Seafood allergies — including shellfish and fish — are among the most common
food allergies in the United States.
While anecdotal reports link allergic reactions to joint pain, particularly in people with
arthritis, research hasn’t shown a connection between food allergies and joint pain or inflammation.
Numerous conditions other than food allergies can cause joint pain, including osteoarthritis,
rheumatoid arthritis, and
fibromyalgia.
Eating excessive amounts of shellfish may lead to
gout, a form of arthritis that can involve intense joint pain, but this condition isn’t associated with food allergies.
If you are experiencing joint pain or suspect you have a seafood allergy, talk with your doctor, who can help get to the root of your symptoms and work with you on a treatment plan.
Most “true” food allergies, including those to seafood, are often lifelong conditions. Seafood allergies
trigger a reaction in your body that starts when your immune system mistakenly identifies a protein in shellfish or fish as a threat.
Your immune system creates a defense in the form of immunoglobulin E (IgE) antibodies that react every time your body detects the protein.
Crustaceans are one type of shellfish, and include crab, lobster, shrimp, and crayfish. When you have an IgE antibody-triggered allergy to one type of crustacean, you’re likely to be allergic to others and should avoid these as well.
Mollusks, the other type of shellfish, include clams,
oysters, mussels, and scallops. People who get a reaction from a crustacean, such as crab, may be able to eat mollusks, such as oysters, without an issue. Similarly, being allergic to shellfish doesn’t automatically mean you will also get a reaction from eating finned fish because these animals aren’t closely related.
It’s important to ask your doctor for a list of foods to avoid that are specific to your allergy. They may be able to conduct an allergy test that provides more details about the foods that may cause a reaction.
Symptoms of a seafood allergy can vary, and while some are mild, others are potentially life-threatening. Signs to watch out for include:
- Itchy or irritated skin
- Hives
- Swelling of the face, tongue, lips, throat, or other areas of the body
- Nasal stuffiness
- Dizziness, fainting, or lightheadedness
- Coughing and choking, or a tight feeling in the throat
- Wheezing or trouble breathing
- Stomach pain, vomiting, diarrhea, or nausea
In the most severe cases, you may experience a medical emergency known as anaphylaxis, which prompts your immune system to release a large amount of chemicals into your body, possibly resulting in shock.
Signs of anaphylaxis include:
- Swollen throat or tongue
- Tightness in the throat or difficulty breathing
- Symptoms of shock, including a rapid or weak pulse and a severe drop in blood pressure
- Choking, coughing, or wheezing with trouble breathing
- Dizziness, fainting, or lightheadedness
- Severe skin rash, hives, itching, or swelling
- Diarrhea, nausea, or vomiting
Even though some anecdotal stories suggest a shellfish allergy as the cause of joint pain, studies haven’t shown this to be true.
Several conditions besides food allergies, such as gout, may lead to joint pain after you eat certain foods. You may have also heard myths about other connections between joints and seafood, including the misconception that allergic reactions cause or worsen inflammation in rheumatoid arthritis, leading to joint pain. However, there’s no evidence to support this.
Some people have questioned if there is a link between mast cell activation syndrome (MCAS), joint pain, and seafood allergies. MCAS is a rare form of immune system dysfunction. Similar to a food allergy, it causes your immune system to overreact when it senses a trigger.
Potential triggers can include certain foods or beverages as well as temperature changes, exercise, fatigue, some odors, infections, and
stress. Symptoms of MCAS also have a lot of overlap with symptoms of an allergic reaction to food, and can include itching and hives, shortness of breath, throat swelling, lightheadedness, changes to
blood pressure, nausea, and vomiting.
MCAS can also cause joint pain, along with other issues in the bones and muscles.
Seafood is often reported by patients as a common MCAS trigger. Some with MCAS avoid it as part of a
low-histamine diet, which limits foods that commonly release histamines, one of the chemicals involved in the immune system's overreaction. However, a true seafood allergy isn’t the same mechanism as an MCAS trigger. It’s also possible to have both MCAS and food allergies. Your doctor can order skin or blood tests to determine more about potential food allergies.
The most effective way to
manage a seafood allergy is to identify which type (or types) of seafood you’re allergic to and avoid them.
Avoidance is easiest at home, and can be challenging when you’re eating food you didn’t make yourself.
When eating out, be aware of cross-contact (or cross-contamination), which is when fish-related ingredients contaminate your food through practices such as sharing kitchen utensils or using the same vat of cooking oil. For this reason, those with a seafood allergy should avoid seafood restaurants. Read labels carefully, and be aware of some unexpected places to find fish-related ingredients, including barbecue sauce, Worcestershire sauce, and Caesar salad dressing.
If you have a seafood allergy and accidentally eat seafood, your treatment plan depends on the severity of your allergy and your particular treatment plan. Those with a mild allergic reaction may be able to treat symptoms with an over-the-counter
antihistamine. More severe reactions can be life-threatening and need immediate medical attention.
Talk to your doctor to see if you need a prescription
epinephrine auto-injector (EpiPen), which you can carry and use in case of an emergency while waiting for medical care. This device delivers an injection of epinephrine to reverse symptoms of anaphylaxis.
- A seafood allergy is not likely to cause joint pain, but instead may cause swelling in the tongue or other parts of the face, wheezing or difficulty breathing, hives and itchy skin, nasal congestion, and GI discomfort such as nausea, vomiting, and stomach pain. Symptoms can be life-threatening.
- Eating seafood may trigger mast cell activation syndrome (MCAS) in certain people, and consuming excessive amounts may lead to gout, and while both conditions may cause joint pain, neither is a true seafood allergy.
- Research hasn’t shown a connection between seafood allergy and joint pain. Other sources of joint pain include various types of arthritis, including rheumatoid arthritis, and fibromyalgia.
Additional reporting by Jenna Fletcher and Sarah Shelton.
