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Red flags that suggest allergy, not intolerance: Diarrhea PLUS hives, facial swelling, or lip tingling Diarrhea PLUS throat tightness or difficulty swallowing Diarrhea PLUS wheezing, cough, or shortness of breath Diarrhea PLUS dizziness, rapid heart rate, or feeling faint Symptoms that worsen with repeated exposures (sensitization pattern) Symptoms triggered by trace amounts (cross-contamination) When to get allergy testing: Any respiratory or cardiovascular symptoms with peanut ingestion Severe symptoms (requiring medical care) from small amounts Family history of peanut allergy Personal history of other IgE-mediated food allergies Symptoms that began in childhood and persist Testing options: Skin prick test (results in 15-20 minutes, high sensitivity) Serum-specific IgE (blood test, quantifies antibody levels) Component-resolved diagnostics (measures IgE to specific peanut proteins like Ara h 2, which predicts severity) If testing confirms IgE-mediated allergy, you need: Epinephrine auto-injector (EpiPen) carried at all times Strict avoidance of peanuts and peanut-containing products Medical alert bracelet Action plan for accidental exposure If testing is negative but symptoms persist, you have non-IgE intolerance
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