Shellfish Allergy: Symptoms and Management Tips

Crustacean allergy issues?

Whenever I eat shellfish like shrimp or crab, my lips become itchy, and the taste is overwhelmingly fishy, making my throat and esophagus feel uncomfortable.
In severe cases, I even feel like vomiting.
I can only barely eat grilled shrimp, but it still feels strange.
However, I do not experience symptoms like hives.
I remember that I didn't have this issue over ten years ago, but it started after I entered the workforce.
Doctor, could this be a food allergy?

A-Hsing, 30~39 year old female. Ask Date: 2022/06/12

Dr. Liao Yaopan reply Family Medicine

Hello, based on your description, there is a possibility of an allergic reaction, as allergic responses are not solely limited to urticaria.
It is advisable to consult an allergist for further evaluation.
Online consultations are not equivalent to in-person medical visits and cannot provide a diagnosis or treatment recommendations.
Changhua Hospital cares about your well-being.

Reply Date: 2022/06/12

More Info

It sounds like you are experiencing symptoms consistent with a shellfish allergy. Shellfish allergies are among the most common food allergies and can manifest in various ways, including the symptoms you described. When you consume shellfish, such as shrimp or crab, your immune system may mistakenly identify proteins in these foods as harmful, triggering an allergic reaction.

Symptoms of Shellfish Allergy
The symptoms of a shellfish allergy can vary from mild to severe and may include:
1. Oral Symptoms: Tingling or itching in the mouth, lips, or throat, which you have experienced.

2. Gastrointestinal Symptoms: Nausea, vomiting, diarrhea, or abdominal pain, which can occur after eating shellfish.

3. Respiratory Symptoms: Difficulty breathing, wheezing, nasal congestion, or throat tightness.

4. Skin Reactions: While you mentioned not experiencing hives, some individuals may develop rashes or swelling.

5. Anaphylaxis: In severe cases, shellfish allergies can lead to anaphylaxis, a life-threatening reaction that requires immediate medical attention.

Management Tips
1. Avoidance: The most effective way to manage a shellfish allergy is to avoid all shellfish products. This includes shrimp, crab, lobster, and other crustaceans. Be cautious with cross-contamination in restaurants and food preparation areas.

2. Read Labels: Always read food labels carefully. Shellfish can be hidden in many processed foods, sauces, and even in some non-food products.

3. Emergency Plan: If you have a history of severe reactions, it is crucial to have an emergency action plan. This includes carrying an epinephrine auto-injector (like an EpiPen) at all times and knowing how to use it.

4. Consult an Allergist: If you suspect you have a shellfish allergy, it is advisable to consult an allergist for proper testing and diagnosis. They may perform skin prick tests or blood tests to confirm the allergy.

5. Educate Yourself and Others: Make sure that friends, family, and coworkers are aware of your allergy. Educating them can help prevent accidental exposure.

6. Consider Alternatives: If you enjoy seafood, there are many alternatives to shellfish that you can safely consume, such as fish (if not allergic) or plant-based seafood alternatives.

Understanding the Allergy
It is interesting to note that food allergies can develop at any age, even if you previously consumed the food without any issues. This phenomenon is known as adult-onset food allergy. The exact reasons why some individuals develop allergies later in life are not fully understood, but it may involve changes in the immune system or environmental factors.

Conclusion
Based on your symptoms and experiences, it is highly likely that you are dealing with a shellfish allergy. Avoiding shellfish and being vigilant about potential exposure is essential for your safety. If you have any doubts or experience severe symptoms, seek medical advice promptly. Remember, managing a food allergy is about being informed and prepared, so take the necessary steps to protect your health.

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