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Common Food Allergy Triggers and Where They Hide

Fish Allergies

A fish allergy is relatively easy to avoid. When you've had a severe anaphylactic reaction to a type of fish, your health care provider will show you how to avoid similar foods that might trigger this reaction. For example, if you have a history of allergy to shrimp, allergy testing will usually show that you are not only allergic to shrimp but also to crab, lobster, and crayfish. This is called "cross-reactivity."

There's also the risk of contamination from other foods. When eating in restaurants, check with the chef. Make sure your fish is not cooked in the same skillet or in the same oil as other food. Also, certain food products (like dressings and sauces) contain small amounts of fish protein that could trigger an allergic reaction.

You should avoid:

  • Fish oils
  • Roe, caviar
  • Surimi (imitation seafood)
  • Anchovies
  • Caesar salad dressing, steak sauce, or Worcestershire sauce, which may contain anchovies
  • Asian dishes: Thai, Japanese, Vietnamese, Chinese
  • Sushi, sashimi, tempura
  • Fish sauce, fish soup, fish balls
  • Shrimp balls, noodles, chips, salad rolls
  • Prawn chips
  • Fish and shellfish flavoring

Check product labels for: 

  • Agar, alginic acid, alginate -- gelatins in products
  • Disodium inosinate in fish sauces
  • Fish or shellfish flavoring

Shellfish Allergies

If you have an allergy to shellfish, you must avoid all types of shellfish. Also, be careful of cross-contamination in restaurants. Some places fry fish in the same skillet or oil as other food.

Shellfish is not often a hidden ingredient in foods. However, there are a few things you should be careful of. Caesar salad dressing and chili may contain fish or shellfish. Some imitation shellfish (Surimi) contain flavoring made from small amounts of real shellfish. Many Asian dishes contain fish and shellfish.

Shellfish includes:

  • Abalone
  • Clams
  • Crab
  • Crawfish (crayfish)
  • Lobster
  • Oysters
  • Scallops
  • Shrimp
  • Cockle, sea urchin
  • Mussels

Common foods containing fish and shellfish:

  • Asian dishes: Thai, Japanese, Vietnamese, Chinese
  • Sushi, sashimi, tempura
  • Fish sauce, fish soup, fish balls
  • Shrimp balls, noodles, chips, salad rolls
  • Prawn chips
  • Fish and shellfish flavorings
  • Worcestershire sauce

A food allergy is serious, but it is manageable. Talk with your doctor, and be careful to avoid your trigger foods.

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WebMD Medical Reference

Reviewed by Kimball Johnson, MD on August 02, 2012

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