Managing Shellfish and Fish Allergies

in Fish & Shellfish
Published: October 4, 2010

Steamed LobstersThere is no cure for allergies to fish or shellfish, so people who develop allergies to seafood must avoid even small traces of the foods that cause them to react.

It’s crucial that people with a severe allergy to seafood carry epinephrine (brands include EpiPen, Auvi-Q, Allerject) with them at all times, as well as other medications, such as antihistamines and inhalers, that may be recommended by their allergists.

It’s also important to remember that epinephrine is considered an emergency measure – not a treatment – so people should avoid taking unnecessary risks. But with a few simple precautions, people with allergies to seafood should be able to lead full, normal lives.

What’s Safe?: It’s possible to be allergic to just one or two forms of fish or shellfish – for example, some people can eat lobster but not scallops, while others can eat cod but not salmon. But because there is a high level of cross-reactivity within the food groups, many need to avoid either fish or shellfish in all their forms.

It is important to note, however, that the key allergens in fish and shellfish are completely unrelated, so even if you are allergic to shellfish, finned fish might be just fine. (There are people who are allergic to both fish and shellfish, but this is rare.) If you’re unsure of what’s OK and what’s not, make sure to talk it over with your allergist.

Acceptance: Most people with seafood allergies develop them later in life, which can be tricky, because they may be accustomed to eating without restrictions. “But I’ve never had a problem with seafood,” is a common refrain, so sometimes people take unnecessary risks and try to eat the food that has caused them to react. But once you have a seafood allergy, it’s very important to avoid the allergen altogether, as the allergy can worsen with more exposure.

Know What You’re Eating: Seafood comes in many different forms.
Shellfish can include mollusks such as clams, mussels, and oysters, as well as crustaceans such as shrimp, lobster and crabs. Other forms include squid (the main ingredient in calamari), octopus, prawns, periwinkle, limpets, abalone, cockles, quahogs, snails (or “escargot”), langoustines and sea urchins. The most allergenic type of shellfish is shrimp.

There are many different types of fish, including anchovies, bass, bluefish, catfish, char, chub, cod, eel, flounder, grouper, haddock, hake, halibut, herring, mackerel, mahi-mahi, marlin, monkfish, perch, pickerel, pike, pollock, rockfish, salmon, sardines, shark, smelt, snapper, sole, sturgeon, swordfish, trout, tuna, turbot, whitefish and more.

It is very important that you understand the different names of the food you are allergic to, and carefully read all food labels so you can avoid them.
See: Label Aware

One thing to be cautious of with seafood allergies: imported foods. Not all countries have the stringent labeling requirements of the United States, Canada and the European Union. Don’t take chances if you suspect fish or shellfish could be ingredients of an import.

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