Allergic traveller in Southeast Asia

October 18, 2018 5:56 PM

I am allergic to All nuts, as well as peanuts. I am allergic to fish. (I am not allergic to shellfish). I am NOT allergic to their smell or even minimal contact, but I must not ingest these foods. I carry 2 epipens with me at all times, but obviously I don’t want to deal with super-high stress at every meal. Can I travel in Vietnam? In Cambodia? In Thailand? Thanks
posted by uans to Health & Fitness (22 answers total)

Are you allergic to nam pla?
posted by TWinbrook8 at 6:13 PM on October 18, 2018

I can only speak for Vietnam but you would have to be insanely careful. Peanuts and peanut oil are everywhere, and fish sauce is omnipresent. Like it would be doable but works involve really careful meal planning and restaurant vetting. Certainly no street food.
posted by smoke at 6:13 PM on October 18, 2018

I think that a lot of this is going to depend on how you like to travel, where you’re planning on traveling, and your budget. For example, Siem Reap, Cambodia is full of luxury hotels and western restaurants catering to tourists - if you’re willing to pay US prices for food or a bit cheaper, I’m sure there’s a way to make it happen. Both Thai food and Vietnamese food can have hidden peanut oil or fish sauce, but again if you skip street food and are generally in more touristy areas, there’s likely a way around it. You may be able to find a few common dishes that are commonly okay - for example I *think* that Vietnamese sandwiches do not contain fish sauce or peanuts, but there are a few conflicting resources about that.

This thread looks really helpful.
posted by asphericalcow at 6:13 PM on October 18, 2018

Also—-I am allergic to sesame seeds
posted by uans at 6:21 PM on October 18, 2018

Twinbrook8—I don’t know what nam pla is
posted by uans at 6:22 PM on October 18, 2018

Nam pla is Fermented fish sauce and is a nearly ubiquitous seasoning in Southeast Asian cuisine.
posted by Karaage at 6:26 PM on October 18, 2018

To build on what Karaage said about nam pla - it’s kind of like how Parmesan cheese can end up on/in a lot of American Italian food without you realizing it - a rind in the soup, cheese in the sauce, cheese as a topping - only way more so.
posted by asphericalcow at 6:30 PM on October 18, 2018

Yes, but you'll be missing the essential part of the travel experience in SE Asia, as I would not count on being able to convince restaurants to make Thai/Cambodian food to accommodate your allergies if I were you.
You should be able to find "western" food in most places - Thais in touristy areas make pizza fairly competently. A staple breakfast in Cambodia can be a baguette with cheese (I'm told Vietnam too). Oh, and there are lots of different fruits (at least in the fall) everywhere, you can probably survive on that in a pinch for a while.
posted by Dotty at 6:31 PM on October 18, 2018

I have had fish sauce ( made from anchovies) and there was no problem. I am guessing feementation made a difference
posted by uans at 6:32 PM on October 18, 2018

I’m just allergic to shellfish and decided some time against traveling there since I’d avoid so much tasty food, especially the street food.
posted by rtha at 6:32 PM on October 18, 2018

I have friends with fish allergies and friends who are vegan who won't even eat in Thai restaurants in North America- it's kind of a fish-based cuisine given that they use fish and shrimp basically as a major source of salt in many dishes.

Having had one variety of commercially prepared nam pla (probably, assuming you're in the West) that didn't make you sick may not be enough- what if a place uses homemade nam pla which is fermented differently, or less, or has a different fish in it..?

And peanuts are a major ingredient in many Thai dishes too so cross contamination seems inevitable.

Trying to explain multiple life threatening allergies to foundational ingredients, over a language barrier? And epipens will buy you time but not cure a major reaction. It seems overly risky to me.
posted by pseudostrabismus at 6:50 PM on October 18, 2018

I've traveled very widely in that area, and while I think you could perhaps pull it off successfully, it would be very risky and in the end I think you'd be better off not going unless you can go with a high-end package tour that makes all arrangements for you.

