How to Treat it Coconut Allergy

The Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA), which addresses the issue of the labeling of foods that contain certain food allergens, requires all food products that are regulated by the FDA to be labeled in a specific way. This is to enable the consumers to check for the presence of the eight major food allergens (milk, egg, fish, crustacean shellfish, tree nuts, wheat, peanuts, and soybeans). According to the FDA, tree nuts include almonds, beech nuts, Brazil nuts, cashews, chestnuts, Chinquapin nuts, coconut, hazelnuts, ginkgo nuts, hickory nuts, lichee nuts, macadamia nuts, pecans, pine nuts, pili nuts, pistachios, shea nuts, and walnuts. It must be noted that the FDA recognizes coconut as a tree nut for the purposes of labeling, although coconut is not a tree nut in the strictest sense.

The scientific name of coconut is Cocos nucifera, and it belongs to the Arecaceae family. It is a dry drupe and is only distantly related to tree nuts. It has a smooth exocarp (outer layer), fibrous mesocarp (middle layer), and a hard endocarp (layer that surrounds the seed). The reason behind the recognition of coconut as a food allergen might be due to the documentation of a few cases of allergic reaction (especially anaphylactic shock) on consumption of coconut.

Cross-reactivity Between Coconut and Walnut

In terms of allergic reactions, cross-reactivity is said to occur when an allergic reaction develops on exposure to substances containing structurally similar proteins. A common example of cross-reactivity can be explained with reference to tree nuts. There have been instances where some individuals who are allergic to one of the tree nuts developed an allergic reaction on consuming other tree nuts. In the U.S., the incidence of allergic reaction to walnut (34%) is much higher than any other tree nut, whereas a coconut allergy is quite rare. However, a few cases regarding cross-reactivity between coconut and walnut/hazelnut have been documented. The proteins that are believed to cause allergies after ingestion of coconut include:

➠ Coc n 7S globulin
➠ Coc n 11S globulin (Cocosin)
➠ Coc n Profilin (protein isolated from coconut tree pollen)

In a study conducted by Teuber and Peterson, two patients with primary walnut allergy and secondary coconut allergy were studied. The tests that were conducted suggested substantial IgE cross-reactivity between walnut and coconut. This study also suggested that it was IgE resulting from primary walnut exposure that contributed to a secondary cross-reaction to coconut.

There have been cases where the allergic reaction occurred only due to the ingestion of coconut, as the affected individual could tolerate other tree nuts, seeds, dates, etc. However, allergic reactions to coconut alone is quite rare. Most people who are allergic to tree nuts can safely eat coconut, but an allergic reaction could occur in rare cases due to the cross-reactivity between coconut and some other tree nuts.

Oils from both coconut, as well as palm contain 7S globulin proteins. These oils are commonly used in cosmetic products such as creams, lotions, soaps, shampoos, etc. It is believed that the slight increase in the incidence of allergic reactions to coconut could be due to the sensitization to these proteins due to the topical exposure through the skin.

Coconut Allergy Symptoms

Coconut allergy is a type 1 hypersensitivity, wherein the immune system produces a response, as it considers the presence of certain proteins in coconut as a threat. The response involves the activation of the immune cells which produce Immunoglobulin E (IgE) antibodies to defend the body. These antibodies bind to the proteins in the coconut, thereby stimulating the mast cells to release histamine. It is the release of histamine that causes the blood vessels to dilate, thereby causing the untoward symptoms that are associated with allergic reactions.

