Fish and Shellfish Allergy

Who wouldn’t love to dine at a seafood restaurant? Well, those who have fish allergies of course. No matter how much they want to enjoy a buttered salmon steak or any other fish dish, they just can’t. There is also a risk in ordering a non-fish dish because the skillet, spatula, or oil used to cook the food may have been used to cook fish.

Fish allergies prevail among countries wherein fish is a part of their staple diet, like in Spain, Japan, and Scandinavian countries, and affects around 20 percent of all populations.

What makes some fish allergenic?

Fish allergies are caused by the protein in the flesh of fish. Fish oils and fish gelatin, even if they are not made of fish meat, can still trigger allergies because these products may have been contaminated by the proteins from the fish meat.

Cod, salmon, trout, herring, sardines, bass, orange roughy, swordfish, halibut, and tuna are fish known to cause allergic symptoms, and oftentimes severe anaphylactic reactions.

However, there are times when people who are allergic to one type of fish, such as cod, will also react to other fish, such as hake, haddock, mackerel and whiting. This happens because the protein allergens of these fish are similar.

When it comes to preparation, raw fish can be more allergenic than cooked fish because heat can denature the allergenic proteins, but that is not always the case. Some people can be allergic to cooked fish, but not raw fish.

What are the symptoms of a fish allergy?

In highly sensitive people, the mere smell of fish can trigger their asthma, and eating foods cooked in reused cooking oil, or using utensils and containers that may have been used in storing or cooking fish can cause anaphylaxis, a severe life threatening allergic reaction. Reactions can be immediate, or delayed for as long as 24 hours.

More common reactions to a fish allergy are the same as symptoms of other food allergies which can affect the skin, the digestive system, and the respiratory system. Specifically, there could be presence of urticaria (hives), eczema, and angioedema (swelling), itching, upset stomach, loose stools, vomiting, cramps, gas, vomiting, nasal congestion, shortness of breath, wheezing, asthma, heart burn, lightheadedness, or fainting.

How to live with a fish allergy?

Find out which types of fish trigger your allergy so that you can eliminate them from your diet. But if you are like majority of fish allergy sufferers, the best thing to do is to avoid eating all kinds of fish altogether.

Take extra precaution when dining out or eating foods prepared by others. Even if it is not at a seafood restaurant, check if the chef uses the same skillet or reuses the oil to cook both meat and fish. If this is the practice then there is a possibility that the materials may have already been contaminated with fish proteins. Opt not to eat at all rather than risk an allergic reaction.

Watch out also for typical condiments, sauces, or dressing that may contain fish proteins such as Worcestershire sauce, Caesar salad, caviar, roe (fish eggs), or imitation seafood often used in sushi.

Among food allergens, fish is the easiest to avoid, but its manifestations can be most severe. So if you suffer from a fish allergy, educate others about your sensitivity. Make sure that you are aware of all ingredients that may indicate fish protein content in prepared or processed foods. Wear a Medic Alert badge, and carry an injectable adrenaline syringe, just in case of a sudden allergy attack.

Shellfish allergy

Just like fish allergy, shellfish allergy is relatively easy to avoid, but unlike fish, if you are allergic to one type of shellfish, you are allergic to all of them.

Once you are diagnosed with a shellfish allergy, you must bid farewell to eating species of crab, lobster, shrimp, prawn, abalone, crawfish, crayfish, oysters, cockle, sea urchin, and all types of mollusks (clams, mussels and scallops).

Symptoms are more common in adults, but children can also develop an allergy but eventually outgrow it, but some end up dealing with their allergy for the rest of their life.

What makes some shellfish allergenic? What are the symptoms?

Proteins in shellfish cause allergic reactions. The symptoms are similar to that of other food allergies which manifest on the skin, in the digestive system, and in the respiratory system. Within 2-24 hours of eating shellfish, the person may experience hives, itching, swelling, wheezing or shortness of breath, asthma, nasal congestion, nausea, upset stomach, cramps, heart burn, gas, diarrhea, lightheadedness, or fainting. In other people, their allergies can be triggered by merely inhaling cooking vapors or handling shellfish.

