Fish and Shellfish Allergy

If you are allergic to fish should you avoid shellfish?
Fish and shellfish are two distinct categories of foods (shellfish may be categorized as either mollusk or crustacean) like peanuts and tree nuts are separate categories of foods.

There is a potential for cross-contamination in the preparation of these foods, which prompts many individuals with fish allergy to avoid all seafood. Fish and shellfish may be handled together at the fish market, displayed together, mixed together to make imitation seafood, and prepared together on grills and in fryers.

Individuals with fish allergies should be tested for shellfish allergy so they are aware of their allergic status with respect to shellfish. If an individual is not allergic to shellfish, he or she could eat it if he or she were sure there was no cross-contamination with fish. If you believe that you are allergic to fish, but would like to have fish in your diet, talk to your allergist about the possibility of being evaluated for fish allergy.

Are fish sticks and anchovies fish, too?
Yes, both of these should be avoided by fish-allergic individuals. Fish sticks are typically made from a white fish such as pollack. Anchovies are actually small fish that resemble herring. They are used frequently in salads, sauces, and as pizza toppings. Worcestershire and barbecue sauces with Worcestershire sauce as an ingredient and Caesar salad dressing often contain anchovies!

Where else might fish be hidden?
Various Asian dishes use fish sauce as a flavoring base. As noted, imitation seafood is made from fish that has been shaped and flavored to resemble seafood such as crab and lobster. Individuals with fish allergy should use caution when eating in seafood and Asian restaurants that serve a variety of fish dishes.

Anyone with a severe fish or shellfish allergy should carry an Epi-pen, which is an injectible adrenaline, and can be prescribed by your Allergist.

If you have any further questions please contact our hotline:

Ellen Epstein, M.D. FAAAAI, FACAAI
Advanced Allergy and Asthma, PLLC.
Adult and Pediatric Allergy
165 N. Village Ave.-Suite 141
Rockville Centre, NY 11570


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