Khao Soy – Potentially deadly to someone with a shellfish food allergy!

“Watch that bus jump over the median and hit you,” I said to my friend Pete as we were walking towards a ramen place for dinner on his first night in Bangkok.

“Wouldn’t it be funny if lighting struck your umbrella and you died before eating?” added Andy.

Pete laughed as the jokes about his demise for two reasons: 1) he has terrible allergies to shellfish and tree nuts that make Thai cuisine incredibly poisonous for him, and 2) he has a delightfully dark sense of humor that makes hanging out with him a lot of fun, even when he crashes his motorcycle into a ditch and you have to feed him cookies while he soaks the road rash out of his hands.

Everything Pete carried around to help him not die in Thailand after his motorcycle incident. Notice the cards explaining his food allergies in Thai. 

Thailand’s cuisine is a pain to navigate for someone with shellfish allergies because so often the allergens in question are invisible to the eye and not mentioned on the menu. However, I don’t think that should stop anyone from traveling or seeking out local food in a destination, especially in Thailand. The richness and diversity of the country’s food culture means that there is something tasty for everyone to eat, even those with severe food allergies.

In his week and half in Thailand, Pete was able to eat several Thai meals with no ill effects. His epi pen thankfully went unused, and his only visit to the hospital was a $7 stop at the emergency room to mend some road rash. If he could do it, you can, too.

Below is a list of where allergens might lurk in Thai food. 

Disclaimer: I am not a doctor, and this is not an exhaustive guide; it’s only what I personally know about common allergens in common Thai dishes. Obviously, you need to be responsible for your own health and ask questions every step of the way while visiting Thailand. Don’t sue me if you follow this post as gospel and have an allergic reaction.

Common Food Allergies and Thai Food

Shellfish

Nearly all Thai food has some form of shrimp in it, whether it’s visible or not, which can make ordering dinner very tricky for someone with a shellfish allergy. While it’s easy to avoid foods with shrimp (goong/กุ้ง) in the title like tom yum goong or shrimp-fried rice, it’s harder to suss out what other menu items are trying to kill you.

Shrimp paste, kapi, กะปิ - Shrimp paste is a major ingredient in Thai food, and is especially dangerous to those with allergies because it’s not visible in the dish or on the menu. For example, all curries (แกง) will contain shrimp paste unless they’re served at a strictly vegetarian restaurant. That knocks  out red, green, and yellow curries from your diet as well as any curry-based soups, including khao soy (ข้าวซอย), the Chiang Mai favorite.

Shrimp paste also lurks in many of the dips, marinades, and spreads served with fruit and various meat-on-a-stick products. Unless you’re traveling with someone who speaks excellent Thai, it’s best to avoid these altogether when served on the street or at a restaurant without English-speaking staff.

Dried shrimp, goong haeng, กุ้งแห้ง –  If you have a shellfish allergy, you’ll also need to watch for tiny pieces of dried shrimp mixed in your salads, stir-fries, and, well, everything else. These tiny pieces of death go undercover in some Thai favorites including pad Thai (ผัดไทย) and som tam (ส้มตำ), the ubiquitous green papaya salad.  Again, it’s best to avoid any street carts or restaurants operating only in Thai language if you want to try these dishes and live to tell the tale.

Oyster sauce, saut oy nang-ron, ซอสหอยนางรม – You know how a lot of Thai food, especially stir-fries, have this mystery brownish glaze on them? That could be oyster sauce, though it could also be less deadly soy sauce. Most likely, it’s a special sauce made by the cook using some combination thereof. The safest thing to do is avoid anything with a brown sheen. Some Thai dishes that call for oyster sauce include pad gra pao (ผัดกระเพรา), assorted grilled meats, and stir-fried morning glory (ผักบุ้งไฟแดง).

To add to the confusion–and I almost don’t want to tell you this at all–some brands of oyster sauce have NO oysters in them at all, which means you could eat some of these foods without dying! For the sake of safety, however, let’s all agree to pretend that every oyster sauce originates with the dangerous oyster.

Alternatives and Solutions – Carnivores with food allergies don’t want to hear this, but the best advice I can give to travelers who want to taste Thai flavors without risking anaphylactic shock from shellfish should head to strictly vegetarian restaurants. Even if you pick a dish that seems to be vegetable-based from a meat-serving restaurant, it’s likely that the shrimp stays in. As for curry, most cooks used pre-mixed curry pastes, so the shrimp paste can’t be omitted in a special order. Same with som tam, pad Thai, and other major dishes that I’m sure I’m forgetting. It’s too risky.

