Should people with coconut allergy avoid coconut oil?

Coconut oil is usually found as a cold-pressed oil, which is unrefined and should be avoided by people allergic to coconut.

 

Oil and extracts of coconut are used in some cosmetics and toiletries especially in soaps, hand gels, shampoos and hair conditioners. The risk posed by these products is unknown as far as we know, so we would advise people with coconut allergy to read ingredient lists carefully and avoid any product containing coconut.

 

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Coconut Allergy

 

If you believe you are allergic to coconut, this should be reported to your GP, who can either arrange a test if he or she is qualified to do so or refer you to an allergy clinic for testing.

 

Many cases of food allergy are mild but, in a few people, an allergic reaction can be life-threatening.

 

The term for a severe allergic reaction is anaphylaxis. People who are at risk of anaphylaxis are prescribed adrenaline in injectable form. This must be carried at all times so that an injection can be given if a severe reaction occurs.

 

Reports of allergy to coconut in medical and scientific journals are highly uncommon compared with those reports that focus on tree nuts. Because of this we believe that allergy to coconut is rare in the UK, although no precise statistics are available.

 

Should people with tree nut allergy avoid coconut?

 

Tree nuts include almonds, walnuts, hazelnuts, brazil nuts, cashew nuts and pistachios.  People who are allergic to tree nuts sometimes ask us if they are likely to react to coconut because of the name.  Foods that are close biological relatives often share similar proteins, which can lead to a process called cross-reactivity – where a person allergic to one food also reacts to another. But the coconut is a member of the palm family and only distantly related to tree nuts. The botanical distance between coconuts and tree nuts would suggest that people with tree nut allergy should be able to tolerate coconut and studies have shown that this is generally true. Therefore, there is no general recommendation that patients with tree nut allergy should avoid coconut.

 

Rare exceptions have been reported in scientific research papers. Two people allergic to walnuts were found to react to coconuts due to a cross-reacting protein. Another person who was allergic to coconut suffered symptoms of oral allergy to several tree nuts. A cross-reacting protein found in both coconut and hazelnut was identified as the cause.

 

The medical reviewer of this article, who works in a busy NHS allergy clinic, occasionally sees patients who had been mistakenly advised that they were allergic to coconut due to the misinterpretation of the results of a popular allergy blood test.  The test is called ImmunoCAP fx1 Mixed Nuts and it is available to GPs in some areas.  It checks to see if one or more nut antibodies (specifically peanut, hazelnut, brazil nut, almond or coconut) is present in the blood serum. If the test is positive, it indicates an allergy to at least one nut, but it does not mean that the patient is allergic to all of them. In order to confirm this, a separate test to each nut should be carried out.  However, not all NHS laboratories do this as a matter of routine when the test is positive unless they have been specifically asked to do to so.

 

If you have been told you are allergic to coconut but are unsure if a separate coconut allergy test has been carried out, or if you are allergic to one or more tree nuts and don’t know if you are allergic to coconut, we would advise you to ask your GP to arrange for a coconut allergy test.

 

Where is coconut used?

 

Coconut can be bought fresh or as coconut milk, coconut water, creamed coconut or desiccated coconut.  It can be used as an ingredient in baking, ice cream, breakfast cereals and confectionary.  It is widely used in South-East Asian cooking. A member of Anaphylaxis UK reported finding coconut oil to be an ingredient used to cook crisps in France.

 

There are likely to be other uses for coconut. We advise people who are allergic to coconut to read food labels carefully every time they shop. Coconut does not appear on the list of major food allergens that must, by law, always be labelled on food packages, so if you are in doubt about any product, contact the manufacturer.

 

When eating out, question staff carefully. Caterers are required by law to be able to provide ingredient information on major food allergens but as these do not include coconut, you will need to ensure that the staff you question understand that you must avoid coconut.

 

The following are just a few of the products that you need to watch out for:

 

  • Macaroons
  • Bounty bar
  • Vegan cheese
  • Malibu rum
  • Some fruit juices contain coconut

 

Reviewer

The text of this article has been peer reviewed by Dr Michael Radcliffe, Consultant in Allergy Medicine, University College London Hospitals NHS Foundation Trust.

 

Publication Date: October 2019
Review Date: Under review