What are pine nuts?

Pine nuts are the edible seeds of pine trees grown in Europe, the USA and Asia. They are used as ingredients in lots of different food products such as pesto sauce, breads and cereals.

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What is a food allergy?

A pine nut allergy is a type of food allergy. Food allergy occurs when the body’s immune system wrongly identifies a food as a threat. When this happens, the body releases chemicals, such as histamine, in response. It is the release of these chemicals that causes the allergic symptoms.

Symptoms of a food allergy

The symptoms of a food allergy usually come on quickly, within minutes of eating the food.

Mild to moderate symptoms may include:

  • nettle rash (known as hives or urticaria) anywhere on the body
  • a tingling or itchy feeling in the mouth
  • swelling of lips, face or eyes
  • stomach pain or vomiting.


More serious symptoms are often referred to as the ABC symptoms and can include:

  • AIRWAY – swelling in the throat, tongue or upper airways (tightening of the throat, hoarse voice, difficulty swallowing).
  • BREATHING – sudden onset wheezing, breathing difficulty, noisy breathing.
  • CIRCULATION – dizziness, feeling faint, sudden sleepiness, tiredness, confusion, pale clammy skin, loss of consciousness.


The term for this more serious reaction is anaphylaxis (anna-fill-axis).

In extreme cases there could be a dramatic fall in blood pressure. The person may become weak and floppy and may have a sense of something terrible happening. This may lead to collapse and unconsciousness and, on rare occasions, can be fatal.

Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves the ABC symptoms.

Getting a diagnosis

If you think you may be allergic to pine nuts, see your GP who can refer you to a specialist allergy clinic if needed. They can find a clinic in your area from the British Society for Allergy and Clinical Immunology (BSACI).

It’s important to get a referral even if your symptoms were mild because it can be hard to tell if future allergic reactions could be more serious.

Once you get a referral, the consultant will discuss your medical history and symptoms with you. They might suggest skin prick, blood tests, and food challenge tests to help diagnose the allergy and work out how serious it may be. Read more about allergy testing.

Some clues that you might be at higher risk are:

  • you have already had a serious reaction, with any of the ‘ABC’ symptoms
  • you have asthma, especially if it is not well controlled
  • you have reacted to a tiny amount of the food.

Treating symptoms

If you have mild allergic symptoms you may be prescribed antihistamine medicine that you take by mouth. If you are at risk of anaphylaxis, you may be prescribed adrenaline to use in an emergency.

Adrenaline comes in pre-loaded adrenaline auto-injectors (AAIs) that are designed to be easy to use. Make sure you know how and when to use them. Ask your healthcare professional to show you, and find help on the manufacturer’s website.

The adrenaline auto-injectors prescribed in the UK are:


You must carry two with you at all times, as you may need to use a second one five minutes after the first if your symptoms don’t improve or get worse.

If you have asthma, and it is not well controlled, this could make an allergic reaction worse. Make sure you discuss this with your GP or allergy specialist and take any prescribed medicines.

Which foods contain pine nuts?

Pine nuts are often found in pesto sauce. They’re also used in sandwiches, cakes, bread, salads, pizzas, biscuits, confectionery and ice cream.

Pine nuts can sometimes turn up in products where you don’t expect them. They have been seen as ingredients in a lentil and mint lamb leg joint, a butternut squash rolled pork loin, vegan chocolate tortes, and a Christmas pudding. They’re also often included in packets of mixed seeds.

If you are allergic to pine nuts, read food labels carefully and be direct when talking to catering staff. Tell people you have to avoid pine nuts and pine kernels.

The phrase “nut free” does not mean there are no pine nuts included because pine nuts are in a different botanical category to tree nuts.

In the UK there are 14 food allergens which must be highlighted in ingredients lists of pre-packed foods, under food information regulations. Pine nuts are not among those 14 so you will not see them highlighted.

Pine nut oil is rarely used – it is golden coloured and can be used for making salad dressings and drizzling on to dried or grilled meats.

Other names for pine nuts to look out for

Pine nuts are known by a variety of other names including pine kernels, pinon, Indian nut, pignoli and pignolia.

‘Pine mouth’ syndrome

Some people find they have a metallic or bitter taste that comes on within 48 hours of eating pine nuts and can last for up to two weeks. Doctors are uncertain what causes pine mouth syndrome but don’t believe it is harmful. It is not thought to be an allergic reaction.

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