The symptoms of tree nut allergies are similar to most other allergic reactions. Mild symptoms include rash, hives, welts, and a sensation of the throat feeling like cotton. However, a large proportion of those who have tree nut allergens react with anaphylaxis. Some argue that peanut allergen anaphylaxis is more prevalent, but this is skewed by the fact that peanut allergens are more prevalent. In fact, tree nut allergens more often to lead to anaphylaxis than peanut allergens. This makes them particularly dangerous, and it is important for those diagnosed with peanut allergens to always carry an epinephrine pen. These reactions are typically more severe with raw nuts, but even very small amounts of oils can cause reactions.
The only effective form of treatment for tree nut allergens is to strictly avoid foods containing such nuts, cooking revolving around tree nuts, as well as avoiding the tree nuts themselves. Such a task is easier with tree nuts than with some other allergens because tree nuts are not as prevalent in the American diet. Foods that nearly always contain tree nuts include pesto, marzipan, Nutella, baklava, pralines, nougat, and nut liqueurs.
In addition, a multitude of cereals, crackers, baked goods, candies, chocolates, granola bars, flavored coffees, frozen desserts, marinades, and sauces frequently contain tree nuts. When eating out, the most common reactions occur due to cross contamination. This is most common at Greek, Chinese, and African restaurants. Typically Latin American and Japanese food are fairly safe in regards to cross contamination.
Regulation
The FDA requires that any packaged product that contains tree nuts be specifically labeled as part of the Food Allergy Labeling and Consumer Protection Act. This includes products with coconut. However, the Food Allergy and Anaphylaxis Network says that coconut allergens are incredibly rare, and that there is a low probability of cross reactivity.