Nutmeg, water chestnut, butternut squash and shea nuts are not tree nuts (the term “nut” does not always indicate a tree nut) and are generally well tolerated by tree nut-allergic individuals. Although the Food and Drug Administration labels coconut as a tree nut, the vast majority of tree nut-allergic individuals also tolerate coconut without difficulty, since coconut is not truly a nut, but rather a fruit. They also usually tolerate macadamia nut and pine nut, which are also both seeds. Individuals with tree nut allergy can also typically consume seeds without difficulty, such as sesame, sunflower and pumpkin. If an individual allergic to certain tree nuts chooses to consume other tree nuts, they should always account for the potential risk of cross contamination (the introduction of trace amounts of the allergenic food during preparation and handling), which may or may not be clinically relevant for all individuals.Īlthough 30% of peanut-allergic individuals are also allergic to tree nuts, having a tree nut allergy does not necessarily mean an individual is allergic to peanuts. This decision must be made after careful discussion with an allergist and should be based on multiple factors, including the age of the individual, results of allergy testing, risk of potential cross reactivity between the nuts, quality of life implications and family preferences. Even though individuals allergic to tree nuts are often allergic to more than one type of tree nut, it may be appropriate and safe to consume certain tree nuts while avoiding others. Tree nuts include almonds, Brazil nuts, cashews, hazelnuts, pecans, pistachios and walnuts.Īn allergy to one tree nut does not necessarily mean an individual is allergic to other tree nuts, but certain tree nuts are closely related, including cashew with pistachio and pecan with walnut.

Tree nuts grow on trees, whereas peanuts grow underground and are considered legumes. Tree nut allergy is one of the eight most common food allergies, affecting roughly 0.5 to 1% of the U.S.

Pistachio and cashew allergy