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Shellfish Allergy

Over Thanksgiving I had a pretty intense allergic reaction. The doctor thinks the reaction was to shellfish and this will be determined for sure by bloodwork next week. I've done a lot of research and think they are probably right due to the symptoms.

I just turned 50 and have been eating shellfish all of my life, originally from New England , so this is disappointing news. I realize food allergies can show up at any point so I guess I will just have to learn to deal with it.

To that point, I am wondering aside from obviously avoiding shellfish, if anyone who also suffers from this has any tips. Are restaurants accomodating? How diligent do you need to be to avoid cross contamination? Any particular cuisine to be avoided entirely?

First time dealing with any food allergy at all so any tips are greatly appreciated. I never want to feel that way again!

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  1. I don't want you to take this as medical advice - BECAUSE IT'S NOT.

    But you may want to ask your doctor if the source of the reaction could have been due to what the shellfish (am I wrong to think this was shrimp?) were feeding on.

    I only mention this because an acquaintance of mine - who had never had an allergic reaction to shellfish in his life (Age 50) - had one. Serious - throat closing up, ER serious. But bit the bullet a couple of years later at a party & no reaction at all.

    Turns out that there's lots of evidence that folks who think they're allergic to "shellfish" are actually allergic to what the shellfish has been eating.

    Again - I'm NOT saying you should experiment with this without your doctor's blessing, but it may be something you may want to bring up with him/her if you're a serious shellfish lover.

    4 Replies
    1. re: Bacardi1

      Interesting...I wouldn't have thought of that. Not sure if it was only shrimp beacuse it addition to the shrimp I had lobster, mussels and oysters that weekend.

      1. re: Bacardi1

        Some folks are only allergic to shellfish consumed with or in alcohol. I know two folks who have this condition. It could be what else the diner is consuming, too, not only the shellfish.

        1. re: mcf

          Good to know. I will admit to a couple of glasses of wine while consuming said shellfish. If I have to choose however, I pick the wine!

          1. re: baseballfan

            You need to know if you're allergic without the wine, too, though. In my sister's case, she became violently ill with gut symptoms for years off and on, until she connected it to only those times she had alcohol. Same with SIL who ended up in the ER in her wedding dress, and was red and blotchy the rest of the reception after having champagne and shrimp.

      2. I sympathize with you, developing allergies after you've spent years being able to eat something is not fun. Restaurants can be very accomodating, depends on the place & the chef, as well as manager & servers. You have to decide how comfortable you are trusting that they take it seriously. Always carry your emergency medication, as mistakes do happen.

        This may be an unpopular comment, but I find family/friends to be more difficult to deal with than a restaurant. Some people who know my teen (who has developed food allergies, demonstrated by blood tests as well as physical reactions) seem to have trouble accepting that really, she cannot eat nuts any more, even if they used to bake her chocolate chip cookies with walnuts. And you can't just leave nuts out of 1/2 the batter and use the same utensils, pans, bowls, etc.

        I have a family member with a shellfish allergy, and she finds it very easy to deal with. She eats out often, carries an EpiPen, and rarely has had to use antihistamines to deal with an accidental exposure. Be upfront about what you must avoid, use the word allergy (as opposed to saying " I can't eat lobster"), and use common sense. Shellfish is one of the top allergens, and so must be disclosed in ingredients per U.S. law. That will help you determine prepackaged foods that are not safe.

        Cross contamination is an issue, no doubt, but a good chef should be aware & able to deal with allergies in their kitchens. Dealing with food allergies can be tricky, but it shouldn't stop you froom enjoying fantastic meals!

        1 Reply
        1. re: elfcook

          I have a feeling that could be the case with my extended as well. I have had asthma for almost my entire life and my mom still thinks I should wean myself off of my medications. Of course my doctor is opposed to this lol!

        2. My husband has a shellfish allergy and we have rarely had an issue while dining out. Unlike some more insidious allergies there is not a major concern with cross contamination or shellfish "hidden" in a dish. Even so you should always tell your server in advance of ordering. Places that offer lots of fried dishes may fry clams, scallops etc in the same oil as the fries, etc.

          In terms of how diligent you need to be will be determined on how "severe" your allergy is. My brother who is allergic to shrimp can't even handle them. His hands will swell, any where he touches will develop hives, swelling etc. My husband on the other hand can handle shellfish, shuck oysters, etc. Your blood work will give you an idea on how severe your allergy is and you might want to consider seeing a allergy specialist in addition to your regular physician.

