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Living with a Shellfish or Fish Allergy
Living With a Shellfish Allergy
Unless your doctor is able to identify exactly which type of shellfish causes your allergic symptoms, strictly avoiding all shellfish and food containing shellfish is the only way to prevent a reaction. This is the case for the majority of shellfish allergy sufferers as often, if you are intolerant to one variety there is an increased possibility of being intolerant to others.
Some examples of shellfish are:
Abalone, Shrimp, Prawns, Clams, Mussels, Crab, Squid, Octopus, Cuttlefish, Lobster, Crawfish, Crayfish, Oysters, Scallops, Cockles, and Sea Urchin, Limpet, Periwinkles...and Snails!
In biological terms, shellfish are aquatic invertebrates rather than fish. They can be divided into four main groups:
Crustaceans (e.g. crab, lobster, crayfish, shrimp, prawn)
Molluscs - broken down into:
Bivalves (e.g. mussels, oysters, scallops, clams)
Gastropods (e.g. limpets, periwinkles, snails)
Cephalopods (e.g. squid, cuttlefish, octopus)
People who have reacted to one type of shellfish (e.g. crab) are likely to react to other members of the same group (i.e, other crustaceans). Shellfish from the other groups may not necessarily present a problem, (although they may do for some people).
Fish and shellfish are biologically distinct. People who are shellfish-allergic may be able to eat fish, and vice versa - unless they have both allergies. But, be aware of the risk of cross contamination in restaurants, markets and open fish counters.
If you have a shellfish / fish allergy… ALWAYS CHECK THE LABEL FOR INGREDIENTS!!!
Ingredients and Foods to watch out for:
Pre-packaged foods
As they are relatively expensive, shellfish and fish are rarely an undeclared or unexpected ingredient in pre-packaged foods so always check the label for the type of shellfish/fish to which you are allergic. Some supermarkets indicate the presence of fish and shellfish, but policies vary with different stores and brands. Be especially mindful when choosing stocks, soups and highly processed foods, which may contain shellfish or fish extract to add flavour.
As well as the above and the obvious fish stews and meals, dishes and ingredients to look out for include paella, bouillabaisse, gumbo (a Tex Mex dish), frito misto (a mixed fried fish dish from the Mediterranean coast), and fruits de mer (seafood). Oriental food tends to contain lots of different kinds of fish in one dish, and chopped pieces can be difficult to spot. Oriental pre prepared pastes, sauces and meals are likely contenders so proceed with care.
Surimi (a processed seafood product) is usually made from white fish but may contain shellfish extract. Surimi can be present in processed foods such as pizza toppings as can anchovies
Caesar salad dressing normally contains anchovies, Caponata, (a traditional sweet and sour Sicilian relish) often include them and Worcestershire Sauce may do also.
Kedgeree is made with rice and fish.
Fish sauce can be made with shellfish as well as fish and is a common ingredient in the Far East. Terms to look out for are Nuoc Mam and Nam Pla.
Patum Peperium (Gentleman's Relish) is a spread made with anchovies.
Don’t forget that prawns and seafood are often fried in the same oil as other fish and French fries etc so make a point of asking the restaurant, fish and chip shop etc to prepare you a special order in unused oil – it may be best to order ahead by phone to be fair to them.
Imitation shellfish often still contain derivatives of shellfish for flavouring so even these are likely to be off the menu for you – sorry!
Although it is the flesh of shellfish that contains the allergen, people with shellfish allergy are advised to also avoid shellfish shells and skeletons.
Read the labels of cosmetics and health supplements carefully as vitamins, soaps. Makeup, paint, insect repellents, and weatherproofing treatments often contain fish dervitives.
Iodine
People with shellfish allergy are sometimes warned against iodine, an element present in a wide range of items including shellfish, seaweed, cleaning products, and X-ray dyes. However, iodine allergy is unrelated to shellfish allergy. The allergen present in shellfish is not iodine but muscle protein in the flesh.
Your allergy consultant should be able to provide you with a list of ingredients that may indicate shellfish and/or fish protein. There are always new products being created with newly processed ingredient names. If you are not sure of the exact nature of the ingredient, don’t eat it!
Bandages?!
There is a new bandage developed for forces in combat called the HemCon® Bandage which incorporates shrimp shells (chitosan) . Although trials indicate it does not cause a reaction and it is not yet widely available it is yet another area to consider.
Shellfish and Fish Allergy and children
Sensitivity to shellfish is rare in young children, and not usually apparent until teenage years or adulthood. This could just be because shellfish is not often part of the diet of young children.
Allergy to fish (such as cod and other white fish) may be seen in childhood and if so is likely to be for life
Allergies to shellfish or fish are potentially serious and there may be a rapid onset of symptoms. A GP's advice should be sought in all cases and a referral made to see an allergy specialist.
Patients known to be at risk may be prescribed auto-injectors containing adrenaline (also known as epinephrine).
Someone who reacts to one type of fish - even if the symptoms are mild - might be advised to play safe and eliminate all fish from their diet. This is partly because they may react to another type of fish, but also because of the high risk of cross-contamination among different types of fish (e.g. at fish markets or on fish counters).
The same applies to shellfish. If allergic to one type it would be wise avoid all shellfish.
Sometimes a reaction to fish or shellfish is not an allergy at all, other causes can be:
Anisakis (also known as the cod worm)
Histamine, sometimes present in spoiled fish (especially tuna and mackerel), can cause a condition not unlike allergy called scrombroid poisoning. However unlike an allergy, this would affect everyone who consumed the offending food.
Shellfish sometimes absorb poison from toxic algal blooms (red tide), in waters at certain times of year. This can cause illnesses known as amnesic, diarrhetic, paralytic and neurotoxic shellfish poisonings. Again these these toxins will affect everyone who eats the shellfish.
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