Severe allergic reaction after an energy drink traced to cod collagen in a US teen's case

A 15-year-old boy in the United States developed a severe allergic reaction after trying a new energy drink, according to a report by the American College of Allergy, Asthma and Immunology (ACAAI).

The case was presented at the ACAAI's 2026 Annual Scientific Meeting, held November 12-16 in Phoenix, Arizona. According to the report, after trying the new beverage the teen developed widespread hives, wheezing and difficulty breathing.

The teen was taken to hospital, where he received two doses of epinephrine, albuterol, an antihistamine and IV fluids. His symptoms resolved after treatment, the report said.

A review of the drink's label revealed that it contained 5 grams of collagen derived from cod. Anaphylaxis, a severe and potentially life-threatening allergic reaction, is usually tied to peanuts or shellfish, but in this case the source identified was fish-derived collagen.

According to the report, the teen had reported mild throat itching and lip swelling when eating canned tuna, although he had eaten salmon without an issue. He also has eczema, asthma and allergic rhinitis, commonly called hay fever.

Despite those symptoms, skin prick testing for tuna, cod and flounder allergy all returned negative. The findings are initial research presented at the ACAAI conference and have not yet been published in a peer-reviewed journal.

Allergist Annabelle Rowland, M.D., the study author and an ACAAI member based in Georgia, said in a news release that the case shows how tricky fish allergy can be. She said collagen from fish is showing up in a growing number of products, from drinks to supplements, and that standard fish allergy tests mostly look for a different fish protein and contain very little collagen, so a person can test negative and still react.

A spokesperson for the Council for Responsible Nutrition in Washington, D.C., said in a statement that collagen ingredients can come from several animal sources, like fish, cattle and pigs. The spokesperson said fish-derived collagen can pose an allergy risk for people sensitive to fish, and that processing or hydrolysis does not necessarily eliminate that risk.

The spokesperson recommended that those with fish allergies carefully review product labels, which are required to identify major food allergens such as fish, and consult their healthcare provider before considering these products. The spokesperson added that a single suspected reaction does not establish how frequently such reactions occur.

Sung Poblete, Ph.D., CEO of the Virginia-based Food Allergy Research & Education (FARE), said fish collagen is increasingly being used in products like supplements, beverages and wellness items. She said reactions can vary between individuals and between different fish-derived proteins, so someone can be allergic to one type of finned fish and not another, and that labels must identify the species of fish, while crustacean shellfish such as shrimp, crab and lobster must also be specifically identified, according to the FDA.

Poblete said that for someone managing fish or shellfish allergy, 'marine collagen' on a label calls for a closer look at the ingredient list and 'contains' statement, and that if the source still isn't clear, FARE encourages people to call the manufacturer before using the product. She added that the case is a timely reminder to read every label, including on drinks and supplements, and to talk with an allergist about any reaction, even if a test came back negative.