Fish Allergy

An estimated 2.3% of Americans, that’s nearly seven million people, report allergy to seafood, including fish and shellfish. Salmon, tuna and halibut are the most common kinds of fish to which people are allergic. It is generally recommended that individuals who are allergic to one species of fish avoid all fish. If you have a fish allergy but would like to have fish in your diet, speak with your allergist about the possibility of being tested with various types of fish.

Fish allergy is considered lifelong; once a person develops the allergy, it is very unlikely that they will lose it. Approximately 40% of those with fish allergy first experienced an allergic reaction as an adult. To avoid a reaction, strict avoidance of seafood and seafood products is essential. Always read ingredient labels to identify fish ingredients. In addition, avoid touching fish, going to the fish market and being in an area where fish is being cooked, because the protein in the steam may present a risk.

Some Unexpected Sources of Fish

  • Salad dressing
  • Worcestershire sauce
  • Bouillabaisse
  • Imitation fish or shellfish
  • Meatloaf
  • Barbecue sauce (some are made from Worcestershire)

Keep in Mind

  • If you have a seafood allergy, avoid seafood restaurants. Even if you order a non-seafood item off of the menu, it is safer to always assume that cross-contact is possible.
  • Asain restaurants often serve dishes that use fish sauce as a flavoring base. Exercise caution or avoid eating there altogether.
  • Avoid foods like fish sticks and anchovies. Some individuals with fish allergy make the mistake of thinking that such foods don't "count as real fish".
  • Fish and shellfish protein can become airborne in the steam released during cooking and may be a risk. Stay away from cooking areas.
  • Many people who are allergic to fish or shellfish are allergic to more than one kind. Get tested and have your allergies confirmed by a physician so that you know for sure what foods to avoid.

Commonly Asked Questions

Should carrageenan be avoided by a fish-allergic individual?

Carrageenan is not fish. Carrageenan, or "Irish moss," is a red marine algae. This food product is used in a wide variety of foods, particularly dairy foods, as an emulsifier, stabilizer and thickener. It appears safe for most individuals with food allergies. Carrageenan is not related to fish and does not need to be avoided by those with food allergies.

Should iodine be avoided by a fish-allergic individual?

Allergy to iodine, allergy to radiocontrast material (used in some radiographic procedures) and allergy to fish or shellfish are not related. If you have an allergy to fish, you do not need to worry about cross-reactions with radiocontrast material or iodine.