Sian Baker

Medically reviewed by Sian Baker, Dip ION mBANT mCNHC
on March 25, 2024. To give you technically accurate, evidence-based information, content published on the Check My Body Health blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

A pistachio nut allergy means your body reacts negatively after you eat pistachios or foods containing them. Symptoms can range from uncomfortable to severe, including itchy skin, stomach pain, and in rare cases, breathing difficulties or anaphylaxis. In this post, we’ll discuss the signs and symptoms of pistachio nut allergies, their prevalence, and which foods to avoid if you think you may have this allergy.

Can you actually be allergic to pistachios? 

Yes, pistachio nut allergies are a reality for some individuals. These allergies can range from mild to severe and are triggered by the immune system’s response to the proteins found in pistachios. Given that pistachios are tree nuts, individuals with pistachio allergies may also be allergic to other tree nuts, including almonds, walnuts, and cashews, due to a phenomenon known as cross-reactivity.

How common is this allergy? 

Tree nut allergies, including pistachio allergies, are among the most common food allergies, affecting approximately 0.5 to 1% of the American population. It’s important to note that nut allergies are generally lifelong, with only about 9% of children outgrowing their tree nut allergy.

One study found that between 1997 and 2008, the prevalence of peanut or tree nut allergy in U.S. children had more than tripled, highlighting a significant increase in these allergies over the years

Pistachio Nut Intolerance & Allergy | Signs & Symptoms

Signs & Symptoms of a Pistachio Nut Intolerance or Allergy

Pistachio nut allergies manifest through various symptoms, from skin reactions to gastrointestinal discomfort and respiratory issues. Anaphylaxis, a severe, life-threatening reaction, is a rare but critical condition to be aware of.

What are the symptoms of a pistachio nut allergy?

Symptoms can include:

  • Hives, itching, or eczema
  • Swelling of the lips, face, tongue, throat, or other body parts
  • Wheezing, nasal congestion, or difficulty breathing
  • Abdominal pain, diarrhea, nausea, or vomiting
  • Dizziness, lightheadedness, or fainting

What are the symptoms of a pistachio nut intolerance?

Unlike allergies, intolerances to pistachios might result in:

  • Stomach or intestinal pain
  • Bloating
  • Diarrhea
  • Constipation
  • Nausea

What is food intolerance?

Food intolerance occurs when the body has difficulty digesting certain foods. Unlike allergies, intolerances do not involve the immune system but can cause discomfort and gastrointestinal symptoms.

How common is a pistachio nut intolerance?

Intolerances to specific nuts, including pistachios, are less documented than allergies. However, individuals who experience adverse reactions to pistachios without immune system involvement may be suffering from a food intolerance.

How do you test for a pistachio nut allergy or intolerance?

Testing can involve:

  • Consultation with a healthcare professional for diagnosis through medical history and potential testing.
  • Keeping a food diary to identify correlations between pistachio consumption and symptoms.
  • Elimination diets to confirm the cause of symptoms.
  • Allergy testing, such as skin prick tests or blood tests, to identify specific allergens.

What should you do if you think you have a pistachio nut allergy or intolerance?

If symptoms suggest a pistachio nut allergy or intolerance, it’s important to avoid pistachios and related products. Consulting with a healthcare provider for accurate diagnosis and management strategies is the best course of action. For allergies, emergency medication, such as epinephrine, might be necessary.

What foods should you avoid if you have a pistachio nut allergy or intolerance?

Avoiding pistachios and pistachio-containing products is critical. This includes:

  • Pistachio ice cream
  • Baked goods with pistachios
  • Pistachio-flavored products
  • Mixed nuts containing pistachios

Due to the risk of cross-contamination, it’s also important to be cautious with foods processed in facilities that handle tree nuts.

Top Findings from Recent Studies

When reviewing the study “Pistachio allergy-prevalence and in vitro cross-reactivity with other nutswe can infer the following findings.


  • Higher Prevalence in Cultivation Areas: Living in or near pistachio cultivation areas doubles the likelihood of developing a pistachio allergy, emphasizing the role of environmental exposure.
  • Cross-Reactivity with Other Nuts: The research highlights the strong allergenic cross-reactivity between pistachios and cashews, and to a lesser extent, almonds and peanuts, affecting management and dietary restrictions.
  • Pollen Food Allergy Syndrome (PFAS): Individuals with pistachio allergies may also experience PFAS, which is triggered by cross-reactivity between certain pollens and food proteins, including those in pistachios.

10 alternatives to pistachios

For those avoiding pistachios, consider these alternatives:

  • Seeds, such as pumpkin or sunflower seeds
  • Legumes like chickpeas or lentils for protein
  • Grains such as quinoa or bulgur for texture in dishes
  • Other nuts (if not allergic) like almonds or cashews
  • Dried fruits for snacking or baking
  • Soy nuts or soy nut butter
  • Peas or beans as a protein source in meals
  • Coconut flakes for texture and flavor in baking
  • Oats or granola without nuts for breakfast
  • Rice cakes as a nut-free snack option

How to test if you have a pistachio nut allergy or intolerance

Determining whether you have an allergy or intolerance to pistachios involves observing symptoms in relation to consumption and undergoing medical testing. An accurate diagnosis can guide dietary choices and management strategies to avoid discomfort and serious reactions.

To further understand your body’s reactions to pistachios and other foods, consider taking a food intolerance test offered by Check My Body Health. These tests can help identify sensitivities to a wide range of foods, providing valuable insights for managing your diet and well-being.


Click to buy our best food intolerance test
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