A recent case report raises the possibility that fish-derived collagen in an energy drink can trigger a serious allergic reaction. Anaphylaxis is more commonly associated with foods such as peanuts and shellfish, but this case involved a 15-year-old boy who developed widespread hives, wheezing and trouble breathing after trying a new drink.
The case was presented at the American College of Allergy, Asthma and Immunology’s annual scientific meeting in Phoenix, held Nov. 12–16. The teen was treated in hospital with two doses of epinephrine, albuterol to help open his airways, an antihistamine and IV fluids. His symptoms improved.
Investigators found that the drink contained five grams of collagen derived from cod. The boy had previously experienced mild throat itching and lip swelling after eating canned tuna, though he could eat salmon without a problem. He also had eczema, asthma and allergic rhinitis.
Skin-prick tests for tuna, cod and flounder allergies were negative. The findings are preliminary and have not yet appeared in a peer-reviewed journal.
Annabelle Rowland, an allergist and one of the report’s authors, said the case illustrates how complicated fish allergies can be. Many standard tests focus on a different fish protein and contain little collagen, she noted, so someone could test negative and still react to fish-derived collagen.
Collagen is made from several animal sources, including fish, cattle and pigs, according to the Council for Responsible Nutrition. A spokesperson for the organization said fish collagen may pose a risk for people with fish allergies, and that processing the ingredient does not necessarily remove that risk. Consumers should check labels and discuss products with a healthcare provider, the spokesperson advised.
The spokesperson also cautioned that one suspected reaction cannot show how common these reactions are. Manufacturers are required to provide accurate ingredient information and disclose major food allergens.
Sung Poblete, chief executive of Food Allergy Research & Education, said fish collagen is increasingly found in supplements, drinks and other wellness products. Reactions can differ from person to person and between fish proteins, she said, meaning someone may react to one type of finned fish but not another.
Labels must identify the fish species used, Poblete said. For people managing fish or shellfish allergies, a label that says “marine collagen” may warrant a closer look at the ingredients and allergen statement. If the source is unclear, she recommended contacting the manufacturer and asking how the collagen is sourced, packaged and tested for allergens.
Poblete said the case is a reminder to check labels on drinks and supplements and to speak with an allergist about any reaction, even when allergy testing is negative.