          There are no cuisines we have to avoid because even heavily seafood driven menus have plenty of non-shellfish options. We have a bigger issue with chefs tasting menus since many chefs wont substitute out allergens.

          The only time my husband ever got sick was actually at Italian restaurant years ago. There was a huge group of us and we had ordered lots of appetizers. He asked if any of them had shellfish and was told no.Well the stuffed mushroom ended up having minced clams. We called the next day (after a night in the ER) and thats how we found out.

          17 Replies
          1. re: foodieX2

            This is true. My ex husband developed an adult onset allergy that appeared after eating fried shrimp. He went to an allergy specialist who determined that he was severely allergic to shrimp and oysters yet could easily eat as much crab meat as he wanted. If you get further testing done, you will know the extent of your allergy, how careful you must be and maybe you will still be able to enjoy certain types of shellfish.

            1. re: Ikkeikea

              I will defintely be seeing an allergist once we see what the bloodwork reveals. The shrimp I can live without but I do love lobster and crab.

              1. re: baseballfan

                you definately want the allergist to determine which kind your allergic to since it sounds like had a couple different types... I can not eat mollusks, but have no problem with crustaceans (sp). Since I was never a huge fan of any of the mollusk family, this is not a big deal for me. Now shrimp and crab i would MISS.

                good luck!

            2. re: foodieX2

              I am curious about the handling of shellfish as well. One of my sons was very concerned about the crab that I was planning for Christmas Eve dinner.

              1. re: baseballfan

                Well you should know more once you get your blood tests back. If it is in the high/critical range you probably shouldn't handle it. Better than safe than sorry so you don't end up spending Christmas in ER!

                An allergist can also give you a "scratch" test if you want one. They are not standard anymore, as blood tests are considered more accurate these days but a scratch test can give a clear answer on whether you allergy is so severe that you shouldn't even handle them.

                1. re: foodieX2

                  I'm sorry to disagree, but I just went through yet another round of testing 2 weeks ago, which was a torturous skin prick test. I have all sorts of allergies and am taking shots, so I *intimately* know allergies, testing, and treatment.

                  You are incorrect about the scratch test, which is, in fact more common and also more accurate. Blood tests are only for those that cannot stop their medication or have skin issues that rule out using skin-prick. Skin testing is THE best way of determining allergies.

                  And just because you are allergic to a food doesn't mean you'll have a reaction. I carry an epi-pen just in case, but often eat the foods I test positive for with testing. Some people can't ingest at all, others can, with a risk. Allergies are very misunderstood.

                  1. re: gardencook

                    I don't consider that disagreeing with me. Every situation is different which is why I suggested he might want to see a specialist as well as his GP and then request a scratch test if he felt warranted.

                    SO no disagreement, its just your experience is the exact opposite I had with my son and husband.

                    My son, who has a life threatening allergy, who must carry an epi pen at all times and wear an identifying bracelet has never had a scratch test. His specialist, who actually wrote the number one book on peanut allergies and is considered a leader in his field (food allergies) felt his blood test gave us all the info we needed. Again just shows you that everyone person (an possibly Dr) is different.

                    My husband, who had both, was only given a scratch test after he requested it. The scratch tests did not show anything different than his blood test.

                    They real key is here that everyone should to discuss all options with their own Dr, No one should take the advice/anecdotes/information/experiences given by strangers on the internet as accurate for them. It should be taken with a grain of salt, really.

                    Bottom line is the OP is working with Dr and thats the most important thing.

                    1. re: foodieX2

                      skin & blood tests both have their benefits & drawbacks, which is why a good allergist should do both. and even then, they're not 100% accurate. i had the full battery of scratch & blood testing done a few months ago and i didn't react to eggplant at all - tell that to my mouth & throat every time i eat it.

                      (food challenge is actually the most accurate form of testing, but it's not an option for everyone.)

                      1. re: goodhealthgourmet

                        Exactly - food challenge or a symptom/food diary is the only real way to go.

                        It is not currently considered good practice to diagnose a food allergy on the basis of testing alone. Both blood and skin prick tests have up to a 50% false positive rate.

                        I've had both. My results are not the same for both tests, though there is some agreement. There are things that I test positive to through blood or skin testing that I can eat just fine. There are things that I test negative to through blood or skin testing that I cannot. It is not yet an exact science.

                        1. re: goodhealthgourmet

                          a former colleague of mine went through food challenge -- I can't remember what she ended up being allergic to, but I remember the weeks and weeks of lamb and rice with nothing -- even salt added. She wasn't a foodie, but it really put her through hell to have fruits and vegetables and even herbs and spices taken away from her.

