|SSM Cardinal Glennon Children's Medical Center|
Having an egg allergy doesn't have to be a big thing — all you need to do is skip breakfast, right? Wrong. Eggs are found in more than just omelets (and we all know skipping breakfast is never a good idea!). Living with an egg allergy means you have to be aware of what you're eating and read food labels carefully. It's work, but it's worth it.
What Happens With an Egg Allergy?
Eggs in themselves aren't bad. But when you're allergic to them, your body thinks they are. The body's immune system normally fights infection. But when someone is allergic to a food, like eggs, the immune system overreacts to proteins in that food.
Most people who are allergic to eggs react to the proteins in egg whites, but some can't tolerate proteins in the yolk. Every time the person eats an egg, the body thinks these proteins are harmful invaders. The immune system responds by kicking into high gear to fend off the "invader." This causes an allergic reaction, in which chemicals like histamine are released in the body.
The release of these chemicals can cause someone to have the following problems:
Egg allergies can cause a severe reaction called anaphylaxis. Anaphylaxis may begin with some of the same symptoms as a less severe reaction, but then quickly worsen. A person might have trouble breathing, feel lightheaded, or pass out. If it's not treated, anaphylaxis can be life threatening.
Egg allergy usually first appears when kids are very young. Most kids outgrow an egg allergy by the time they're 5 years old, but some people remain allergic.
The viruses for the flu vaccine are grown in chicken eggs. If you have an egg allergy, ask your doctor about whether it's a good idea to get the vaccine. In most cases, it's OK for people to get the shot — but not the nasal mist — if their egg allergy is mild. (A mild reaction is when someone gets hives only, with no other reactions.) Also, if you have an egg allergy, get your flu shot in a doctor's office, not at a supermarket, drugstore, or other venue.
How Can Doctors Tell It's an Egg Allergy?
If your doctor suspects you might have an egg allergy, he or she will probably refer you to an allergist or allergy specialist for further testing. The allergy specialist will ask you questions — these may cover things like how often you have the reaction, the time it takes between eating a particular food and the start of the symptoms, and whether any family members have allergies or conditions like eczema and asthma.
The allergy specialist may perform a skin test on you. This test involves placing liquid extracts of egg protein on a person's forearm or back, pricking the skin a tiny bit, and waiting to see if a reddish, raised spot forms, indicating an allergic reaction.
You will need to stop taking anti-allergy medications (such as over-the-counter antihistamines) 5 to 7 days before the skin test because they can interfere with the results. Most cold medications as well as some antidepressants may also affect skin testing. Check with the allergist's office if you are unsure about what medications need to be stopped and for how long.
Some doctors may also take a blood sample and send it to a lab where it will be mixed with some of the suspected allergen and checked for IgE antibodies.
In some cases, though, positive results of skin and blood tests aren't enough to prove that someone's symptoms are definitely being caused by eggs. So doctors may use what's called a food challenge to help diagnose the allergy.
With a food challenge, the person will eat foods that contain eggs only under close supervision from a doctor. If symptoms appear after eating egg products, it's a pretty sure bet the person has an egg allergy.
How Is It Treated?
Treating egg allergy might seem simple — you just don't eat eggs. But so many foods are made with eggs and egg products that it can be really hard to know what's OK and not OK to eat. It's a good idea to work with a registered dietitian to develop an eating plan that provides all the nutrients you need while avoiding things you can't eat.
If you have an egg allergy your doctor may want you to carry a shot of epinephrine (pronounced: eh-puh-neh-frin) with you in case of an emergency. Epinephrine comes in an easy-to-carry container about the size of a large marker. It's easy to use — your doctor will show you how.
If you accidentally eat something with egg in it and start having serious allergic symptoms, like swelling inside your mouth, chest pain, or difficulty breathing, you can give yourself the shot right away to counteract the reaction while you're waiting for medical help. Always call for emergency help (911) when using epinephrine. You should make sure your school and even good friends' houses have injectable epinephrine on hand, too.
Keeping epinephrine on hand at all times should be just part of your action plan for living with a severe egg allergy. It's also a good idea to carry an over-the-counter antihistamine as this can help ease allergy symptoms in some people. Antihistamines should be used in addition to the epinephrine and not as a replacement for the shot.
If you've had to take an epinephrine shot because of an allergic reaction, then you should go immediately to a medical facility or hospital emergency room so they can give you additional treatment if you need it. Up to a third of anaphylactic reactions can have a second wave of symptoms several hours following the initial attack. Therefore, you might need to be observed in a clinic or hospital for 4 to 8 hours following the reaction.
Living With an Egg Allergy
The best way to be sure a food is egg free is to read the label. Manufacturers of foods sold in the United States must list on their labels whether a food contains any of the most common allergens. This means that you should be able to find statements like these somewhere on the label: "contains egg ingredients," "made using egg ingredients," or "made in a facility that also processes eggs."
This new label requirement makes things a little easier than reading the ingredients list — instead of needing to know that the ingredient "ovoglobulin" comes from egg protein, you should be able to tell at a glance which foods to avoid.
Still, to make sure the foods you eat are egg free, you'll need to be on the lookout for any ingredients that might come from eggs. That means asking questions when eating out at restaurants or at a friend's home and carefully reading food labels.
When you eat in a restaurant or at a friend's house, try to find out how foods are cooked and what's in them. In some cases, you may want to bring your own food with you. When you're shopping, look for egg-free alternatives to foods that usually contain eggs, such as pasta.
People with an egg allergy may find that the health food section of the grocery store offers the most options. That's where you'll find vegan foods that are made without eggs or egg products.
When preparing your own food, you can substitute one of these egg alternatives in your recipes. Each of these replaces one egg (these substitutes may not work as well in recipes that call for more than three eggs):
When cooking at home, always carefully scrub the utensils you're using in case they have been used on egg products.
Although the number of people in the United States with food allergies is low (just over 1% of the total population), there's a growing awareness about food allergies. This means that everyone — from the waitstaff at a restaurant to food manufacturers — is more understanding and willing to accommodate a person's food needs.
So living with an egg allergy doesn't have to be a big pain, just a bit of an adjustment.
Reviewed by: Nathan B. Richards, MD, and Sheelagh M. Stewart, RN, MPH