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 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.

You may have Pollen-Food Allergy Syndrome if you suffer from almond allergy with oral allergy symptoms to 3 or more of the foods mentioned in cross reactivity section.

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.

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.

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