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 Allergy Symptoms

    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.

    Egg Allergy Causes

    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

    Insurance Carriers

    We accept most PPOs* from the following carriers:

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    *Not a guarantee of coverage. Please contact your insurance company directly to determine if the Food Allergy Institute is within your network and considered a participating provider under your plan.