DEAR DR. GOTT: I suffered anaphylactic shock from hazelnuts and was advised not to eat any kind of nuts. Does this include palm oil, cocoa, pure maple syrup and coconut? It is hard enough to find powdered mixes without the facilities also processing nuts there. I also became very sick (vomited) after eating clams, so should I now avoid them and other types of shellfish? Thank you for any help you can give me.
DEAR READER: Let’s start with the clams, as this is the simplest question to answer. While you may have experienced an allergic reaction, it is more likely that you developed food poisoning from eating bad clams. An allergy to shellfish often includes swelling of the mouth, tongue, lips, throat and/or face — not simply vomiting.
Now to your tree nut allergy. Tree nuts include hazelnuts, walnuts, cashews, pistachios, almonds and Brazil nuts. Sufferers are typically told to avoid peanuts (a legume, not a nut), as well, because of the potential for cross-contamination at processing facilities and a possible co-allergy.
Cocoa, or rather, cacao, is not a nut, but is the fruit of the cacao tree. Chocolate is made from the seeds of this fruit. Coconut, while classified as a tree nut by the FDA, is not a true nut, but rather a drupe (a specific type of fruit). Pure maple syrup is derived from the sap of the maple tree. Finally, palm oil is made from the fruit of palm trees.
As you can see, these substances are not tree nuts, so you are not likely allergic to them. Because you developed anaphylactic shock, you were likely rushed to the emergency room, but you should have been told to see an allergist for testing and further treatment. If you were not, your hospital failed to take appropriate steps toward helping you with this condition. If you were told but simply didn’t go, you must do so now.
If you are already under the care of an allergist, you should have asked your questions during the initial visit. You should also undergo allergy testing to determine the extent of your allergy and what, if any, other substances you may be allergic to.
You are now responsible for thoroughly checking labels on any foods, condiments and beverages you consume, as tree nuts can be found in unexpected places. Because of the severity of your initial reaction, you should also keep a physician-prescribed EpiPen with you at all times in case of accidental ingestion.
Readers who are interested in learning more can order my Health Report “Allergies” by sending a self-addressed, stamped No. 10 envelope and a $2 U.S. check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing, or print an order form from my website’s direct link: www.AskDrGottMD.com/order_form.pdf.