In Chiang Mai, Khun Churn and A Taste of Heaven serve strictly vegetarian menus that will safe from the get-go. All of the soups at Just Khao Soy have a vegetarian broth, regardless of the protein you order, which is great for folks who don’t want to skip the meat in a meal. For meat on the street, you should be fine with fried chicken as long as it’s not covered in a sauce; Pete ate street-side gai tod (ไก่ทอด) in Bangkok and in Chiang Mai without croaking, but She Simmers’ recipe calls for an oyster sauce marinade. Use your judgement.

Thai fried chicken is probably okay for people with shellfish allergies in Thailand.

Nuts

Peanuts, tua lisong, ถั่วลิสง - Whole peanuts are not as common to Thai food served within Thailand as the recipes and restaurants abroad would have you think. They’re in pad Thai, of course, and sprinkled on a few other stir-fried noodle dishes, but for the most part peanuts stay off the plate. Peanut oil (น้ำมันถั่วลิสง/naman tua lisong), however, is much sneakier. While most restaurants use palm or soybean oil, you need to check before ordering. The other issue folks with peanut allergies might run into is cross-contamination. Thai food labels might not mention allergens at all, and you certainly can’t control what the pad Thai cook does with the spatula that tossed the peanuts on the last guy’s order.

Tree Nuts – The good news for visitors to Thailand with tree nut allergies is that there are far fewer instances of tree nuts in Thailand’s Thai food than in America’s Thai food. Cashews (เม็ดมะม่วง/med mamuang) do pop up from time to time, but they’re expensive, and often the menu’s wording and price will reflect their presence. Cashews are generally served either alone as an appetizer, with stir-fried chicken, or in American-fried rice, which is so gross you shouldn’t eat it anyway. Almonds, walnuts, and pistachios are mostly limited to stand-alone snacks and the western foods you’re already familiar with.

I didn’t list the Thai translation for “nuts,” because it isn’t useful for allergies. In spoken language, the Thai word for nut may also include beans and seeds.

Alternatives and Solutions – The good news for people with peanut and tree nut allergies in Thailand is that you can’t go 50 meters without running into a 7-11, where packaged foods with English labels abound. Plenty of these have the allergen labeling you’re used to reading. Also, peanuts and tree nuts can often be left out of dishes made to order, so you don’t need to worry about seeking out special nut-free restaurants.

Depending on your food allergies, a Thai omelet could kill you. 

Fish

Depending on your sensitivity to fish, Thailand’s cuisine could be your own personal heaven or  hell. Though fishy condiments abound, they tend to be used in small amounts in most dishes. However, they’re widespread and used in nearly every dish, many of which cannot be made to order specifically for you.

Fish sauce, nam pla, น้ำปลา - Thailand’s food may be most unaccommodating for people who are highly allergic to fish. Almost anytime a dish calls for a salty flavor, Thai cooks reach for fish sauce, a caramel-colored condiment made of anchovies, salt, and water. Anything stir-fried or made in a giant pot is bound to have some fish sauce within, as are most standalone dishes, including a seemingly innocuous omelet. Additionally, any restaurant or plastic table on the street will have fish sauce on the table, either in bottled form or in a dish with thinly sliced hot chiles. Beware!

Fish broth - Though fish broth isn’t common, it can be used as a base for tom yum soups, whether or not your order the fish, shrimp, chicken, or tofu versions.

Alternatives and Solutions – Fish sauce permeates Thai cuisine. Depending on how bad your allergies are, you may need to follow the advice I gave for shellfish allergies and head to exclusively vegetarian restaurants that will use soy sauce instead. If you are at a restaurant or stall where each dish is clearly made-to-order, you could ask for a dishes where fish sauce is added at the end to be omitted. Some preparations where salt or soy sauce could easily replace fish sauce include laab, som tam, and tom kha gai. However, don’t be disappointed if your request cannot be fulfilled.

Gluten

Thailand makes a great vacation spot for celiacs and folks with gluten allergies as rice rules supreme. Even the rice labeled “glutinous” is actually gluten-free and 100% rice. Unfortunately, most oyster sauces and Thai soy sauces contain gluten.

Soy sauce, see ew, ซีอิ๊ว - Dishes where oyster sauce and soy sauce are common include vegetable stir-fries, pad Thai, pad see ew (ผัดซีอิ๊ว), grilled meats, pad gra pao, and stir-fried morning glory. Avoid stir-fries and other foods that have a Chinese-influence to cut the likelihood of encountering a soy sauce.

Oyster sauce - See the “Shellfish” section.

