Key Allergens

Almonds are generally classified as tree nuts, but are more closely related to the Rosaceae family of plants which include apples, strawberries and peaches. Allergic reactions to almonds are less common than other tree nuts.

Almonds contain 6 allergenic proteins, Pru d 1 is a Bet v 1-like protein. This means it is similar in shape to the Bet v 1 allergen found in birch pollen. This is an airway allergen, but it can cause cross reactions with other fruit with similarly shaped proteins. This is called Pollen Food Allergy Syndrome. The symptoms of this are called oral allergy symptoms.

Pru d 3 is a Lipid Transfer Proteinlipid transfer protein (LTP). This group of proteins commonly cause allergic symptoms.

Pru d 4 is a profilin protein, this is a panallergen which can cause problems across many different foods.

Most tree nut allergies are caused by seed storage proteins, almonds only have 1 type of seed storage protein, Pru d 6 is an 11S seed storage protein which can cause people to be allergic to whole groups of tree nuts, seeds and legumes.

If you have a serious almond allergy you will not be able to drink almond milk as the allergenic proteins, in particular the seed storage proteins, are not damaged by heat or processing. Some people find that they can drink almond milk even though they cannot eat almonds, these people are most likely allergic to Bet v 1 proteins which are damaged easily by heating.

Most almond extracts are not safe to use for those who are allergic, some almond extracts are made from artificial flavourings but could be from other nut or peanut sources.

Food Intolerances

Food is high in FODMAP Food is medium in lectins Food is high in salicylates

Almonds are a high FODMAP food. FODMAP stands for Fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Foods high in FODMAPs can cause symptoms of food intolerance, affecting the gastro intestinal system and this can be mistaken for a true IgE food allergy.

Almonds are a food high in salicylates. Salicylates have the potential to cause worsening of asthma, swelling, itching and hives as well as food intolerance symptoms in people who are sensitive to salicylates.

Almonds are one of the few fruits to contain a moderate amount of lectins, another cause of food intolerance. Cooking foods with lectins makes them more digestible and can reduce the symptoms of food intolerance.

You can read more about Food Intolerances on the dedicated Food Intolerance Page.

Associated Syndromes

You may have Pollen-Food Allergy Syndrome if you suffer from almond allergy with oral allergy symptoms like itching of the mouth and tongue. Oral symptoms to 3 or more of the foods mentioned in cross reactivity section would indicate this.

Almond allergy is often linked to LTP Syndrome, where similarly shaped proteins in other plants resemble those in almonds and elicit an allergic reaction.

Allergy to almonds is sometimes linked to Celery-Mugwort-Spice Syndrome as the sensitising allergen is a profilin protein called Art v 4, these proteins are also sometimes also called Bet v 2 proteins.

There is a link between almonds and Latex Food Syndrome. The plant involved in latex allergy Hevea brasiliensis, the rubber tree plant, has an allergen called Hev b 8 which is a profilin protein. Those very sensitised to latex may have a contact allergic reaction from other foods or plants containing profilin proteins, there is less evidence of this than sensitisation to other latex linked proteins like hevein and chitinases.

Cross Reactivity

There may be cross reactivity with other plants in the Rosaceae family. This includes apples, cherries, strawberries, peaches, plums, apricots, pears and raspberries.

If sensitised to birch tree pollen you may have Pollen Food Allergy Syndrome and may also react to kiwi, pear, peach, plum, nectarine, apricots, apple, tomato, celery, carrot, potato, parsnip, pepper, dill, cumin, peas, coriander, fennel, hazelnut, walnut, almonds, peanuts, lentils and beans.

Common foods involved in LTP allergy include kiwi, strawberries, sunflower seeds, walnut, apple, mulberry, banana, pea, apricot, cherry, plum, almond, peach pomegranate, raspberry, tomato, grape, celery, peanut, asparagus, cabbage, broccoli, chestnut, lemon, tangerine, orange, hazelnut, lettuce, lentils, lupin, green bean, pear, mustard, wheat and maize.

Profilin proteins are also found in pineapple, celery, peanut, chilli, watermelon, orange, hazelnut, carrot, strawberry, soya, barley, walnut, lychee, lupin, apple, banana, dates, cherry, kiwi, peach, pear, mustard, tomato, aubergine and wheat.

11S seed storage proteins are also found in kiwi, cashew, pecan, macadamia, peanut, brazil nut, pumpkin, soya beans, walnut, pistachio, sesame and mustard.

You can download a Tree Nut Allergy Factsheet from the Allergy Resources Ko-fi Shop for just $0.50 (£0.40 or €0.45). This has up to date information on which foods contain linked allergens and what foods to avoid if you think you have an allergy to tree nuts.

These food lists are not exhaustive, the most up to date information is on the Cross Reactivity Tool.



Allergen Encyclopedia - Almond

Science Direct - Legumins

Allergy information for: Almond (Prunus dulcis)

Anaphylaxis Campaign - Almond Allergy

What Are the Symptoms of a Nut Allergy?

Allergy UK - Quick Guide to Tree Nut Allergy

FARE - Tree Nut Allergy

Healthline - FODMAP Foods

ATP Science - Salicylate Food List

Articles and Journals

Immunoglobulin E-Mediated Food Sensitization in a Moroccan Pediatric Population with Celiac Disease, 2024

Diagnosis and Management of Pollen Food Allergy Syndrome to Nuts, 2024

Prevalence of tree nut allergy in Europe: A systematic review and meta-analysis, 2023

Tough Nut to Crack: Transplant-acquired Food Allergy in an Adult Liver Recipient, 2023

High oral challenge success rate in almond-sensitized children, 2023

Rosaceae food allergy: a review, 2022

The influence of cultural attitudes to nut exposure on reported nut allergy: A pilot cross sectional study, 2020

Analysis of Oral Food Challenge Outcomes in IgE-Mediated Food Allergies to Almond in a Large Cohort, 2019

Review of 400 consecutive oral food challenges to almond, 2019

Almond (Prunus dulcis) Allergen Pru du 8, the First Member of a New Family of Food Allergens, 2019

Almond Allergy: An Overview on Prevalence, Thresholds, Regulations and Allergen Detection, 2018

Cloning and characterization of profilin (Pru du 4), a cross-reactive almond (Prunus dulcis) allergen, 2006

A voluntary registry for peanut and tree nut allergy: characteristics of the first 5149 registrants, 2001

Let me know if you found any of these interesting or useful. If you spot an article or research that you think is interesting you can message me or tag me on Facebook or Twitter - links at the bottom of the page.

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