Fish allergy

A fish allergy is a reaction of the immune system to proteins in fish with fins, such as salmon, cod, tuna, anchovy and trout. It is a different allergy from shellfish allergy: someone allergic to fish may be able to eat shrimp, and the other way around. Cooking does not remove the proteins. Some people react to only some kinds of fish, but only an allergist can tell you which, if any, are safe.

Substitutes

Fish often adds savory depth, or umami, to a dish. To replace that:

• Use kombu, a seaweed, to make a fish-free stock in place of a dashi made with bonito flakes.
• Use miso, mushrooms or a little soy sauce, if soy is safe for you.
• Use capers and olives in place of anchovies in pasta sauces and dressings.

Common mistakes

• Missing anchovies. They are in Caesar dressing, Worcestershire sauce, tapenade, many pizza toppings and some salsa verde recipes.
• Missing fish sauce, which seasons many Thai, Vietnamese and other Southeast Asian dishes and curry pastes.
• Forgetting fish stock in soups, risotto and seafood sauces, and the bonito flakes in Japanese dashi.
• Sharing frying oil, grills or pans with fish.
• Forgetting roe and caviar, surimi (imitation crab) and fish oil supplements.

In recipes

Both the EU and the US treat fish as a major allergen:

• In the EU and the UK, fish is one of the 14 allergens and must be emphasized in the ingredients list. Fish gelatin used to carry vitamins, and isinglass used to clear beer and wine, are exempt.
• In the US, fish is one of the nine major allergens, and the label must name the species, such as "cod" or "anchovy".

Shellfish are labeled separately. If you have a fish allergy, read labels every time you buy, ask restaurants how dishes are made, and talk to a doctor or dietitian about what you need to avoid.