The symptoms of coconut allergy include:

➠ Watery eyes
➠ Red, itchy eyes
➠ Runny nose
➠ Hives
➠ Itching
➠ Vomiting, nausea, and diarrhea
➠ Sneezing
➠ Wheezing or asthma-like symptoms
➠ Breathing problems
➠ Flushed face
➠ Low blood pressure
➠ Lightheadedness

In extreme cases, one could even develop an anaphylactic shock. This condition is characterized by the following symptoms:

➠ Swelling of the throat/tongue/lips/face
➠ Shortness of breath
➠ Breathing difficulties
➠ Difficulty in swallowing
➠ Heart palpitations
➠ Drop in blood pressure
➠ Wheezing
➠ Skin turning blue
➠ Confusion
➠ Loss of consciousness

Prevention and Treatment

Every individual who has had an allergic reaction to any food needs to identify the food that he/she might be allergic to. This can be done with the help of skin prick tests, food challenges, and blood tests that check the blood for antibodies. In case of an allergy, the avoidance of the food is the best treatment option. Thus, individuals who are allergic to coconut should avoid food products that contain coconut in any form.

➠ Coconut milk, coconut cream, or shredded coconut might be used in some cake mixes, bread, baked goods, pastry products, dough, chocolate, soups, ice creams, sauces, puddings, salad dressings, dumplings, etc. So, make sure that you read the food labels.

➠ In case of recipes wherein coconut flour is used, unprocessed bran, tapioca flour, or almond flour (avoid almonds, if you are allergic to them) can be used as a substitute for coconut. Clarified butter can be used instead of coconut butter. In case of any doubts, consult a dietitian or a nutritionist to learn about the best substitutes.

➠ Be very cautious while eating out. Make it a point to ask about the ingredients used in dishes. Avoid any dish that contains coconut.

➠ While antihistamines or corticosteroids help alleviate the symptoms of an allergic reaction, it would be best to keep an epinephrine injection ready, so as to tackle an anaphylactic reaction.

Though some people who are affected by tree nut allergies could develop an allergic reaction on consuming coconut, coconut allergy is quite rare. It must be noted that some people might develop allergic dermatitis on coming in contact with coconut oil. Such individuals should avoid the use of cosmetics, shampoos, soaps, or other products that contain coconut diethanolamide, cocamide sulfate, cocamide DEA, and CDEA. On a concluding note, avoidance of the allergen is the only way to avoid the untoward symptoms associated with allergies.

Characteristic Features Nut Allergy

An allergic reaction occurs when the immune system reacts adversely to an allergen present in food, insect venom, medication, etc. Humans are found to be allergic to a wide range of food items, the most common among them being eggs, milk, peanuts, tree nuts, soybeans and shellfish. Certain proteins found in these foods are responsible for the adverse reactions triggered by the immune system, which wrongly identifies them as harmful to the body. In order to protect the body, the immune system produces immunoglobulin E (IgE) antibodies. The action of these antibodies results in release of certain chemicals, like histamine, which in turn causes allergic symptoms. The nature and severity of allergic reactions may vary from one person to another. It may also happen that the same person exhibits different symptoms at different times.

Peanut and Tree Nut Allergies

Both peanuts and tree nuts, are among those food items that are commonly found to cause allergies, especially in kids. Nut allergy usually denotes tree nut (like almonds and cashews) allergy, but include reactions caused by peanuts (groundnuts) too. This is because of the fact that the proteins in peanuts are similar in structure to the proteins in tree nuts, which are the common types of edible nuts. Even though peanuts come under the category of legumes, and not nuts, allergic reactions to both tree nuts and peanuts are almost the same.

When compared to tree nut allergy, peanut allergy is more prevalent. It has also been observed that a person with tree nut allergy may or may not react to peanuts, and vice versa. Those who are allergic to one type of tree nut may exhibit allergic reactions to other types of nuts. While almonds are considered the safest among tree nuts, reports of allergic reactions to walnuts and cashews are very common. Even though nut allergy can develop at any age, it is a problem which is predominantly found in children. It has been observed that most of the affected people develop this condition before the age of three.

Routes of Exposure

Consumption of nuts is the most common route through which a person is exposed to the allergen. Unintentional digestion is found to be a common cause for allergic reactions to nuts. Apart from ingestion, inhalation may also cause minor adverse reactions in allergic individuals. This may happen if they get exposed to airborne particles released while cooking. Factories (where nuts are handled) may also release such particles while crushing or processing nuts. There is no conclusive evidence to prove that smelling or touching nuts can cause any such symptom. However, such instances may happen rarely.


