Fish Allergy Symptoms and Treatment

A fish allergy is an allergic response to the proteins present in finned fish like salmon, catfish, cod, tuna and others. One of the most common food allergies, fish allergies are reported to affect 1% of the U.S. population. While many people develop fish allergies early in life, studies report that 40% of people develop fish allergies during adulthood.

Because fish and shellfish are not closely related, a person with a fish allergy will not necessarily have a shellfish allergy. Cross-contamination between fish and shellfish is common, however, and precautions should be discussed with medical providers.

Because fish allergy reactions can be severe and, in some cases, life-threatening, it is important to diagnose and treat a suspected fish allergy as soon as possible. The following sections provide an overview of common fish allergy reactions, fish allergy causes, and fish allergy treatment.

Fish Allergy Symptoms

Fish allergy reactions may result in a variety of skin, respiratory, digestive, and cardiovascular manifestations. These manifestations may include:

Hives
Itching
Mouth or throat becoming itchy
Swelling of the tongue or lips
Runny nose
Red or watery eyes
Abdominal pain
Diarrhea
Nausea or vomiting
Wheezing, coughing, shortness of breath

Fish allergies can lead to anaphylaxis (anaphylactic shock). Anaphylaxis is a severe allergic reaction that can be life-threatening. Symptoms of an anaphylaxis include:

Shortness of breath (and/or wheezing)
Constriction of the throat
Persistent dizziness or collapse
Confusion
Weak, rapid pulse
Pale and floppy (young children)

Fish Allergy Causes

Fish allergies are primarily caused by an abnormal immune response to proteins found in finned fish. When an individual with a predisposition to fish allergies comes into contact with fish proteins, their immune system mistakenly identifies these proteins as harmful invaders and triggers a fish allergy reaction.

Genetics play a role in the development of fish allergies as individuals with a family history of allergies are more prone to developing this condition.

Cross-contamination of foods can also expose individuals to wheat allergens unknowingly, underscoring the importance of allergen awareness and careful food preparation for those with shellfish allergies.

Fish Allergy Testing

Fish allergy testing plays an important role in diagnosing and managing allergies to fish, which can be life-threatening for some individuals.

Fish allergy testing may include:

Skin Prick Test

A test in which the skin is lightly pricked with a tiny amount of fish allergens, followed by monitoring for a reaction.

Blood Test

Measures the levels of IgE antibodies developed by the immune system, providing valuable information about the severity of the allergy.

Component Test

A blood test that evaluates a patient’s ability to tolerate specific components of allergens. A fish allergy component test is essential in differentiating between a cross-reaction to pollen or a potentially life-threatening allergic reaction.

Oral Food Challenge

A gradual process in which a patient consumes a small amount of a suspected allergen over a period of three to four hours. As serious allergic reactions can be life-threatening, it should only be conducted under the guidance of a qualified clinician.

FAI’s Advanced Food Allergy Testing

Our Foundation Labs (CLIA Certified) specializes in component testing of 130+ different allergens, including allergen components that are not available at national laboratories and hundreds of different biomarkers.

Foods to Avoid to Prevent
Fish Allergy Reactions

One of the most important things you can do to avoid a fish allergy reaction is to stay away from all fish and fish products. Steer clear of seafood restaurants, fish markets, and areas in which fish is being cooked. The following list of fish and fish products is not exhaustive, but includes the most commonly reported allergy-causing fish.

Anchovies
Bass
Catfish
Cod
Flounder
Grouper
Haddock
Hake
Halibut
Herring
Mahi mahi
Perch
Pike
Pollock
Salmon
Scrod

Sole
Snapper
Swordfish
Tilapia
Trout
Tuna
Snapper
Swordfish
Tilapia
Trout
Tuna
Fish flavoring
Fish gelatin
Fish oil
Fish sticks

Fish Can be Found in Unexpected Places

Fish is not always present in these foods, but it is important to read food labels and ask questions about ingredients before eating something that you have not prepared.

Barbecue sauce
Bouillabaisse
Caesar salad and Caesar dressing
Caponata, a Sicilian eggplant relish
Cuisine from Africa, China, Indonesia, Thailand and Vietnam. Even if you order a non-fish meal, there is a high chance of cross-contamination in these types of foods.
Imitation or artificial fish or shellfish
Worcestershire sauce

Fish Allergy Treatment

For those with fish allergies, the only proven food allergy treatment that makes it possible to achieve remission is the Food Allergy Institute's Tolerance Induction Program™ (TIP).

TIP™ builds tolerance to the unique proteins each individual is allergic to, all before introducing their most anaphylactic allergen(s).

This ensures patient safety, and over time alters their immune system to not react to any of their allergens. Once an individual has reached remission, they can eat like anyone without a food allergy for the rest of their life.

OIT and similar food allergy treatments aim to desensitize patients to protect them from "accidental exposure." Through TIP™, patients can eat as freely as a non-allergic person would.

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Allergens Treated

The Tolerance Induction Program™ (TIP) successfully treats ALL severe food allergies, including the TOP 9 major allergens and many more!

Peanuts
Tree Nuts
Milk
Eggs
Shellfish
Wheat

Soy
Fish
Lentil
Mustard
Sesame
And more

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