• Allergies

Fish Allergy: Surprising Foods to Avoid

Medically reviewed and edited by Benjamin Domingo, FNP-BC

Published: March 07, 2025
Updated: April 15, 2025
4 mins

Fish has a distinctive taste and smell that make it easily identifiable. Still, fish is an active ingredient in some sauces and foods you may not expect. It’s important to know how to identify fish sources if you have a fish allergy or live with someone who has one.

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What is a Fish Allergy?

A fish allergy is an immune response to proteins in fish. Those with a fish allergy have an immune system that perceives fish as a threat. While having a fish allergy does not mean a person is allergic to all types of fish, many health experts still recommend exercising caution and avoiding all fish. 

What are Fish Allergy Symptoms?

Those with a fish allergy may experience symptoms within two hours of consuming fish proteins. Common symptoms a person may experience include:

• Hives

• Itchiness

• Swelling

• Abdominal pain

• Vomiting

• Dizziness

If you experience trouble breathing or other potential signs of anaphylaxis (a life-threatening allergic reaction), reach out for emergency assistance immediately.

What is Cross-Contamination?

Indirect exposure to fish proteins can happen through cross-contamination — when fish proteins mix with foods that don’t contain fish. Cross-contamination can occur when food is cooked in the same oil as fish products or using the same utensils. Proteins from fish can remain in oil even after the fish has been removed from the pan.

Some places may have a higher risk of cross-contamination than others. It’s important to look out for mislabeled fish products in supermarkets as well. Be sure to check with grocery store staff and consider only purchasing foods packaged separately from fish products.

Hidden Fish Sources to Know

Many Thai, Japanese, Vietnamese, and West African dishes have fish as a main ingredient. When eating at a restaurant specializing in cuisines that use fish heavily, it’s important to let restaurant staff know if you or someone at your table has a fish allergy.

Despite the name, even “imitation fish” may contain traces of real fish. Other sources of fish that may not be obvious are:

• Barbecue sauce

• Caponata

• Caesar dressing

• Worcestershire sauce

• Fish gelatin

• Kimchi

Fish gelatin is often used in processed foods like hot dogs and pepperoni. Be sure to carefully read the labels of all foods in case of hidden fish ingredients.

Substitutions for Popular Dishes Made with Fish

Many filling dishes use fish as a staple ingredient. However, some dishes have vegetarian and vegan alternatives. If you enjoy the following dishes, consider making them your own to have a similar rich flavor without fish.

Kedgeree

This rice dish is an Indian staple with a British influence. Kedgeree (kitchiri) consists of rice with curry powder, hard-boiled eggs, and smoked fish. It’s a one-pot dish that can easily feed a group of people. Smoked fish adds a unique flavor and fullness to the light taste of the rice and egg. Instead of fish, you can add your favorite vegetables or extra eggs.

Paella

Paella is a classic fragrant Spanish dish of saffron rice, seafood, and other sources of protein. However, the original recipe for paella included a variety of protein sources. Paella is also made with chorizo, sausage, or chicken and without seafood.

Bouillabaisse

This brothy French dish is best enjoyed in the winter months. Originating in Marseille, it’s often made with sea bass, mussels, squid, and other seafood. Vegetarian bouillabaisse instead adds more vegetables like carrots, onions, and potatoes.

Fritto misto

This Italian dish is ideal during the summer. Fritto misto is traditionally a fried mix of seafood. However, it can also be made with fried vegetables. The recipe can be flavored with salsa verde, lemon, and other tangy flavorings.

Étouffée

This hearty dish is a staple of New Orleans because of its origins in Creole cuisine. Traditional étouffée has a seafood mix, roux, vegetables, and traditional Cajun seasonings. Everyone makes their étouffée according to their liking. Instead of using seafood, consider making it with other protein sources like chicken, sausage, or tofu.

Tom yum soup

Tom yum soup is a satisfying Thai noodle soup packed with bold flavor and tanginess. A few ingredients used in the soup are shrimp, evaporated milk, and lemongrass. While it’s often enjoyed with shrimp or shrimp stock in the broth, you can use vegetables instead. 

One option is to flavor your tom yum soup with umami mushrooms and other flavorings that are not fish-based.

Where Can I Learn More About Managing a Fish Allergy?

Avoid fish as much as possible to reduce your risk of allergic reactions. At LifeMD, a healthcare provider can give you tips for dealing with accidental exposure and making protein-rich foods without fish.

Get started today with learning more about managing a fish allergy.

Benjamin Domingo, FNP-BC

Benjamin earned his Master’s of Science degree in nursing from The Sage Colleges in New York. He’s driven by his passion to provide top-notch care to his patients so they can achieve and maintain optimal health. In his spare time, Benjamin enjoys volunteering in a clinic for the uninsured, advocating for animal issues, skiing, playing hockey, cycling, and spending time with family.

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