Cashew Allergy
Treatment & Desensitization
Cashew Allergy Desensitization in NYC, Manhattan, Upper East Side
At NY Food Allergy & Wellness, located on the Upper East Side of Manhattan, we specialize in the diagnosis and treatment of cashew allergies. Our team, led by Dr. Atul Shah, provides personalized care to help you manage and desensitize to your cashew allergy safely and effectively. Cashew allergies are among the most common tree nut allergies, with studies indicating that about 20% of people with tree nut allergies are allergic to cashews, often leading to severe reactions, including anaphylaxis in approximately 70 %+ cases. According to Dr. Shah and his team’s observation, the cashew allergic individuals react at a much lower dose of cashew compared to other treenuts and low IgE level patients have more chance of failing the oral food challenges. Majority of cashew allergic individuals also react to pistachio. At NYFA, we are committed to preventing severe reactions through advanced diagnostics and treatment.
Understanding Cashew Allergies
Cashew allergies occur when the immune system mistakenly identifies proteins in cashews, such as Ana o 3, as harmful, triggering an allergic reaction. These reactions can range from mild to life-threatening and are particularly prevalent in children, though they can develop at any age. The prevalence of cashew allergies is increasing, especially in regions where cashew consumption is common, and only about 10% of individuals outgrow this allergy (Allergy Insider).
Symptoms and Diagnosis of Cashew Allergies
Symptoms of a cashew allergy can appear within minutes of exposure and may include:
Skin reactions such as hives, redness, or swelling (angioedema)
Itching or tingling in or around the mouth and throat
Gastrointestinal symptoms such as stomach ache, nausea, vomiting, or diarrhea
Respiratory symptoms like tightening of the throat, shortness of breath, or wheezing
Anaphylaxis, a severe, potentially life-threatening reaction requiring immediate medical attention (Verywell Health)
Food Allergy Testing for Cashews
Source: Lincoln Diagnostics
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Skin prick tests are a quick and effective way to identify specific allergens. During the test, a small amount of allergen is placed on the skin, which is then gently pricked to allow the allergen to enter. Results are typically visible within 15-20 minutes, making it a fast and reliable option. Needle-free tests are ideal for children and needle-phobic patients. Using advanced technology, these tests provide precise results without the discomfort associated with traditional testing methods.
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Blood tests are highly accurate and comprehensive, suitable for all age groups. They measure the presence of specific IgE antibodies in the blood, which can indicate an allergy. This method is particularly useful for patients who cannot undergo skin testing.
IgE specific to cashew and cashew components are very helpful in the accurate diagnosis of true cashew allergy compared to false positives. Ana o 3 is considered a component with potential for systemic reactions.
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At NY Food Allergy & Wellness, we are proud to offer the Basophil Activation Test (BAT), a cutting-edge diagnostic tool for identifying food allergies. This advanced test measures the activation of basophils, a type of white blood cell, in response to allergens. The BAT provides highly accurate results and can detect allergic reactions that might not be identified through traditional testing methods.
We are the only certified lab in the region offering the Basophil Activation Test. Our certification ensures that we maintain the highest standards of accuracy and reliability in our testing procedures. By choosing NY Food Allergy & Wellness for your allergy testing needs, you can be confident that you are receiving the most advanced and reliable diagnostics available.
The Basophil Activation Test is particularly useful for patients who have complex allergy profiles or who have not found answers through conventional tests. It can also be used to monitor the effectiveness of ongoing allergy treatments, providing valuable insights for personalized care plans.
Key benefits of the Basophil Activation Test include:
High Accuracy: Detects allergic reactions that may not be visible through skin prick or blood tests.
Comprehensive Analysis: Measures the specific activation of basophils, providing detailed information about allergic responses.
Certified Lab: Conducted in our certified lab, ensuring the highest standards of testing quality and reliability.
If you suspect you have a food allergy and need precise and reliable testing, the Basophil Activation Test at NY Food Allergy & Wellness is an excellent choice. Contact us today to learn more about this innovative test and to schedule your appointment. -
Oral Food Challenges are considered the gold standard for diagnosing food allergies. During an OFC, the patient consumes small amounts of the suspected allergen under strict medical supervision to observe any reactions. This method provides definitive results and is conducted with the utmost care and safety.
Managing Cashew Allergies in Daily Life
Managing a cashew allergy requires vigilance and preparedness. At NY Food Allergy & Wellness, we provide comprehensive guidance on:
Reading Food Labels: Identifying hidden cashew ingredients in processed foods, such as baked goods, sauces, and snack bars, and looking for warnings like “may contain tree nuts.” Majority of cashew allergic patients also need to avoid pistachio.
Restaurant Safety: Communicating your allergy to restaurant staff and avoiding dishes with potential cross-contamination, especially in Asian, African, and Middle Eastern cuisines where cashews are common. Many Indian sweets contain cashew and may not be obvious.
Emergency Preparedness: Carrying an epinephrine (e.g., epinephrine auto-injectors like EpiPen, Auvi-Q or epinephrine nasal spray like Neffy) at all times and having an action plan for accidental exposures.
Managing Multiple Food Allergies
Cashew allergies often coexist with other tree nut allergies, such as pistachio, due to similar protein structures, and approximately 30% of individuals with a tree nut allergy are allergic to multiple nuts (Allergy Insider). At NY Food Allergy & Wellness, our FATE™ (Food Allergy Tolerance Enhancement) Program specializes in managing multiple food allergies through comprehensive diagnostics and desensitization, helping patients achieve greater dietary freedom.
Diagnostic Approach
We begin with:
Detailed Patient History: Reviewing the patient’s medical history and symptoms.
