Beginner's Safety Guide

Newly diagnosed with a nut allergy? Here's what you need to know right away. No fluff, just the essentials to keep you safe.

What to Carry With You at All Times

This isn't optional. If you have a severe nut allergy, these items should be with you every single time you leave the house.

1. Two Adrenaline Auto-Injectors

Always carry two. Not one. Two. If you have a severe reaction, you might need a second dose before emergency services arrive. Keep them in their original packaging, check expiry dates monthly, and replace them before they expire.

2. Antihistamines

Carry non-drowsy antihistamines (like cetirizine or loratadine). These can help with mild reactions, but they are not a substitute for adrenaline in severe reactions.

3. Your Allergy Action Plan

A written plan from your GP or allergist that explains what to do in an emergency. Keep a copy on your phone and a physical copy in your wallet or bag.

4. Emergency Contact Information

Have your GP's number, your allergist's number, and an emergency contact saved in your phone. Make sure someone close to you knows where your auto-injectors are and how to use them.

Pro tip: Set a monthly reminder on your phone to check your auto-injector expiry dates. Don't let them expire.

How to Read Food Labels Properly

In the UK and EU, food manufacturers must clearly label if a product contains any of the 14 major allergens, including nuts. Here's what to look for:

1. Check the Ingredients List

Nuts must be listed in bold or highlighted in the ingredients. Look for:

Almonds, almond oil, almond extract
Brazil nuts, cashews, hazelnuts
Macadamia, peanuts, pecans
Pistachios, walnuts
Any product containing "nut" in the name

2. Look for the Allergen Statement

Many products have a separate "Contains" or "Allergens" section. This is usually near the ingredients list and will clearly state if nuts are present.

3. Watch for Hidden Names

Some ingredients contain nuts but don't obviously say "nut":

Marzipan (almond paste)
Nougat (often contains almonds or hazelnuts)
Praline (usually contains nuts)
Nut oils (almond oil, walnut oil, etc.)

Unexpected sources to watch for:

Alcohol filtered through almond shells:

Some spirits, particularly gin, are filtered through almond shells during the production process. This filtering method can leave trace amounts of almond protein in the final product, which poses a risk for those with almond allergies. For example, Bombay Sapphire gin uses this filtration method. Always check with the manufacturer or look for allergen information on the bottle if you have a nut allergy.

Wine finings through fish scales:

Many wines use a process called fining to clarify the liquid and remove sediment. Some winemakers use isinglass (derived from fish swim bladders) or other fish-derived products in this process. While the fining agent is typically removed before bottling, trace amounts may remain, which could affect those with fish allergies. This is particularly common in traditional winemaking methods. Always check wine labels for allergen information or contact the winery directly if you have a fish allergy.

Pet food containing allergens:

Dog and cat food can contain allergens like peanut butter or lupin as ingredients. This is important to know if you handle pet food regularly, as cross-contamination can occur. For example, THE PACK No-Fishy Dishy wet dog food contains ingredients that may include peanut butter or lupin. Always read pet food labels carefully, especially if you have severe allergies and handle pet food, as residue on your hands could potentially cause a reaction.

4. When in Doubt, Don't Risk It

If you can't be 100% certain a product is safe, don't eat it. Contact the manufacturer if you need clarification, or choose a different product.

Understanding "May Contain" Warnings

This is one of the most confusing parts of living with a nut allergy. Here's what you need to know:

What "May Contain" Actually Means

The product doesn't intentionally contain nuts, but it's made in a facility that also handles nuts. There's a risk of cross-contamination during manufacturing.

It's a Legal Protection

Manufacturers use these warnings to protect themselves legally. It doesn't necessarily mean the product is unsafe, but it means they can't guarantee it's 100% nut-free.

Your Decision

Whether you avoid "may contain" products is a personal risk assessment:

Many people with severe allergies avoid all "may contain" products. This is the safest approach.
Some people contact manufacturers to ask about their cleaning procedures and risk management.
Some people are comfortable with certain "may contain" products from trusted brands they've used safely before.

There's no one-size-fits-all answer. Talk to your allergist about your risk level and make an informed decision.

Creating Your Emergency Action Plan

An emergency action plan is a written document that tells you (and others) exactly what to do if you have an allergic reaction. Your GP or allergist should provide one, but here's what it should include:

1. Your Personal Details

Your name, date of birth, known allergies, and any other medical conditions or medications.

2. Signs of a Reaction

What symptoms to watch for:

Mild: Itchy mouth, hives, mild swelling
Moderate: Widespread hives, swelling of face/lips, difficulty swallowing
Severe (anaphylaxis): Difficulty breathing, wheezing, dizziness, collapse, loss of consciousness

3. Step-by-Step Instructions

Clear instructions on:

When to use your auto-injector
How to use your auto-injector (with pictures if possible)
When to call 999
What to do while waiting for help

4. Emergency Contacts

Your GP's number, your allergist's number, and emergency contact details for family members.

Important: Make sure family members, friends, colleagues, and teachers (if applicable) know where your action plan is and how to use your auto-injector.

When to Use Your Auto-Injector

This is the most important decision you'll make. Here's when to use it:

Use It Immediately If:

You have difficulty breathing or wheezing
Your throat feels tight or you're having trouble swallowing
You feel dizzy, lightheaded, or like you might pass out
You have widespread hives or severe swelling
You have any combination of symptoms that suggest anaphylaxis

The Golden Rule

If you're unsure whether to use it, use it. It's better to use it unnecessarily than to wait too long.

Adrenaline is safe to use. The risk of not using it when you need it is far greater than using it when you might not need it.

After Using Your Auto-Injector

Call 999 immediately. Tell them you've had an allergic reaction and used your auto-injector.
Lie down with your legs raised (if you're not having trouble breathing).
If symptoms don't improve within 5-10 minutes, use your second auto-injector.
Stay with someone until paramedics arrive.
Go to hospital even if you feel better. You need to be monitored for a biphasic reaction (a second wave of symptoms).

Never delay using your auto-injector if you suspect anaphylaxis. Seconds count.

Next Steps

You've got the basics. Here's what to do next:

See an allergist. Your GP can refer you. An allergist can help you understand your specific risk level and create a personalised management plan.
Register with a nut allergy charity. Organisations like Allergy UK provide support, resources, and updates on product recalls.
Tell people. Don't be shy about your allergy. Tell friends, family, colleagues, and anyone who might be preparing food for you.
Practice using your auto-injector trainer. Most auto-injectors come with a training device. Practice regularly so using it becomes second nature.
Read more. Check out our other guides and insights for more detailed information.

Important Medical Disclaimer: This guide provides general information about managing nut allergies. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your GP, allergist, or other qualified health provider with any questions you may have regarding your allergy. Never disregard professional medical advice or delay in seeking it because of something you have read here.