- Fish is considered a priority food allergen by Health Canada. Priority food allergens are the foods that cause the majority of allergic reactions.
- Fish (e.g., trout, salmon), crustaceans (e.g., lobster, shrimp), and molluscs (e.g., scallops, clams) are sometimes collectively referred to as seafood.
- In North America, fish allergies are more predominant in adults, while in countries where fish is a dietary staple, fish allergies are common among both adults and children.
- Allergies to fish are usually lifelong conditions.
- People who are allergic to fish may not need to avoid fish oil supplements. Fish oils supplements on the market tend to be refined enough to remove all of the proteins that can trigger allergic reactions. However, if you have a fish allergy, consult with your allergist before consuming anything made with fish oils.
- People who are allergic to one type of seafood, may not be allergic to other kinds of seafood. Many people are only allergic to a single type of seafood. For example, some people can eat lobster safely, but have allergic reactions to fish.
Allergic reactions to fish
An allergic reaction usually happens within minutes after being exposed to an allergen (e.g., fish), but sometimes it can take place several hours after exposure. Anaphylaxis is the most serious type of allergic reaction.
Individuals with fish allergy can experience allergic reactions without eating fish. On rare occasions, exposures to fish proteins in cooking vapours (such as steam from cooking fish) and on dishes used to present these foods (like sizzling woks or skillets) can cause an allergic reaction.
Symptoms of anaphylaxis generally include two or more of the following body systems:
- Skin: hives, swelling (face, lips, tongue), itching, warmth, redness
- Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain/tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing
- Gastrointestinal (stomach): nausea, pain/cramps, vomiting, diarrhea
- Cardiovascular (heart): paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock
- Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, metallic taste
However, a drop in blood pressure without other symptoms may also indicate anaphylaxis. It is important to know that anaphylaxis can occur without hives.
If you have an allergy to fish, keep an epinephrine auto-injector (e.g., EpiPen®) with you at all times. Epinephrine is the first-line treatment for severe allergic reactions (anaphylaxis).
Be allergy-aware: How to avoid fish
- Read ingredient labels every time you buy or eat a product. If the label indicates that a product “Contains” or “may contain” fish, do not eat it.
- If you do not recognize an ingredient, if there is no ingredient list available, or if you don’t understand the language written on the packaging, avoid the product.
- Do The Triple Check and read the label:
- Once at the store before buying it.
- Once when you get home and put it away.
- Again before you serve or eat the product.
- Always carry your epinephrine auto-injector. It’s recommend that if you do not have your auto-injector with you, that you do not eat.
- Check with manufacturers directly if you are not sure if a product is safe for you.
- Chopped fish products (such as canned tuna) have a high risk for being contaminated with many other types of fish during processing.
- Check with manufacturers directly to see if the product is safe for you even if your allergen is not listed on the ingredient list.
- Be careful when buying products from abroad since labelling rules differ from country to country.
- Watch for cross-contamination, which is when a small amount of a food allergen (e.g., fish) gets into another food accidentally, or when it’s present in saliva, on a surface, or on an object. This small amount of an allergen could cause an allergic reaction.
Names of common types of fish
- Catfish (channel cat, mud cat)
- Monkfish (angler fish, lotte)
- Orange roughy
- Pickerel (dore, walleye)
- Tilapia (St. Peter’s fish)
- Tuna (albacore, bonito)
- White fish
Other examples of fish
- Caviar and roe (unfertilized fish eggs)
- Gravad Lax
- Kamaboko (imitation crab and lobster meat)
- Minced fillets
- Surimi (used to make imitation crab and lobster meat)
- Tarama (salted carp roe)
Possible sources of fish
- Deli meats, hot dogs
- Dips, spreads, imitation crab/lobster meat
- Combination foods such as fried rice, paella, spring rolls
- Fish mixtures
- Garnishes, e.g. antipasto, caponata (Sicilian relish)
- Gelatin, marshmallows
- Pizza toppings
- Salad dressings
- Sauces, e.g., marinara/puttanesca, Nuoc Mâm, and Worcestershire
- Spreads, e.g. taramasalata
- Tarama (roe)
- Wine and beer (used as a fining agent)
- Fried foods (from contaminated frying oil)
Non-food sources of fish
- Fish food
- Lip balm/lip gloss
- Pet food and pet bedding
- Compost or fertilizers
Note: These lists are not complete and may change.