Awareness of the many benefits of fish oil is growing, particularly around their cognitive benefits and ability to support the body’s inflammatory response. However, if you suffer from a fish allergy, this news might not be as exciting.
The good news is that if you have a fish allergy there are alternative omega-3 supplements to consider. However, plant-based sources aren’t always efficiently converted to the active forms of EPA and DHA, so looking for a wide range of non-fish sources is key.
Like other food allergies and sensitivities, fish allergies are best addressed using an integrative medicine approach that considers discomforts that might be linked to food intolerances and potential underlying causes like gut health and stress.
Seafood allergies are one of the most common allergies in adults and children, with around 2.5% of adults and 0.5% of children allergic to shellfish. Allergies to finned fish like salmon, cod, and flounder are less common: around 1% of the adult population and less in children. The most common finned-fish allergies come from halibut, salmon, and tuna.[1]
These statistics mean that those with shellfish allergies might still be able to take fish oil supplements, but should always check first with their doctor. However, anyone with a finned fish allergy will most likely need to seek out their omega-3 supplements from other sources.
While these signs of a fish allergy can occur in children, research shows that about 40% of first-time allergic reactions to fish occur in adults.[2] Reactions could include the following:
With any respiratory discomfort like swelling, difficulty breathing, or dizziness, it’s essential to seek emergency care. People without a fish allergy can still experience unpleasant sensations with fish oil supplementation, most commonly GI upset, stomach discomfort, or nausea. If this happens, starting with a lower dosage and always taking the supplement with food can help. Liquid fish oil supplements or enteric-coated soft gel capsules tend to be better tolerated.
Doctors recommend that people with any type of fish allergy take their fish oil supplement to a dermatologist or other qualified medical professional for specific testing. Still, it’s better to be safe than sorry.
It’s also important to note that more studies are needed, and existing research yields somewhat conflicting results. Most fish oils come from fatty and oily fish like anchovies, mackerel, herring, tuna, and salmon. Other types of fish oil include krill, cod liver, and marine lipid oils. Many pure fish oils could have trace amounts of shellfish proteins, so do your due diligence by choosing a trusted supplement brand.
Consulting with an allergist or qualified professional before taking any fish oil supplements is best for anyone with a fish allergy. If you are allergic to fish oil supplements, there are non-fish omega-3 supplement alternatives.
Plant-based omega-3 supplements are the next best choice for those who can’t take fish oil, whether due to a fish allergy or for vegans and vegetarians. However, some people (especially women) are less able to convert the plant-based omega-3 ALA to the more active DHA and EPA fatty acids. For these individuals, algae oil is one plant-based source that directly offers EPA and DHA. When fish consume algae that contains ALA, they end up with high concentrations of EPA and DHA in their tissues. Combining algae oil with other ALA-containing fats such as sesame, chia, pumpkin, flax, and hemp can help lay the foundation for a balanced intake of fatty acids. Black currant seed oil is a source of the essential fatty acid GLA that supports hormonal health and nervous sytem balance.
Excellent non-fish food sources include oils high in ALA, like flax oil and flaxseeds, walnut oil and walnuts, pumpkin seed oil, and pumpkin seeds. Some of these fats (particularly flax oil) are also known for supporting women’s hormonal balance and breast health.[3]
If you have a fish allergy, speaking with your doctor before proceeding with any fish-based supplement is essential. In the meantime, look for alternative omega-3 supplements like algae oil that provide pure EPA and DHA, and plant-based oils as supplements or in your daily diet, like flax, walnut, chia, and pumpkin.
[1] https://www.foodallergyawareness.org/food-allergy-and-anaphylaxis/food-allergens/fish/
[2] https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/common-allergens/fish
[3] Parikh M, Maddaford TG, Austria JA, Aliani M, Netticadan T, Pierce GN. Dietary Flaxseed as a Strategy for Improving Human Health. Nutrients. 2019 May 25;11(5):1171. doi: 10.3390/nu11051171. PMID: 31130604; PMCID: PMC6567199.