Advanced Testing: Utilizing skin prick tests, blood tests, and the Basophil Activation Test to identify specific allergens and assess reaction severity.
Continuous Support
Regular Follow-ups: Monitoring progress and adjusting treatment plans.
Patient Education: Providing resources and training for effective management.
Support Groups: Facilitating patient support groups for shared experiences and strategies.
Personalized Treatment Plans
Our customized plans aim for food allergy desensitization and may include:
Oral Immunotherapy (OIT): Gradually introducing allergens to desensitize the immune system.
Sublingual Immunotherapy (SLIT): Administering allergens under the tongue to build tolerance.
Medications: Antihistamines can relieve mild symptoms, while epinephrine is used for severe reactions like anaphylaxis. Omalizumab (Xolair) injections can be considered to reduce the risk or reactions.
Dietary Management: Guidance on safe food choices and avoidance strategies.
Emergency Preparedness: Training on using epinephrine auto-injectors and creating action plans for accidental exposures.
Frequently Asked Questions
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Yes, it is possible to be allergic to cashews alone, although many individuals with a cashew allergy may also react to pistachios due to shared allergenic proteins. Comprehensive testing at NY Food Allergy & Wellness through our FATE™ Program can confirm whether the allergy is specific to cashews or includes other tree nuts (NYFA).
Currently, cashew avoidance is a general recommendation, but several treatments can help manage the condition:
Avoidance: The primary treatment involves avoiding cashews and cashew-containing products.
Medications: Antihistamines can relieve mild symptoms, while epinephrine is used for severe reactions like anaphylaxis. Omalizumab (Xolair) injections can be considered to reduce the risk or reactions.
Sublingual Immunotherapy (SLIT) and Oral Immunotherapy (OIT): These treatment options gradually introduce small amounts of peanut to desensitize the immune system over time (American Academy of Allergy, Asthma & Immunology). At NYFA, we offer SLIT and OIT products and options based on patient needs (single vs. multi-foods) and family’s preference for safety and the most efficient way to get to freedom.
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Yes, cashew allergies can develop at any age, even in adults who previously consumed cashews without issue. Risk factors include a family history of allergies, other food allergies, or conditions like asthma or eczema. Our FATE™ Program offers precise diagnostics to identify new allergies and tailor treatment plans. (NYFA)
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Individuals with a confirmed cashew allergy, those allergic to pistachios, or those with a history of tree nut allergies should avoid cashews. Proper diagnosis is essential to know if one or all tree nuts need to be avoided. Testing through our FATE™ Program can clarify who needs to avoid cashews (NYFA).
Do Cashew Allergies Get Worse with Age?
Cashew allergies can persist throughout life and may become more severe in some patients. However, with proper management and treatment, the risk of severe reactions can be minimized. Studies have shown that desensitization therapies, such as those provided in our FATE™ Program, can help manage cashew allergies effectively, even in adults (NYFA).
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Cashews and peanuts are among the most severe for allergies due to their high rates of anaphylaxis (74% for cashews and 50-62% of fatal food allergy cases for peanuts). Walnuts and hazelnuts also pose significant risks. Our FATE™ Program uses BAT and OFC to assess severity and guide desensitization (NYFA).
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Peanuts are legumes and many wrongly label peanuts as “the most common nut allergen”, affecting millions worldwide. The tree nuts include cashew, pistachio, walnuts, pecans, hazelnuts, macadamia, Brazil nuts, and almonds. Our FATE™ Program provides advanced diagnostics to identify the specific nut allergen, and we tailor treatment accordingly.
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For individuals with allergies, cashews can be particularly dangerous due to their high anaphylaxis risk. From a nutritional perspective, no nut is inherently “unhealthy” for non-allergic individuals when consumed in moderation. Our FATE™ Program helps patients navigate dietary choices safely.
Dr. Atul Shah:
Pioneering Food Allergy
Treatments in Manhattan.
Dr. Atul Shah, MD, FACAAI, FAAAAI, is the founder of NY Food Allergy & Wellness and a renowned allergist with over 20 years of experience. With more than 15,000 success stories across children, teens, and adults, Dr. Shah’s expertise knows no age limits. He holds dual fellowships and has been honored with prestigious awards, including the Global Fellowship Award and America’s Top Physician. Dr. Shah is a leader in allergy care, offering personalized, life-changing treatments for all ages.
Dr. Atul Shah, MD, FACAAI, FAAAAI, is the founder of NY Food Allergy & Wellness & a renowned allergist with over 20 years of experience. With more than 15,000 success stories across children, teens, & adults, Dr. Shah’s expertise knows no age limits. He holds dual fellowships & has been honored with prestigious awards, including the Global Fellowship Award & America’s Top Physician. Dr. Shah is a leader in allergy care, offering personalized, life-changing treatments.
What our patients are saying...
About Dr. Atul Shah: Testimonials
Dr. Shah Interview with Donna Drake
Food Allergy Success: Cameron
New York City Location
110 East 60th St., Suite 708
New York, NY, 10022
Hours of Operation
Tuesday: 9am-5pm
Wednesday: 9am-5pm
Thursday: 9am-7pm
Friday: 9am-5pm
Saturday: 9am-2pm
Sunday/Monday: Closed
Where can I learn more about Dr. Atul Shah?
There are several ways to learn more about Dr. Atul Shah. Follow these links for more detailed information, including interview by WABC and News 12. Health.usnews, healthgrades, doximity, center4asthma, OIT101, NYULangone, Sharecare, Medicalnewstoday, Matherhospital, NPIdb, PatientFusion, MD.com, Medifind, Spacial Health, Amerimmune.
You can find more information on all treatments, including success stories and more on Instagram, Facebook, TikTok, YouTube and Amazing Allergist.