How to prevent a shellfish allergy?

Like all other allergies, the best way to prevent the symptoms is to avoid the allergens. Therefore, to prevent a shellfish allergy, avoid eating all kinds of shellfish. If you know if you are allergic to shrimp, but not sure if you are allergic to shellfish of another group, such as clams, undergo an allergy test to be sure.

Be discriminating when reading product labels, especially processed Asian-style foods, because shellfish is very popular in Asian cuisine. When dining out, if you are unsure of an item, ask about its ingredients and make sure shellfish is not included in any of the sauces and broths.

Allergies can also act up from cross contamination in the food preparation so it is best to know the restaurants’ practices in cooking food. Make sure that the chef does not cook shellfish on same skillet, or in the same oil as other food. It is possible that in some restaurants, they may cook chicken and clams in the same oil. If so, then opt not to order any food at all because the onset of a shellfish allergy can be life threatening.

Have someone else handle shellfish because in sensitive individuals, contact with shellfish can already activate the symptoms. Inhaling fumes from cooking shellfish can also set off the allergies, so if you know that someone nearby is cooking shrimps, crabs, or other shellfish, stay far away.

If you have experienced an allergic reaction to eating any kind of shellfish before, do not attempt to eat it again. A shellfish allergy persists for several years, and at this time, there are no allergy shots available for food allergies.

Also, cooking shellfish does not decrease its allergenic properties either. Shellfish, both cooked and raw, can trigger allergies with the same intensity.

For sensitive individuals, always wear a Medic Alert badge and carry an injectable adrenaline syringe. If you have any other concerns about diagnosis, symptoms, and prevention tips, seek advice from your healthcare profession.

Fish and shellfish allergies can cause anaphylaxis

People with fish and shellfish allergies can have a variety of reactions to their allergens. Along the most extreme lines are the anaphylactic responses. Although anaphylactic reactions can be mild, the term is generally used in regards to the severe and life threatening reactions that can happen in relation to an allergen. When exposed to an allergen the body responds by releasing histamines. These histamines cause a variety of symptoms the severity of which is related to the amount of exposure and how sensitive the person is to those allergens.

Anaphylaxis is a systemic response and involves a combination of symptoms including the respiratory, gastrointestinal and cardiovascular systems of the body. Reactions can happen immediately after exposure up to 2 hours and in rare instances as long as 4 hours after exposure.

Symptoms of anaphylaxis

There are differing symptoms for anaphylaxis. The over arching issue is the rapidity of response and the fact that it frequently impairs breathing, needing emergency intervention. Some people will experience a tingling, itching or numbness in the tongue, lips and roof of the mouth and may include a strange metallic taste. This can advance rapidly to swelling of the mouth and throat cutting off the ability to breath. Also noted is flushing, increased heart rate or palpitations, a rapid drop in blood pressure, asthma and related breathing difficulties and a loss of consciousness.
Related symptoms as in bee & wasp stings can be hives, rash, itching and breathing difficulties, asthmas and loss of consciousness as well.

Treatment for anaphylaxis 

Treatment for severe allergies resulting in anaphylaxis starts with avoidance. Of course it might take a single exposure to realize how important this is. Reading labels on food, questioning food servers at restaurants is important but they don’t always have the necessary information. Staying armed with a fast acting antihistamine is a good idea as is carrying an Epipen (prescribed by a physician). Getting a person to the emergency room or a physician as quickly as possible is important as life threatening symptoms can come on quickly. It can help to immerse a person in a hot bath or a hot shower to help the body rid itself of the offending toxin. 


