Imagine that you went to a seafood restaurant with your friends and ate delicious food like shrimp, clams, and crabs. But after a while, your whole body starts to turn red and itchy, your lips swell... and you may even find it difficult to breathe. This is what many of us fear, and it can be the beginning of the 'Shellfish Allergy' that many people see. While this may be a minor thing for some, it can be a serious condition that can even be life-threatening for others. So today, let's talk about this in detail and simply.
What is Shellfish Allergy?
Simply put, Shellfish Allergy is an allergy caused by food, that is, a food allergy. When people say 'Shellfish', they think of fish, but that is not the case. Shellfish are animals that live in water and have a shell-like covering around their bodies. They are mainly divided into two groups.
To understand exactly, let's look at this:
| Shellfish type | Examples |
|---|---|
| Crustaceans | Shrimp, crab, lobster |
| Mollusks | Oysters, squid, octopus, mussels, scallops |
Most often, the first group, that is, crustaceans, causes the most allergies. But other types can also cause allergies.
What types of shellfish can cause allergies?
If you suspect you have a shellfish allergy, or have been told by a doctor, you should be very careful about these foods. You should avoid eating them completely.
- Shrimp and prawns
- Crab
- Lobster
- Squid / Calamari
- Oysters (Clams, Oysters, Mussels, Scallops)
- Octopus
- Snails
- Crawfish and Crayfish
- Various types of shellfish like Abalone, Cockle, Conch
The most important thing is that if you are allergic to one type, you should definitely consult your doctor before trying other types.
Are Shellfish Allergy and Shellfish Intolerance the same thing?
Yes, this is where a lot of people get confused. These are two completely different situations. It is very important for your safety to know exactly the difference.
Imagine that after eating some shellfish, you get a slight stomach upset, a stomach ache, or a flatulence. This is most likely a Shellfish Intolerance . This means that your digestive system is unable to digest the food properly. Although this can be uncomfortable, it is not life-threatening.
However, if you experience hives, swelling of your lips, and difficulty breathing after eating shellfish, you may have a shellfish allergy . This is because your body's immune system is attacking the food. This is a serious condition that can be life-threatening.
Only your doctor can accurately diagnose the difference between the two. So if you have symptoms, don't guess and see a doctor.
Who gets this allergy? How common is it?
This allergy can develop in anyone, at any age. The surprising thing is, you can eat shellfish for years without any problems and suddenly become allergic one day.
This is more common in adults than in young children. According to surveys, 60% of people with shellfish allergies first develop symptoms in adulthood. One reason for this may be that we don't eat many types of shellfish when we are young.
What are the symptoms of a shellfish allergy?
Symptoms can vary greatly from person to person. While one person may experience only a mild itch, another may experience severe enough to cause shortness of breath and require hospitalization. Symptoms usually begin within minutes to two hours of eating shellfish.
Let's look at these symptoms clearly.
| Body part | Possible symptoms |
|---|---|
| Skin | Itching all over the body, red rashes (hives), and worsening eczema. |
| Mouth and Throat | Swelling of the lips, tongue, or throat, a feeling of tickling or tightness in the throat. |
| Respiratory System | Difficulty breathing, chest tightness, cough, wheezing. |
| Digestive System | Stomach ache, nausea, vomiting, diarrhea. |
| Other features | Dizziness , lethargy, weak pulse, loss of consciousness, blue skin. |
| The most dangerous condition: Anaphylaxis | |
| This is the most severe and potentially life-threatening stage of an allergy. In this case, symptoms from various systems mentioned above can occur simultaneously. For example, it can be difficult to breathe while the body is being attacked. This is a condition that requires emergency medical treatment. | |
Why do we get this shellfish allergy?
The reason for this is a misunderstanding that occurs in our body's defense system, that is, the immune system.
Normally, the job of our immune system is to protect us from diseases by fighting germs such as viruses and bacteria that enter the body.
But when a person with a shellfish allergy ingests a protein found in shellfish, the immune system mistakenly identifies it as a 'dangerous enemy'. Then, it releases various chemicals (e.g. histamine) into the body to attack that 'enemy'. It is the action of those chemicals that causes all the symptoms we talked about earlier, such as itching, swelling, and difficulty breathing.