Alternatives & Solutions – Plenty of Thai favorites are gluten-free. You shouldn’t have a hard time finding delicious and authentic eats. Most curries and salads, especially those that contain coconut, do not incorporate gluten of any kind, unless they are strict vegetarian preparations using soy sauce as a substitute for fish sauce. As for alternatives to the stir-fried and grilled meats with that telltale brown sheen, you may be out of luck. I believe I’ve seen one health-oriented restaurant advertise the use of gluten-free tamari to replace soy sauce in all of Thailand.

Dairy

No authentic Thai food should have dairy in it. You should be fine at any food cart or hole-in-the-wall Thai restaurant so long as you do not order iced coffee, iced tea, or a roti, all of which may come with sweetened condensed milk by default. Ironically, folks with dairy allergies might have a harder time at the touristy Thai restaurants safer for those suffering from any other food allergy or dietary constriction. The places that are used to catering to tourists may adjust dishes to the perceived western palate by adding milk. In particular, creamy tom yum is growing in popularity.

Etiquette

While I’m tempted to say that the only thing you should be worrying about is, you know, not dying, you should also realize you are in a place where food allergies are not as common among the local population and where “saving face” is of utmost importance. Be patient, polite, and soft-spoken as you explain your allergies. Never raise your voice or insult the restaurant for being unable to accommodate your diet. Be extra thankful to your wait staff, and perhaps leave a tip.

You also need to be aware that a lot of Thais really want to say “yes! I can serve you!” even if they cannot. Don’t ask, “can I eat this?” because your server will be tempted to say “yes” no matter what. Instead, ask if a particular item contains fish sauce, oyster sauce, soy sauce, etc.

Also be mindful that many curries, salads, meats, etc., are already partly or wholly cooked and assembled by the time you order. Do not be surprised, upset, or angry if a waiter informs you that you cannot have laab without fish sauce or meat without a glaze. Simply move to your next choice or excuse yourself from the restaurant. In Thailand, you have to take full responsibility for your food allergies.

9 Responses to Dealing with Food Allergies in Thailand

  1. Andrea says:

    Wow – Pete is so brave!! I adore Thai food but I really take for granted the fact that I’m not allergic to anything. I knew someone who lost his life to a food allergy when a restaurant didn’t heed his request (a New York restaurant, not so exotic) so this is really important information for anyone travelling in SE Asia. Excellent post!

  2. Christine says:

    Thank you for such a great post. I’m a big traveler, and have been really on the fence about a trip to Thailand, Cambodia and Vietnam next year because I too have a severe shellfish allergy. I’m really happy to see that it can be done!

  3. Kirsty says:

    Waw- thanks so much for the great advice. I am travelling Thailand for two months in two weeks time and unfortunately have allergies to nuts, shellfish and seeds. I was scared I would struggle with eating out but this advice makes it seem a lot more do-able! Thanks again.

  4. Jenni Proctor says:

    We have just returned from 17 days in Thailand. Allergic symptoms started soon after arrival, but the week we were in the north the symptoms escalated. My feet were so swollen that I could hardly wear my shoes and my body was full of arthritic aches and pains. I found it difficult to climb stairs and even getting in and out of the 4wheel drive in which we were travelling was a struggle.
    After Friday night Thai takeaways at home I often woke feeling a bit arthritic, but never gave it much thought. Now I have experienced the full reaction I have to start eliminating the problem ingredients.
    My guess….crustacean allergy caused by the shrimp paste and little bits of fried shrimp in many foods.
    Thanks for the article which I found very informative

  5. Kristine says:

    Thanks so much for the fantastic post! I too have a shellfish allergy and I want to go to Thailand at some point, and had this horrible fear I would be eating at grocery stores and McDonalds (if they even have them there ). I have bookmarked this article!!

    • Susan says:

      Good luck! If Pete did it, you can, too! Just be sure to order those allergy cards and eat at places where you are comfortable using them.

  6. jo says:

    We are considering heading to Bangkok for the first time in 15 years with our children. Our son, 10, is allergic to milk, eggs, tree nuts and red food dye. (We’ve waited to return to Thailand until he has outgrown his peanut allergy, which appears to be happening now. :::crossing fingers:::) How easy is it to avoid eggs in Thailand?

    • Susan says:

      Hi Jo! Sorry I don’t keep up with this blog and just now saw this comment. In my experience, eggs usually look like eggs in Thailand. You may want to avoid porridge and custards. Peanut oil is what I would be most concerned about with that list of allergies, but luckily your son is growing out of it! You may also want to be careful with some of the sausages and preserved meats, which may be dyed red. However, red curries and the like are just red because of the chiles used to make the paste. I think your family should absolutely be able to travel to Thailand and avoid allergic reactions!

Leave a Reply

Your email address will not be published. Required fields are marked *


six − 5 =

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>