There are no perfect ways today to cure an egg allergy. Anyone promising you a cure through acupuncture, alternative medicine, probiotics, etc is not being honest with you.
There is no interventional therapy for egg allergy currently approved by the FDA, nor by the European Medicines Agency (EMA). Management of an egg allergy is about strict avoidance, even of tiny or trace amounts.
In the US, laws require food manufacturers to label packaging in plain language, listing egg if it’s an ingredient. But these laws do not necessarily extend to “prepared foods” and foods at farmers markets, etc.
Your baby is much more likely to outgrow an egg allergy naturally if he or she:
- Has mild or no eczema.
- Has had less severe reactions to egg.
- Has low IgE levels.
- Can tolerate baked eggs.
- Has no other food allergies.
What if this doesn’t describe your baby? And even if it does, read on to learn more.
The Latest Science On Egg Allergy Treatment
Eat Baked Egg If Possible
If a child can tolerate baked egg, regularly eating baked egg has been shown to increase the chance of eventually tolerating cooked or raw egg. Regularly eating baked egg was 14 times more likely to lead to outgrowing the whole egg allergy than avoiding eggs.
Oral Immunotherapy (OIT)
There are different types of oral immunotherapy, and there is no standard treatment yet. Oral immunotherapy means regularly eating small amounts of egg through the mouth (as opposed to an injection) with the goal of desensitizing a person to egg and eventually allowing them to fully tolerate egg. Typically, the amount of egg eaten each day starts incredibly small and increases until it is about ½ of an egg each day.
When “desensitized,” a person will not react to egg if they are exposed to it by accident. BUT if they stop eating their daily dose of egg, the previous allergy will return.
The real goal is “tolerance” to egg. In this state, the body continues to ignore egg protein permanently whether or not the person eats eggs every day.
So what does oral immune therapy look like?
- OIT starts with an in-office appointment to figure out the starting dose. This is done by beginning with a tiny amount like 1 milligram of egg protein, and doubling it every 30 minutes until you reach either 50mg or whatever the person can tolerate. That is the starting dose.
- Then a person eats the starting dose for some number of days, say 2 weeks, at home.
- Periodically (i.e. every two weeks) the dose is increased at home by a small amount, for example, 5-10 milligrams.
- The goal is to get all the way up to 2 grams (2,000 milligrams) over a period of 10 - 20 months.
A recent review of 10 studies on oral immune therapy was a mixed bag. The treatment definitely has promise: in the group of children who underwent the treatment, a MUCH larger percent were able to eventually tolerate egg than in the groups of children who did no treatment.
- A far higher percentage of people are desensitized to egg rather than tolerate it ,meaning the reaction comes back once they stop being exposed, rather than being “cured”. That means they are less likely to have an allergic reaction after accidental exposure, but they need to eat their dose amount every day forever.
- A large number of people stop therapy because eating egg in increasing amounts, and sticking to the protocol, is logistically difficult and causes a lot of anxiety.
- A large number of people have an allergic reaction to eggs on their journey. An increased dose one day will be too much for their bodies and they end up needing treatment. On the flip side, strict avoidance means no reactions.
The net is that for those people who are so anxious about their egg allergy that they are restricting their lives, a treatment, even one that isn’t dialed in yet and has some risks, might give them a sense of control over their future.
For those with less anxiety and fear about their egg allergy, this level of effort may cause more pain than needed. They may be better off waiting for the science to improve.
Future Work On Egg Allergy Treatment
Allergic reactions to eggs, as has been stated many times before, are a mistake the immune system is making. The chain reaction that was intended to fight off parasites is the one that is being triggered in an egg allergy. Right now, there isn’t a lot of clarity on why the body mistakenly sees egg protein as a parasite, or how to stop that from happening.
Instead, researchers are focusing on stopping the chain reaction that causes the acute immune reaction (allergic reaction) to happen, basically making it impossible for the body to go into crisis mode.
When the body sees a parasite, or what it thinks is a parasite, T cells transform into TH2 (T helper 2) cells. TH2 talks to B Cells which release the IgE antibodies specific to that parasite. This is called sensitization.
The next time your body sees this parasite, the TH2 release interleukins, and the IgE antibodies turn on eosinophils, easophils, and mast cells. These last three cells are the ones that actually cause what you know of as an allergic reaction (squeezing of the airways, hives, vomiting, etc).
Stay with us because it’s going to pay off.
Steroids work on the eosinophil cells. When the eosinophil is stopped, the allergic reaction stops. That is why when you are having an allergic reaction, you get steroids. But steroids have a lot of effects on other parts of your body that are really harmful. So overuse of steroids is a bad thing.
Instead, new drugs are trying to stop earlier parts of the chain reaction and take the body back to a normal state.
One drug, called Xolair (Omalizumab), works by targeting IgE antibodies. It is given by injection in the doctor’s office, because some people have a reaction to it where they get anaphylaxis.
Another drug, dupilumab, messes with the interleukins (IL-4 and IL-13) that are both produced by, and stimulate the master regulator cells. This drug is given by injection into the skin every two weeks at home.
These drugs have been studied and approved to treat a number of allergic diseases, and are being studied for younger kids and treatment of more kinds of food allergies