Fish and Shellfish Allergies

Fish and shellfish allergies are two of the top 8 most common food allergens. This is a guide for managing these allergies and eating well.

Fish and shellfish allergies are not one and the same since an allergy to fish does not necessarily mean an allergy to shellfish and vice versa. The steps to managing these food allergies, however, are pretty much the same so here they will be discussed together.

Fish and shellfish allergies are not as common in children as they are often developed in adulthood. It is not uncommon for a person who has eaten fish or shellfish for years to suddenly have an allergic reaction to these allergens.

Fortunately, of all of the food allergens, fish and shellfish may be the easiest allergens to avoid (at least in the United States) but they can also cause the most serious reactions so they must be taken very seriously.

People with a fish allergy may be advised by their allergists to avoid all types of fish. It is possible, however, to be allergic to just one species of fish and to be able to eat all other species. An allergy to any type of shellfish, however, usually means avoiding all shellfish.

Tips for managing a fish and shellfish allergy

When eating out, avoid seafood restaurants
This is important for two reasons:
1) the chance of cross-contact at a seafood restaurant is very high
2) you'll have a difficult time finding options other than seafood or fish

When eating out at any restaurant, be aware of the cross-contact risk
Even if it isn't a seafood restaurant, the risk for cross-contact could be quite high. For example, if the restaurant serves fried fish or shellfish, the fryer could be contaminated. This means that if you order french fries and they are made in the same fryer as the fish or shellfish, you could be at risk for getting some of the allergens in your food, causing a reaction.

For more tips on eating out with food allergies, click here.

Hidden sources of fish and shellfish

Anchovies (fish) are found in Worcestershire sauce, some pizzas, Caesar salad, and Caesar dressing.
Gelatin can be derived from fish or shellfish bones (though it isn't very common). Be sure to read all labels and if gelatin is listed it would be a good idea to call the manufacturer to be sure (better safe than sorry!
Asian cuisine often contains fish or shellfish and should be avoided as the risk of cross-contamination is very high.
Fish oil supplements (aka omega-3 supplements) may be cross-contaminated with fish protein.

More resources for managing fish and shellfish allergies

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Kristi Winkels, RDN, LD

Kristi Winkels is a Registered Dietitian and food allergy mom who helps people navigate dietary restrictions due to food allergies and intolerances. Read more about Kristi and get in touch here.

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