Key Allergens

The key proteins associated with fish allergy are called Parvalbumins, they are found in most species of fish. They are found in different concentrations in different species of fish, if you are allergic to these proteins it can be difficult to tell which fish causes you to have more serious reactions.

Parvalbumins are very stable proteins with the ability to cause reactions when cooked or as vapour during cooking (but food is thought to be 20-60% lower in parvalbumins when cooked). The protein is found in high concentrations in the light muscle of fish rather than the dark muscle, so fish like cod and carp are higher in parvalbumin levels compared to swordfish and tuna which have lower levels as they have more dark muscle tissue.

Parvalbumin is the protein used for allergy testing, if you are negative to these tests then your allergy may be to less common proteins found in fish, namely tropomyosin, enolases, aldolases, collagen and gelatin.

Tropomyosin is a protein found in certain types of fish including tilapia, catfish and salmon.

Some fish contain enolase and aldolase proteins. These are minor panallergens found in fish, chicken, rabbit and snake meat. They are heat stable so are allergens of note.

Food Intolerances

Food is low in FODMAP Food is high in histamine Food is high in sulphites

High sulphites and high histamine often go hand in hand. Fresh fish is low in sulphites, but the amount increases in the fish as it is processed, canned or smoked. Sulphites are inorganic salts used in preservations and have the potential to cause symptoms of food intolerance to those sensitive to sulphites, this food intolerance is more common in asthmatics. An improvement in symptoms can be made with a change to a low sulphite diet.

Fish can be considered to be high in histamine, so is not suitable for people following a low histamine diet. The amount of histamine starts to increase once caught, so improperly handled and refridgerated fish can cause what is called 'scromboid poisoning'. The symptoms of this are very similar to a severe allergic reaction, so are often confused.

Fish is a low FODMAP food. FODMAP stands for Fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Foods high in FODMAPs can cause symptoms of food intolerance, affecting the gastro intestinal system and this can be mistaken for a true IgE food allergy.

You can read more about Food Intolerances on the dedicated Food Intolerance Page.

Associated Syndromes

There is currently no information on syndromes associated with fish allergy.

Cross Reactivity

Occasionally there can be cross reactivity between fish and other products containing gelatin.

Other foods containing aldolase and enolase proteins include chicken, cod, catfish, salmon and tuna.

Other seafood which contains tropomyosin includes shrimp, prawns, crab, lobster, squid, oyster, snail and abalone.



NHS - Food Poisoning

Allergy UK - Fish & Seafood Allergy

Allergy UK - Histamine Intolerance

Science Daily - Different food fish can cause different allergies

Thermofisher Allergen Encyclopedia - Cod

Dermnet NZ - Scrombroid Fish Poisoning

Histamine Food List

Healthline - FODMAP Foods

Articles and Journals

Risk Factors for Severe Seafood Allergy Among Adults in an Urban City in Vietnam, 2024

Diving deep into fish allergen immunotherapy: Current knowledge and future directions, 2024

Beware of the toxins: Casting a wide net in suspected fish allergy, 2023

Thermostable allergens in canned fish: Evaluating risks for fish allergy, 2023

IgE-mediated fish allergy in Singaporean children, 2023

A case of acute Food Protein-Induced Enterocolitis Syndrome (FPIES) to fish, turkey and duck, 2022

Comparative proteomics and in silico allergenicity of fresh and powdered skipjack tuna and Nile tilapia, 2022

The first reptilian allergen and major allergen for fish‐allergic patients: Crocodile β‐parvalbumin, 2022

Fish Allergy: Fishing for Novel Diagnostic and Therapeutic Options, 2022

IgE-Mediated Fish Allergy in Children, 2021

Tropomyosin: A panallergen that causes a worldwide allergic problem, 2021

Fish allergy tolerance 16 months after diagnosis, 2021

Fish muscle processing into seafood products reduces β-parvalbumin allergenicity, 2021

A case of pediatric anaphylaxis caused by gummy tablets containing fish collagen, 2020

Cross-reactivity in fish allergy: A double-blind, placebo-controlled food-challenge trial, 2017

Fish collagen is an important panallergen in the Japanese population, 2016

Allergy to fish collagen: Thermostability of collagen and IgE reactivity of patients’ sera with extracts of 11 species of bony and cartilaginous fish, 2016

Fish allergens at a glance: variable allergenicity of parvalbumins, the major fish allergens, 2014

Specific IgE to fish extracts does not predict allergy to specific species within an adult fish allergic population, 2014

Measuring parvalbumin levels in fish muscle tissue: relevance of muscle locations and storage conditions, 2012

Important variations in parvalbumin content in common fish species: a factor possibly contributing to variable allergenicity, 2010

Comparison of allergenicity and allergens between fish white and dark muscles, 2006

IgE antibody to fish gelatin (type I collagen) in patients with fish allergy, 2000

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