How does a doctor diagnose this allergy?
If you develop any symptoms after eating shellfish, the first thing you should do is see a doctor. He or she will ask you a few questions.
- What did you eat? How much did you eat?
- How long after eating did the symptoms start?
- What are the symptoms?
- How long have they been there?
With this information, the doctor may recommend several tests to confirm the allergy.
1. Skin Prick Test: This involves placing a drop of a liquid containing an allergen (a protein from shellfish) on the skin of your hand and lightly pricking it with a small prick. If the area becomes red, swollen, and itchy within 15-20 minutes, it means you may be allergic to that substance.
2. Blood Test: This checks your blood for antibodies against shellfish.
3. Oral Food Challenge: This is the only way to be 100% sure whether you have an allergy or not. But this is only done in a hospital, under the strict supervision of doctors. Here, you are given a small amount of shellfish to eat little by little, and you are asked to watch for any symptoms. Never try this at home alone.
What do you do if you have an allergy?
This is a very important part. Your response will depend on the severity of your symptoms.
For minor symptoms
If it's something minor, like itching or a small rash, your doctor may prescribe an antihistamine (e.g. Piriton). However, these medications cannot control severe symptoms.
For severe symptoms (Anaphylaxis)
If severe symptoms occur, such as difficulty breathing, a tight throat, or loss of consciousness, the only life-saving treatment is an injection of epinephrine .
- If a doctor confirms that you have a severe shellfish allergy, they will prescribe an epinephrine injection. This usually comes in the form of an easy-to-use auto-injector (e.g., EpiPen®).
- The doctor will tell you exactly how to use this.
Very important: If you have a severe allergic reaction and have received an epinephrine injection, the next step is to call an ambulance or go to the nearest hospital emergency department (ETU). Do not wait until after the injection to say, "Okay, now the problem is solved." Because the symptoms may worsen again once the effect of the injection wears off. Therefore, it is essential to be hospitalized and under medical supervision.
How to avoid shellfish allergy?
There is no cure for this allergy. Therefore, the best and only way to avoid it is to completely avoid shellfish and foods containing them.
Here are some things to help you with that:
- Read food labels carefully: Before buying any food or sauce from the store, read the ingredients list carefully. Sometimes things you don't even think about may contain things like "seafood flavoring."
- Be extra careful at restaurants: If you go to a seafood restaurant, even if you only order fish, there's a chance they'll cook your food in the same oil or on the same equipment that they fry shrimp and crab. This is called cross-contamination. So be sure to inform them about your allergies before ordering.
- Avoid cooking and handling shellfish: Some people can be allergic to even just smelling the fumes from cooking shellfish. Some people can also have a reaction just by touching them.
- Be aware of hidden shellfish: Shellfish may be contained in things like fish stock, seafood flavoring, and surimi (artificial meat made to look like crab meat).
Some frequently asked questions
Can't you eat fish if you're allergic to shellfish?
These are two different types of allergies. Shellfish are animals with shells. Fish are animals with shells. So a person allergic to shellfish may be able to eat fish without any problems. Similarly, a person allergic to fish may be able to eat shellfish.
Is a Shellfish Allergy Related to an Iodine Allergy?
No. This is a big misconception among many people. Although shellfish contain iodine, the cause of shellfish allergy is a protein in it. Iodine is an element. Therefore, there is no particular reason for a person allergic to shellfish to be allergic to iodine-containing contrast material given during medical tests.
Will this allergy ever get better?
Shellfish allergy is often a lifelong condition and rarely goes away over time.
Take-Home Message
- Don't take shellfish allergy lightly. It is a serious condition that can sometimes be life-threatening.
- If you experience any unusual symptoms after eating shellfish, do not ignore it and definitely see a doctor for a proper diagnosis.
- The only way to protect yourself from this allergy is to completely avoid shellfish and foods containing them. Read the labels on food you buy at the store, and be careful at restaurants.
- If your doctor tells you that you have a severe allergy, always carry the epinephrine auto-injector he or she prescribes with you. Know exactly when to use it and how to use it.
- If you use the epinephrine injection, then immediately go to the nearest hospital emergency room (ETU).
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