  1. My brother and his wife have just heard of my severe allergy to fish and now they enter the house with a strange odor present with a cologne scent with it. Now my throat is dry, scratchy, and I almost had an asmtha attack yesterday with them and used my inhaler and took two benadryl. They say taunting things to me as: Does your chicken taste like fish? Does this restaurant serve fish? They are going to order fish but luckily no fish was in this restaurant. I never told them I was allergic to fish and they knew I was allergic to eggs and then they cooked eggs everytime they could, frying okra, eggplant, and meat in eggs and flour. But this new thing has them really picking at me and I have left the residence to escape the odor. I am so sleepy from benadryl and lots of water. They go back to Texas in the morning and I hope I recover. Tell me what to do? I know they both use fish oil for health purposes and wonder if they are using it on the sofa where I sit and recline. I am on chemo too and I am not well at all.
    Please tell me how to ck. to see if fish is actually in the house on a sofa or a surface…

  2. Actually I was only concerned due to my health, as fish allergies can kill ya! And who wants to die from ya air ways being completely closed together and suffocate to death? I love my brother and I love his wife…they couldn’t have understood the reality of such.

  3. I am a Navy Lt. and while being in the Pacific two years ago I began to wheeze and developed this irritable rash all over my entire body. I was checked by our medical staff and flown to the nearest hospital and was given injections of prednizone and a dose pak of Medrol. Next I had to be placed on life support with all the tubes in my nose and an incision in my trachea with a tube inserted there into my lungs as my airways were swollen from the severe allergy I was having. The attending Dr. asked me what I had for my last meal and I told him some fish we caught in our nets and he said, “You are lucky to be alive.” Later I recovered and by later I mean weeks… and I took a battery of allergy test and fish was my worst nightmare of an allergy. I will never forget this ordeal and my wife cannot cook fish in the house and I can’t go into a restaurant that is cooking it. So the next time someone tries teasing you Jane, Ask them if they have enough insurance to cover your illness in ICU. This is a very serious condition and not easily handled except with avoidance 100%.


  4. When I have eatten salmon or tilapia I break out in hives 48 hours later and it takes up to a month to clear the hives. I have seen an allergist; a skin test and blood/antibody testing for all fish and shellfish were performed. I am told my reaction is atypical of a food allergy. Is there something else going on?

  5. We have a lot of customers with fish allergy, they take our omega-3 supplement from algae, so if you cant eat fish and your worried about a lack of long chain omega3 (EPA, DHA) in your diet, take an algae supplement instead. There are no proteins associated with fish oil allergy

  6. At 54 I discovered I have a fish & shellfish allergy!
    I have suffered for 33 years with occasional sharp pain and much discomfort.
    I cannot find any link on the Internet with regards to my specific condition with regards to this salmon & herring allergy.
    With no obvious help and doctors not helping, I wish to state here that this allergy caused my external haemorrhoids/piles and the painful attacks that followed.
    Only 3 years ago my throat became swollen and then closed up after eating my first lobster. Only later after realising that I was allergic did I prove that this was happening to the other end with these fish. Apologies for stating this, but I am sure there are many people living with this dreadful condition that do not know it may be due to a fish allergy swelling and closing up the area around their tail end.

  7. my 4 year old grandaughter only has to walk into the house where we are cooking fish and starts getting hives. We didnt know this until recently. Before we discovered she cannot touch a fresh caught trout or perch and she gets big welts on her face and is misreable. She comes from a fishing family and we no longer do fish when we know she is coming over. She will even ask us if she gets ice cream bar out of the freezer is it by fish. Or if she washes her hands at the sink if there has been fish by there. Once time there was fish water stitting next to the sink on the counter and she leaned over and touched it and sure enough her face and legs started to itch.

  8. my mom is allergic. every time she touches it she gets some nasty hives and red spots. her face swells up and has problems breathing. u cant even talk talk to her with fish breath because her face will swell!

  9. When I eat Orange Roughy fish my feet swell and itch very bad. Only fish I have an allergy to.
    Dr said do not eat as it might swell up my throat next time.

  10. I am allergic to every fin fish except for swordfish. I also can eat all shell fish. This is so wierd. Anyone know why I can only eat swordfish and not any other fin fish?

