a cashew nut allergy is unfortunate because many people like to eat cashews. However, there is no cure for food allergies, so it’s best to prevent them as best you can. Food allergies are frustrating, but it’s better to avoid a certain food than to experience the sometimes life-threatening symptoms that can accompany an allergic reaction. Seek advice from a healthcare professional if you experience allergy symptoms after eating cashews.

Frequently Asked Questions

  • How common is a cashew nut allergy?

    Cashew nut allergies are quite common among people with tree nut allergies. Studies show that up to 20% of people with nut allergies are allergic to cashews.

  • Can you be sensitive to cashew nuts without being allergic?

    Generally, if you are sensitive to cashews, it is only a matter of time before you become allergic. Indeed, the first time you consume the nut, your body reacts and considers it a threat but does not yet cause symptoms. When you come into contact with the nut again, symptoms are more likely to occur.

  • Is there a cure for a cashew nut allergy?

    As with all other food allergies, there is no cure. Food allergies should be treated by avoiding or taking medication after symptoms develop.

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