Nuts are rich in nutrients and have various health benefits, but they may prove harmful for some people. They develop allergic reactions ranging from mild to severe, if they consume nuts or foods with nuts. Such reactions appear soon after ingestion of the nut, or within a time span of two hours. As mentioned above, chemicals like histamines are released in the body of the allergic individual, once he is exposed to the allergen. These chemicals affect the bodily systems, especially the gastrointestinal tract, skin, and the cardiovascular system. While some people react severely, some others show only mild symptoms. Such symptoms may subside within some time, or may worsen and lead to more severe symptoms.

Mild Symptoms

  • Itchy and watery eyes
  • Skin rash
  • Sneezing
  • Coughing
  • Runny nose
  • Shortness of breath
  • Tingling of lips and tongue
  • Tightness in the throat
  • Nausea and/or vomiting
  • Stomach pain and diarrhea

Severe Symptoms

Some people who are allergic to nuts may experience symptoms, like swelling of the lips, tongue, and face. The affected person may develop breathing problem, as the throat swells up, thereby narrowing air passage. Dizziness is another severe nut allergy symptom. These symptoms may lead to a more life-threatening condition called anaphylaxis, wherein the airways get swollen, leading to severe symptoms, which are given below.

  • Breathing trouble
  • Wheezing
  • Drop in blood pressure
  • Increased heart rate
  • Shock and loss of consciousness

Though nut allergies are not usually linked to death, in some rare cases, it may happen as very sensitive individuals succumb to severe allergic reactions. So severe allergic reactions warrant immediate medical attention.

Cashew Nuts and Peanuts: Allergic reactions caused by cashew nuts and walnuts can be more severe and fatal. Even though reactions like rash and swelling are common in case of cashew nut allergies, severe reactions, like anaphylaxis is also not uncommon. It has been observed that peanut allergy can be more severe, as compared to the symptoms of tree nut allergies. According to health experts, the immune system can identify peanut proteins easily, as compared to the proteins in tree nuts. Even breathing minute particles of peanuts can trigger severe allergic reactions, while the same amount of tree nuts may not cause such reactions.

Diagnosis and Treatment

The medical history of the patient is very much important as far as diagnosis of nut allergy is concerned. It has been observed that the chances of having this type of allergy is high in those with a family history of allergies or allergy-related conditions, like asthma and eczema. Skin prick test and blood test are also done as a part of diagnosis.

As of now, there is no curative treatment for nut allergies. All you can do is to avoid exposure to the nut or nuts that cause allergic reactions. Even food products containing traces of these nuts must be avoided. In case you develop allergic reactions, seek immediate medical attention. This is highly necessary in case of severe reactions. Mild reactions are often treated with medicines, like antihistamines. Adrenaline injection is used for treating severe reactions.

While some people outgrow nut allergies with age, for others, it is a lifelong condition. Hence, it is always better to avoid nuts, peanuts, and food products with nuts as ingredients. The most common tree nuts include almonds, Brazil nuts, cashews, chestnuts, hazelnuts, filberts, hickory nuts, walnuts, macadamias, pistachios, pecans, pine nuts, etc. Apart from that, food items, like cakes, cookies, crackers, ice creams, health bars, soups, sauces, flavored coffees, frozen desserts, chocolates, etc., may also contain nuts. Even coconut and nutmeg (being nuts), may cause allergic reactions in some people. So make it a habit to check the list of ingredients given on food packets, before consumption. Apart from consumption of nuts, the affected people must also avoid any contact with nuts, which may also cause allergic reactions. It may also happen that a person with allergy to a particular type of nut, may develop nut allergy symptoms to a certain group of nuts only. However, it is safer to avoid any nut or nut products, including peanuts. If you experience any nut allergy symptom, contact your doctor immediately.