Nut allergy can be life-threatening and, surprisingly, in minute quantities can cause a reaction. Studies have reported that people who are highly allergic could suffer an attack if they touched a counter that had been wiped clean of all visible traces of peanut butter. Indirect contact such as being in a room where a jar of peanut butter was opened or being on an airplane with packets of nuts being opened around them can cause a life-threatening reaction in people with severe allergy. If people are allergic to nuts, eating or even just being exposed to a small amount can trigger an allergic reaction. Nuts are one of the most common triggers for anaphylaxis (a severe reaction that can be life-threatening). Anaphylaxis is potentially life-threatening and needs emergency medical treatment. Other signs and symptoms of nut allergy may include

• Hives
• Swelling around the mouth
• Vomiting
• Stomach pains
• Diarrhea
• Breathing problems
• Swollen tongue
• Swollen throat
• Difficulty talking
• Wheezing or coughing
• Choking
• Dizziness
• Collapse
• Becoming pale and floppy

According to the advocacy nonprofit Food Allergy Research & Education (FARE), nearly three million people in the United States report having peanut and tree nut allergies and reactions range from itchiness and hives to anaphylaxis and death.

When people have nut allergies, their body's immune system, which normally fights infections, overreacts to proteins in the nut. If people eat something that contains nuts, their body thinks these proteins are harmful invaders and responds by working very hard to fight off the invader. This causes an allergic reaction.

Even a small amount of peanut or tree nut protein can set off a reaction. However, allergic reactions from breathing in small particles of nuts or peanuts are rare. That's because people usually have to eat the food to cause a reaction. Most foods containing peanuts don't allow enough of the protein to escape into the air to cause a reaction. Just the smell of foods containing peanuts won't cause a reaction because the scent doesn't contain the protein.

Oral immunotherapy or desensitization is one of the treatment approaches to treat nut allergy, especially in people with peanut allergy.

• Oral immunotherapy involves cautiously eating the food which a person is allergic to while being monitored in a medical facility.
• Doses of the food are administered by mouth.
• The initial dose of the food administered is designed to be small enough to not trigger an allergic reaction (sub-threshold dose).
• The amount of food consumed is slowly increased over time, usually at two-week intervals. Because this desensitization process occurs in a medical facility under the supervision of an allergist, if an allergic reaction occurs, the symptoms are promptly treated by the allergy staff.

The goal of oral Immunotherapy is to increase the individual’s ability to consume a food they are allergic to without triggering an allergic reaction.In this way, they increase their tolerance to that food. By increasing one’s tolerance, accidental ingestion has a reduced likelihood of triggering worrisome allergic reactions. This creates a safety net in case of accidental exposure. During the buildup phase of the program, people should continue to avoid the offending food other than during planned exposure for their treatment doses. Some people may eventually be able to incorporate the treatment food into their normal diet. Apart from oral immunotherapy, people may also be placed on antihistamines that can help relieve some mild symptoms of an allergic reaction, such as an itchy mouth or hives.