Living with Dietary Restrictions: Shellfish and Fish

Shellfish and fish allergies are two of the most prevalent of the top food allergies.   These food items account for over half of all food allergies in the United States.  According to AllergicChild.com, “Approximately 12 million Americans suffer from food allergy, with 6.9 million allergic to fish and/or shellfish.”  However unlike many other food allergens, overall shellfish and fish are easier to stay away from  since with the exception of some food, vitamin and cosmetic items, their inclusion in most recipes is fairly obvious.

Photo from 1.bp.blogspot.com

       What’s the difference between shellfish and fish allergies?

Shellfish are overall pretty basic as they are divided into two different groups, mollusks and crustaceans.  Crustaceans include items like crabs, lobster, crayfish, shrimp and prawn, while mollusks include sub-categories such as Bivalves (clams, mussels, oysters and scallops), Gastropods (limpets, periwinkles, snails (escargot) and abalone) and Cephalopods (squid, cuttlefish and octopus).  The Mayo Clinic advises that “Some people are allergic to only one type of shellfish, but can eat others.”  This means it’s important to always ask a physician before eating any shellfish to be positive of which types must be avoided and which might be edible.  The Clinic continues by saying, “You’re at increased risk of developing a shellfish allergy if allergies of any type are common in your family.”

Fish allergies in contrast are much more varied compared to many other types of food allergies.  Since there are so many different types of fish, it’s hard to know exactly what to avoid.   Reactions can be caused by anything from scaly or bony fish to an entire family/species of fish.  Because the proteins in most fish are similar it’s a good idea to avoid all fish products to be safe and avoid an allergic reaction. 

Photo from talkallergy.com

                                     What should be avoided?

Even though it may seem pretty obvious to avoid items like crab, shrimp, lobster, cod, salmon and other types of shellfish and fish it’s also highly important to know about all of the items that contain these allergens.  While you may not realize it there are fish products lurking in many different types of sauces and food toppings.  AllergicChild.com lists many of these items and what they contain: Caesar salad dressing (anchovies), Worcestershire sauce (anchovies), Caponata (anchovies), fish sauce (shellfish/fish) and Patum Peperium or Gentelman’s Relish (anchovies).   The Food Allergy & Anaphylaxis Network also reminds to be on the lookout for ingredients in Barbecue sauce which often contains Worcestershire sauce.   It’s also important to be careful when eating foods like gumbo, paella and many different types of Asian cuisine which can often contain shellfish and/or fish.  

Some everyday products even use Menhaden (a type of fish) such as vitamins, soap, cosmetics and insect spray.  AllergicChild.com also warns of the use of a new type of bandage being used in Iraq.  This item, used since 2003, called a HemCon® Bandage, is actually made from the shells of shrimp. However, so far during the product’s allergy testing no individuals had an allergic reaction, including the 8 patients with known shellfish allergies.  But as with any other shellfish/fish product, it’s important to be cautious when using such an item.

Photo from VegeUsa

                    Shellfish/Fish Alternatives and Eating on the Go

Unlike many other food allergies, there aren’t a huge amount of alternatives to shellfish/fish available.   Because of this it’s easier to look for Vegan options.  This is because Vegan foods will not contain actual animal products and/or by-products which make them a safe alternative and unlikely to suffer from cross-contamination.  VegeUSA suggests that the lack of seafood alternatives is due to the fact that it’s harder to replicate than most other types of meat.  However, they worked at the process and came up with Shrimp, Fish Fillets and Tuna Roll alternatives which are all vegan (aka shellfish/fish free).

With the exception of Seafood based restaurants, eating shellfish/fish free is overall a bit more manageable than other food allergies.  However, it’s always good to remember a few tips.  Avoid ordering French fries or other fried food from a place that also serves fried seafood due to cross-contamination of the frying oil.  Eating out at a Japanese restaurant may also be a no-no since it’s very common for multiple items to be cooked on the same surface (ex: going from cooking one customer’s fish to preparing your steak).  Eating With Food Allergies gives another great tip for eating out with any type of food allergy.  The site instructs that it’s helpful to either eat earlier or later than the normal crowds (i.e. before 6 PM or after 9 PM).   This strategy is essential in order to get more attentive service which can be vital in a server realizing that you suffer from an allergy and that your food needs are a necessity and not simply a preference.

While preparing to go out to eat, it’s always comforting to be able to research the available options on sites like Project Allergy in order to find out what the policies are at your favorite restaurants and hotels.  However, if you’re out and about there are some great casual restaurants to visit.  Macaroni Grill, On the Border, Famous Dave’s, Chili’s and Ruby Tuesday’s all offer online lists that cover each of their foods and what major allergens they may contain.  If you’re looking more for fast-food and/or delivery, Domino’s Pizza, Wendy’s and Boston Market all have similar informational sheets.  With many of these restaurants there are often mostly non-shellfish/fish options and at several places the only seafood item is Caesar Salad Dressing which is often sealed in packets that do not come in contact with other food items.

Photo from VegeUSA

                  Delicious Shellfish/Fish Free recipes to try at home

Vegan Shrimp Scampi from VegeUSA

Anchovy-Free Caesar Salad Dressing from Jewishfood-list

How do you or your family members deal with being Shellfish/Fish Free?  Please share your story. 

One thought on “Living with Dietary Restrictions: Shellfish and Fish

  1. aspecialist

    Fish allergy can be mild to anaphylaxis shock. This happens when a body sees the protein from the fish as a foreign invader and they will send out chemicals that cause allergic reaction. There are medicines like antihistamines and steroids that can lessens the discomfort that causes by the reaction. Usually, these medicines have a side-effects that triggers the allergy. Dr. Sundardas would like to help you and others. We hope that you can check our website at naturaltherapies.com or email us enquiries@sundardasnaturopathy.com so we can discuss naturopathy.

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