  11. I am allergic to only fish, but I can eat shellfish, caviar and canned tuna. I am going to Cancun in a few weeks and scheduled a Dolphin swim. It wasn’t until I already booked the swim that I realized I may have a reaction to the lagoon that the dolphins are in, since they are fed fish. I have never had any issues in the ocean, and have been snorkeling before, but I’m afraid that the lagoons may not be as diluted as the ocean. It’s pretty much a 50/50 chance right now. The worst that could happen is that I break out in hives, but it’s too late to get a refund. Anyone else ever had this issue, or swam with dolphins when you have a fish allergy?

  12. It was about ten yrs ago I had my terrifying unforgettable reaction. My friend offered me a bite of stir fry me thinking it was chicken. Not even maybe 5mins after up my neck into my ears were itchy and tingling, the parts of my lips that touched the fish were swollen, my throat got itchy and I starred to get horse n weezy.. kinda felt like I had a hand squeezing my throat.luckily l wasn’t to far from the hospital I could hardly talk by the time I got there and this all was within a ten fifteen min time period. And they rushed me back and told me I was lucky I got there when I did, all the shots and just the scaryness of not breathing I hyperventilated and passed out. Ever since then I’ve just stayed away from anything along the lines. And well where I’m getting is my friends give me crap about it, I can’t go out on s date to eat without having to ask n feel embarrassed. And also my friends and my father don’t believe im actually allergic… My father because he says I use to eat fish when I was younger? So they think it’s just me being a hypochondriac. Even though still I’ve been to an allergist and had the tests done and I am indeed allergic even to the smell of it cooking.. I’m at a standstill on what to do as far as my friends n father nagging me about it. And just eating it around me like its nothing. (yeah, yeah get new friend’s ) but anything else I can do to help this? Or a way I can just Ignor it not let it upset me so much? Or at least try and make them understand cause I’m highly allergic, and terrified to go through that ever again.

  13. If you have Insensitive denying family and friends. The next time they feed you food that triggers your allergies, give them your medical bills.
    As much as you love family and friends who knowingly serve you food that can possibly kill you, I would take them to court.
    You may never get a straight answer but I would ask WHY ARE YOU SO VICIOUS. Why do you deny what is so very obvious. I have had this for 61 years and I’m thankful that no one has been That EVIL. THE DISREGARD THEY HAVE FOR YOU IS EVIL EVIL EVIL PERIOD

  14. I went out with the family last night…I had halabut .i woke thru the night feeling like I was going to cough up my lungs..head ache, nose running,all my limbs are aching ..I almost couldn’t drive I was so sore..felt like I was ran over by a truck …we went to the same place about 3 years ago…we both came down with horrible flu/cold Simptums..but never dawned on us

  15. I’m allergic to fish but my mom made hamburgers and used a little bit of worchestire sauce and I had no allergic reaction. How is this possible ?

  16. My son has a severe fish allergy even the smell sets him off we nearly lost him when he was 2 and we have been maintaining his anaphylaxis well school has been very hard as tuna sandwiches he react to the smell, as other children have these. just recently he had a reaction to the smell of sushi at school he was struggling to breath it scared him half to death and not to mention the teacher who was amazing by the way but unfortunately we don’t have the support from the principals at the school they don’t seem to take his allergy very seriously as they continue sushi day at school I’ve said I’ll just keep him home from school that day as to not to put him in harms way ( and he is terrified) but they seem to make out I’m over reacting. How is looking after my sons life over reacting

  17. My doctor told me i am not allergic to fish and that its all in my mind. My sensitivity to the smell of fish and the taste of any fish, started when i was 10 yrs old. I get upset stomach, diarrhea and i vomit with just the “smell”, worst whenever i am eating fish. When i started working, i consulted many doctors to understand my situation. Im 34 and i still do not understand why…

  18. I have just realised today that I am showing a mild reaction to fish these past few weeks which Doctors have treated as a viral infection!I have had a blocked nose sneezing attacks a sore throat dizzy spells and a rash. it also seems to come and go one day I have full symptoms then it eases only to return a few days later. I started to wonder was it an allergy so I have been taking note of what I have used and eaten. I am going to cut fish out of my diet for a few days and see what happens

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