shellfish-allergiesAn estimated 7 million people report allergies to seafood, including fish and shellfish. Salmon, tuna, halibut, shrimp, crab and lobster are the most common kinds of fish and shellfish to which people are allergic. A fish allergy is considered lifelong; once a person develops the allergy, it is very unlikely that they will lose it.


Symptoms often occur within minutes to a few hours of consuming the food and may include:

  • Hives and/or itching
  • Tingling or swelling of the lips, tongue, throat
  • Wheezing and difficulty breathing
  • Nausea, vomiting, diarrhea
  • Fainting or dizziness
  • Anaphylaxis


If you experience any of these symptoms near the time you have eaten fish or shellfish, contact your doctor about allergy testing as adverse reactions related to seafood can sometimes be attributed to foodborne illness. Your doctor may recommend one of two tests:

  • Skin test – A skin prick test is used to expose small amounts of the protein to your body. A food allergy is confirmed by the presence of a raised bump or hive at the prick location.
  • Blood test – A blood test, also referred to as an IgE test, measures your immune system’s response to the proteins found in seafood by counting the number of specific antibodies in your blood.

Survival Skills

It’s generally recommended that individuals who are allergic to one species of fish avoid all fish. If you have a fish allergy but would like to have fish in your diet, speak with your allergist about the possibility of being tested with various types of fish. If a seafood allergy is confirmed, you must eliminate that food and food containing fish products from your diet to prevent a reaction. This may include:

  • Fin fish – Salmon, tilapia, catfish, hake, orange roughy, tuna, etc.
  • Shellfish – Clams, crab, lobster, mussels, oysters, scallops, shrimp, etc.

Food Handling: Eating fish and/or shellfish is not the only way to trigger a reaction. You may also be affected by handling seafood or by exposure to fish protein that becomes airborne during the cooking process. Keep these products out of your home, and talk to friends and family in advance when attending group functions where seafood might be cooked or served. Even if you don’t eat the offending food, they must take precautions to avoid cross-contamination by using separate cooking utensils (cutting boards, serving spoons, pots and pans, etc.) for seafood-containing products and by washing their hands in between handling of these foods. Shopping: When you are shopping, it is easy to avoid foods that are plain fish or shellfish. However, you must carefully read labels of other products to make sure they are safe. The FDA mandates the labeling of foods that contain the 8 major food allergens, including fish and shellfish. Before purchasing a product, look for “contains shellfish” or “contains fish.” Take a closer look at common fish-containing foods:

  • Worcestershire sauce
  • Caesar salad dressing
  • Caviar
  • Roe (fish eggs)
  • Seafood flavoring
  • Fish stock
  • Imitation seafood
  • Gelatin

Eating Out: When dining out, ask detailed questions about ingredients and how the food was prepared – your health and safety are at stake! It may be wise to avoid seafood or Asian restaurants altogether if you have a fish or shellfish allergy because of the high risk for cross-contamination in the kitchen. If you choose fried foods, ask whether restaurants use the same oil to fry shrimp and other fish items as they do for chicken and French fries. Watch out for these words on a menu they may clue you in to a food item that contains fish or shellfish:

  • Bouillabaisse
  • Surimi
  • Cioppini
  • Gumbo or jambalaya
  • Ceviche or paella
  • Scampi
  • Sushi or sashimi
  • Caponata
  • Foods served “a l’Americaine”

Don’t Go it Alone

A new diagnosis can be scary. Be sure to build a support system of family, friends and healthcare professionals to help you manage your fish and/or shellfish food allergy. Talk to a doctor or registered dietitian when eliminating foods from your diet about possible vitamin and mineral deficiencies. They may recommend an adjustment in your meal plan or a supplement to replace nutrients lost by eliminating the offending food and food ingredients. Also talk to your doctor about how to prepare for a reaction. You may treat a mild reaction with oral antihistamines to reduce signs and symptoms and relieve discomfort. If you are at risk for severe reactions or anaphylaxis, your doctor may advise you to wear a medical alert bracelet and/or prescribe an injectable epinephrine (EpiPen) to carry with you at all times.

Additional Resources

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The Weis Markets’ Healthy Living website does not provide medical advice, diagnosis or treatment. The information provided on this website is intended for general consumer understanding and education only. It is not intended to be a substitute for professional medical advice. The content is not intended to be used for medical diagnosis or treatment. Additionally, as health and nutrition research continuously evolves, we do not guarantee the accuracy, completeness, or timeliness of any information presented on this website.