Updated March 18, 2015.
Written or reviewed by a board-certified physician. See About.com'sMedical Review Board.
Coconut comes from the coconut palm tree found in the tropics. The seed of the palm is a fruit called coconut. Many individuals confuse the coconut to be a tree nut (not surprisingly with the inclusion of “nut” in the word and the source coming from a tree), however, the coconut is actually a fruit.
The American College of Allergy, Asthma & Immunology (ACAAI) states:
“Coconut is not a botanical nut; it is classified as a fruit, even though the Food and Drug Administration recognizes coconut as a tree nut. While allergic reactions to coconut have been documented, most people who are allergic to tree nuts can safely eat coconut. If you are allergic to tree nuts, talk to your allergist before adding coconut to your diet."
Furthermore, the coconut does not appear on Europe’s list of tree nuts that must always been labeled on food packages, but in the U.S. coconut is classed as a tree nut by the Food and Drug Administration (FDA) for labeling purposes.
Coconut allergy is very rare with only a few reported cases in the literature.
Coconut Allergy Symptoms
Though a rare allergy, food allergy symptoms associated with a coconut allergy may occur after drinking or eating foods made with coconut in those who are allergic, including:
- Skin reactions such as rash, hives or eczema.
- Gastrointestinal symptoms like nausea, stomach pain, vomiting, or diarrhea.
- Airway symptoms including wheezing, coughing, or a runny nose.
- Swelling, also known as angioedema, of the lips, tongue, or face.
- Severe reactions, called anaphylaxis, may occur, affecting multiple organ systems. However, anaphylaxis to coconut is extremely rare.
Contact allergic dermatitis to coconut is more common than a full-blown allergic reaction. This occurs due to the presence of coconut-derived products such as coconut diethanolamide, cocamide sulphate, cocamide DEA, CDEA, which may be found in cosmetics such as shampoos, moisturizers, soaps, cleansers and hand washing liquids. An itchy blistering rash may develop a day or two after contact with the coconut allergen, and take several days to resolve. If you suspect contact dermatitis due to coconut, contact your doctor for proper testing.
Botanically, coconuts are most closely related to other palm and betel nuts. While botanical relationships are not the only factor that determine whether two foods will be cross-reactive, foods that are close biological relatives often share related allergenic proteins. For example, cashews and pistachios are two closely related plants that contain similar proteins. People who are allergic to one of these nuts are often allergic to the other one as well. When it comes to coconut, there is some evidence of cross-reactivity between coconuts and hazelnuts, and coconuts and walnuts.
However, the botanical distance between coconuts and tree nuts would suggest that most people with tree nut allergy may tolerate coconut.
Diagnosis of Coconut Allergy
Coconut allergy is usually diagnosed by a medical doctor (allergist) after a medical history, physical examination, and food allergy testing are performed.
The treatment for coconut allergy is the elimination of coconut from the diet.
How to Avoid Coconut
As mentioned, if an allergy to coconut has been established, all coconut must be eliminated from the diet to avoid an allergic reaction. Coconut is found in many food products and is added for flavor, texture, and as a trendy ingredient inclusion in food products (as of this writing). Avoid all foods made with coconut, like granola bars, cookies, other desserts, and cereals.
The Food Allergy Labeling and Consumer Protection Act (FALCPA) identifies coconut as a tree nut (even though it’s a fruit) for the purposes of product labeling and consumer protection against potential allergens. Manufacturers must list coconut as a potential allergen ingredient and foods containing coconut are required to be labeled "contains tree nuts" under FALCPA. You may also find statements that say, “contains coconut” on the label.
Not only will you find this information in the ingredients list, but it will also be on the package. Some products won’t call out coconut-based ingredients on the label. There are two things you can do in this situation: call the manufacturer and inquire about the specific ingredients contained in the product, and/or skip eating the product.
Foods to Avoid with a Coconut Allergy
To avoid coconut in foods, you must be a food label detective. Coconut is present in many foods as a derivative such as coconut oil, rice, sugar, water, cream, milk, and milk powder. You may find coconut in cakes, chocolates, rum, candy, and many desserts. It may also be included in infant formula. And, as mentioned, many coconut-derived ingredients are found in soaps and shampoos.
Foods that Contain Coconut
- Coconut milk
- Coconut water
- Coconut oil (highly refined oils are generally not problematic)
- Coconut cream
- Coconut milk powder
- Coconut sugar
Food that May Contain Coconut
- Candy bars (Almond Joy)
- Cookies (Macaroons)
- Pie (coconut cream pie)
- Yogurt (coconut flavor)
- Ice cream
Living with a Coconut Allergy
Since there is no cure for coconut allergy at this point in time, living with a coconut allergy means learning to avoid coconut and coconut ingredients in foods and non-food items while being prepared for future reactions.
You will need to carry an emergency first aid kit with you, including contact information, antihistamines, and an epinephrine auto-injector, if prescribed by your doctor.
If you've been diagnosed with a tree nut allergy, you should avoid coconut given that there is a possibility of cross-reactivity and tree nut reactions can be severe.
If you're allergic to another tree nut, yet have a history of eating coconut without a problem, and are interested in seeing whether coconut could be part of your diet, discuss further testing for coconut allergy with your allergist. Your allergist can let you know whether your test results and history indicate more testing or a food challenge as a reasonable next step.
If you have skin sensitivity to coconut--also known as contact allergic dermatitis--keep an eye out for ingredients and alcohols in beauty products that may be derived from coconut and avoid them.
American College of Allergy, Asthma, and Immunology. http://acaai.org/allergies/types/food-allergies/types-food-allergy/tree-nut-allergy
Food Allergy Research and Education. http://www.foodallergy.org/allergens/tree-nut-allergy
Anaphylaxis Campaign. http://www.anaphylaxis.org.uk/what-is-anaphylaxis/faqs