Are you sensitive enough that cross-contamination is a problem? If so, then definitely do not go because I absolutely guarantee there will be cross-contamination at nearly every meal unless you pay a fortune for special high-end treatment (and even then there's a risk)

...phrased differently, it is theoretically possible, but you may need to bring more than two epi-pens.
posted by aramaic at 6:55 PM on October 18, 2018

Maybe if you learned the language and only stayed in places where you could shop and cook for yourself?
posted by amtho at 7:29 PM on October 18, 2018

I have an acquaintance who travels a lot and is gluten-sensitive (note: sensitive, not allergy), and she basically buys crudites and cold cuts from grocery stores whereever she goes. If you're happy traveling like that, go for it!
posted by batter_my_heart at 7:31 PM on October 18, 2018

I recall spending a fortnight in Chiang Mai on a work trip with a colleague who was allergic to fish. He had his epipen out, at the ready, for every meal. He also had to have a discussion with the manager / chef of every restaurant before ordering, in exchanges that were sometimes frustrating because of the lack of options on the menu that wouldn’t kill him. Because some sort of fish sauce is one of the most ubiquitous of cooking ingredients for many Thai dishes, he occasionally had to settle for a dinner of plain white rice just to make sure he wasn’t inadvertently exposed to the allergen.

He survived the two weeks we were there without incident, but reported that he did not enjoy the experience.
posted by darkstar at 8:16 PM on October 18, 2018

I think this would work but it would not look like a traditional trip, because the only places in the region I think you could reliably manage your dietary needs would be in Chiang Mai and in Bangkok, where international food is as interesting and varied as in any other large city and where the standard of English in the most international bits (say. along the Skytrain and in the malls in Bangkok and in the main old town of Chiang Mai) would be high enough to keep you safe. Bangkok is actually the most visited city in the world!

I’ve been to Bangkok probably fifteen times now, and often I simply forget to have Thai food at all because I am at a friend’s gourmet burger place, or we’re at a Korean barbecue, or we’re having brunch at a swanky hotel. I’ve had Ethiopian, Lebanese, Sri Lankan and Persian food there in the last few months too. Chiang Mai is smaller but has a huge community of wellness-oriented folks so it is absolutely possible to (say) buy amazing kale smoothies all over the place. Both cities have major supermarkets with specialist products like gluten-free bread and gorgeous and cheap wet markets for veggies and meats.

Both cities also have very reasonably priced condos/apartments for rent with full kitchens, meaning you could self-cater very easily. There are also many places that are lovely daytrips you can take from these cities, and even the beach is doable if you’re willing to fly down for the day. Ayutthaya in particular is an easy day trip from Bangkok and visually stunning, and perhaps even Angkor Wat is doable with the right flights/hotels.

Good luck!
posted by mdonley at 8:40 PM on October 18, 2018

If fish sauce isn’t an issue for you I think you could probably get by. A few years ago we were in Thailand and met up w a friend also on a vacation there, she has a deadly serious peanut allergy and was able to get a thorough explanation translated by a local friend, which she showed to folks wherever she was going to eat. Peanuts (and peanut oil) are less common in Thai cooking than Thai restaurants in America would lead you to believe.
posted by Exceptional_Hubris at 10:12 PM on October 18, 2018

If you are okay subsisting on plain rice and fresh fruit you could do it for a couple of weeks. But I don't think it would be any fun, and you might be hungry a bit.
posted by lollusc at 3:26 AM on October 19, 2018

I came in to suggest the grocery store idea. Could you buy your own ingredients and cook your own meals? Even without a kitchen, you could get by on fruit, yogurts, meat and cheese sandwiches, etc.
posted by sunflower16 at 3:53 AM on October 19, 2018

I'm allergic to peanuts, but not sensitive enough that cross-contamination is an issue-- nor sensitive enough to react to peanut oil. If you have a similar level of nut sensitivity and fish sauce is okay, I would think you would be fine. Fish sauce would be your biggest risk in most cases where you order vegetarian. But if you are very very sensitive, I wouldn't try it.
posted by frumiousb at 5:07 AM on October 19, 2018

"Can I travel in Vietnam? In Cambodia? In Thailand?". Comfortably and enjoyably--No. Safely--it is a bit like playing Russian roulette--does not strike me as a way to spend your free time. I might mention--if you purchase travel insurance you might want to make sure whether any medical portion might treat this as a pre-existing condition.
posted by rmhsinc at 11:32 AM on October 19, 2018

If you do take this trip, you might want to get cards in the appropriate languages from Select Wisely. They've got ones for nut allergies, fish and shellfish allergies, and sesame allergies. They also make cards by special order if none of their standard ones fully meet your needs.
posted by Lexica at 12:25 PM on October 19, 2018