Breaking through the nut barrier: Hope for adults with peanut allergies
By willowt // 2025-04-28
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  • A clinical trial from King’s College London shows that gradual peanut exposure (oral immunotherapy, or OIT) can help adults with severe allergies build tolerance, with 67% of participants safely consuming up to five peanuts daily.
  • Participants started with tiny peanut flour doses (as low as 0.8mg), gradually increasing under supervision. The average tolerated dose rose 100-fold, improving quality of life—though daily intake is required to maintain tolerance.
  • OIT carries risks, including mild reactions, and is not universally effective. Experts emphasize it must be medically supervised, and long-term durability needs further study.
  • Peanut allergies cause constant anxiety and social burden. Study participants reported reduced fear, but alternatives (like EpiPens, Xolair, or probiotic combos) may suit some individuals better.
  • The study offers promise for the growing peanut allergy epidemic (now affecting ~3M Americans), though more research is needed to refine treatments and expand solutions.
For the estimated 4.6 million American adults with peanut allergies, fear lurks in every bite. A trace of peanut—whether in a dessert, a sauce, or even from cross-contamination—can trigger anaphylaxis, a life-threatening reaction. But new research suggests adults may not have to live in constant vigilance forever. A groundbreaking clinical trial from King’s College London reveals that gradual exposure to peanuts—a method already successful in children—can help adults build tolerance, with some participants safely consuming up to five peanuts a day. The study, published in Allergy, marks the first time oral immunotherapy (OIT) has been rigorously tested for adult peanut allergy. The findings offer hope—but also caution—for the millions navigating a condition that has exploded into a modern epidemic.

The science behind building tolerance

Peanut allergies have tripled in the U.S. since 1990 and now affect about 3 million people. While children have benefited from OIT protocols, adults were left with avoidance as their only defense—until now. The trial involved 21 adults (ages 18–40) diagnosed with severe peanut allergy. Participants began consuming minuscule amounts of peanut flour—as little as 0.8 milligrams (less than 0.3% of a single peanut). Over weeks, doses were carefully increased under medical supervision. By the study’s end, 67% (14) could safely eat the equivalent of five peanuts daily. “The average tolerated dose increased 100-fold,” said lead investigator Dr. Stephen Till. “This improves quality of life.” But experts warn OIT is not a cure. Patients must continue daily peanut intake to maintain tolerance, and reactions—though mild in 95% of cases—remain possible.

A lifelong burden—and a possible lifeline

Living with a peanut allergy isn’t just about avoiding PB&J. It means scrutinizing food labels, interrogating restaurant staff and fearing accidental exposure. “Before, a tiny mistake could have life-threatening impacts,” said Chris, 28, a study participant. Now, he eats four peanuts daily without fear. The psychological toll is immense. Anxiety, social isolation and even PTSD can follow allergic reactions. “Constant fear places a huge burden,” Till noted. OIT could ease that weight—but not for everyone.

No one-size-fits-all solution

While promising, OIT is not without risks. Allergist Dr. Joao Pedro Matias Lopes cautions that longer-term studies are needed to confirm durability. Some alternative options include:
  • Epinephrine auto-injectors (EpiPen, Neffy) for emergencies
  • Xolair injections, an antibody treatment to reduce reactions
  • Probiotic-immunotherapy combos (as seen in Murdoch Institute research)
Each patient’s path is different. “It should be discussed with your allergist,” advises Dr. Edwin Kim of UNC Chapel Hill.

A future free of fear?

For decades, peanut allergies were dismissed as rare. But since the 1990s, they’ve surged into a public health crisis. Scientists still debate why—hygiene hypotheses, dietary shifts and environmental factors all play roles—but one fact is clear: Millions need solutions. This study offers cautious optimism. While not a universal fix, it proves peanut tolerance is possible. More research will refine methods, perhaps paving the way for broader food allergy treatments. As Till notes, “We are very pleased with the results.” For those who’ve lived in fear, that may be hope enough—for now. Sources for this article include: EverydayHealth.com TheEpochTimes.com ScienceFocus.com
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