                          1. re: sunshine842

                            There are a couple of different ways to do it. One is an elimination diet, which sounds like what your colleague did. You cut your diet down to the extreme basics and then add foods back in slowly to see if you react. This way is generally used to figure out intolerances, non-life threatening allergies, or delayed reactions to foods. They might not all be 'allergies' in the sense of the medical description, but if a food makes you feel bad consistently, it doesn't make much sense to keep doing it. I did a not very strict version of an elimination diet and was able to add a food that I test positive to back into my diet - oranges.

                            The other way is a food challenge in a allergists office. These are generally done for people who need to be absolutely sure, or for people who think that they may have outgrown a previously life-threatening allergy. This is what I would do if I thought that I outgrew my apple allergy (which my doctor and I don't anticipate ever happening). My reactions to apples have required ambulances and epi-pens and hospitals, and it is not something that I would ever try at home.

                          2. re: goodhealthgourmet

                            @goodhealthgourmet:
                            What you have, though, is Oral Allergy... not the IgE antibody reaction. That's why testing is negative. I have that for some foods. It's different yet again from foods that are digestive intolerance, which I have as well and come back negative on tests. Some foods cause hives and swelling (IgE), some cause itchy mouth (oral allergy) and some cause me to sit on a toilet, leaning over a trash can (intolerance). The oral allergy... benedryl is a great prophylactic for that.

                            1. re: gardencook

                              Oral allergy is usually a cross-reactive symptom of a pollen or latex allergy, but i tested negative for all of the usual suspects - which was shocking because when i was younger i was so severely allergic to so many things that i got weekly shots for several years. the immunity doesn't usually last forever after you discontinue the desensitization - i'm an unusual and lucky case in that sense. however, OAS is still an immune-mediated response - repeated exposure to the allergen can exacerbate the reaction and in some cases lead to a more severe allergic response, including anaphylaxis. so i personally wouldn't be so cavalier about eating the trigger food with abandon...i'll be limiting my eggplant consumption from now on.

                              as i said earlier, blood & skin tests are not 100% accurate. i experience severe contact & digestive reactions to gluten, yet my test for that was negative as well - the only way to determine some of these things is via food challenge.

                              ironically i have a really bad reaction to Benadryl so i can't take it as a prophylactic.

                              1. re: goodhealthgourmet

                                Yeah, I wouldn't necessarily recommend messing around to much with OAS allergens.

                                Apple used to be only OAS for me...until it wasn't just raw anymore, and it wasn't just mild symptoms.

                                Two years ago, a preschooler accidentally wiped apple on my face. I got to test out the new epi pen design (I prefer the old school ones, thanks) and got to ride in an ambulance.

                          3. re: foodieX2

                            I agree that working with a doc is the most important thing. I carry an epi pen, too and have life-threatening allergies along with more mild reactions for other things. I was just going on what my allergy doctor told me days ago when I asked for the blood test instead and he refused saying that it just isn't as accurate as the skin-prick. The skin-prick is torture, so I'd love to avoid it at all costs. My dd has to endure it, too, which may be even worse to watch as a parent.

                            It's funny that we have such opposite experiences... and my allergist, who is the senior research physician at one of the best teaching medical schools also touts that he is THE leader in his field of food allergy research and has written the textbooks to go along with it. Go figure. :)

                            1. re: gardencook

                              "skin-prick is torture" -- no kidding. The doctor had to hold my hands to keep me from scratching my skin off -- and my reaction was so strong (dust mites) that he just gave up and rubbed Benadryl on it before the full test time had elapsed. (hey, there's no doubt you're highly allergic -- let's just stop this before it drives you insane.)

                    2. re: foodieX2

                      Absolutely -- I don't have seafood allergies, but the spectrum is very wide, and your behavior from now forward relies entirely on your tests.

                      I have tons of friends with fish and seafood sensitivities, and it ranges from someone who flares if she eats french fries that have been cooked in the same fryer as fried shrimp -- to people who can handle and cook seafood for others, but just can't eat it.

                    3. I have a variety of food allergies - shellfish among them - and eat out quite a bit. the shellfish allergy has never been a big concern in terms of cross contamination.

                      as far as managing the allergy, vigilance is key. if there's a possiblity the dish might contain shellfish, ask. If they don't know or aren't willing to find out/modify it, order something else. I've had some GREAT dishes recently that I wouldn't have been able to eat if the chef had not been willing to leave out an ingredient for me... on the other hand, I've avoided a lot of great sounding dishes, because I just couldn't trust I'd be safe.

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