Egg Allergy – How to Stay Safe

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Egg is a popular food and ingredient. Unfortunately, this versatile and nutritious food is also one of the Top 8 Allergens. Egg Allergy is a serious condition, but with education and planning, it is possible to eat a healthy and enjoyable diet.

Keep reading for more information about this common allergy. This article will help you understand risk factors, avoiding eggs, getting help from healthcare providers, and planning a safe diet.

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Risk Factors

Risk factors for egg allergy include history of atopic dermatitis and family history of food allergies. Egg allergy is more common in children than in adults. Other factors may include genetics, environment, epigenetics, sex, ethnicity, nutritional status, inflammation, and dietary history (source).

Allergy Symptoms

The symptoms of an egg allergy can present similarly to those of other allergens. However, not everyone will experience the same exact symptoms. Symptoms may occur if eggs are eaten or touched.

  • Abdominal pain
  • Diarrhea
  • Dizziness
  • Eczema
  • Fainting
  • Hives
  • Itching
  • Itching in the mouth
  • Lightheadedness
  • Nausea
  • Nasal congestion
  • Swelling of any body part
  • Swelling of the face
  • Swelling of the lips
  • Swelling of the tongue and throat
  • Tingling in the mouth
  • Trouble breathing
  • Vomiting
  • Wheezing

Anaphylaxis

Anaphylaxis is a life-threatening allergic reaction. Anaphylaxis can be caused by food allergy or other allergic reaction.

Signs and Symptoms of Anaphylaxis include (source):

  • Constriction of the airway
  • Difficulty breathing
  • Dizziness
  • Fast pulse
  • Lightheadedness
  • Loss of consciousness
  • Sensation of a lump in the throat
  • Drop in blood pressure
  • Shock including a drastic drop in blood pressure
  • Swollen throat
  • Tightening of the airway

Food Family

Most eggs consumed in America come from Chickens. Chicken and Chicken Eggs are part of the Pheasant or Phasiandae Food Family. Other birds in this food family include Cornish hen, pheasant, quail, and turkey.

Cross Reactivity

If you have had an allergic reaction to egg, you may also need to avoid the following:

  • Duck
  • Goose
  • Turkey
  • Quail

Avoiding Eggs

When you can’t eat eggs for safety reasons, avoiding eggs and egg products is more complex than simply avoiding eggs at breakfast. Eggs are used as an ingredient in many foods and medical products.

Common Forms of Egg

  • Boiled Eggs
  • Cooked Eggs
  • Dried Eggs
  • Egg Wash
  • Egg White
  • Egg Yolk
  • Fried Eggs
  • Liquid Eggs / Cholesterol Free Liquid Eggs such as Egg Beaters
  • Powdered Eggs
  • Scrambled Eggs
  • Whole Egg

How Eggs Are Used in Cooking

Many foods have eggs as a hidden ingredient. It is helpful to think about what eggs do and how they are used.

  • As a Binder – This holds water and other food ingredients together.
  • As an Aerator – Eggs add to the structure of baked goods and hold air in small pockets.
  • As an Emulsifier – This prevents oil and water from separating from each other.

Hidden Egg in Common Foods

Egg is a common food and may be used as a condiment, main ingredient, side dish, snack or for functional purposes. Eggs help to provide shape and structure in baked goods.

  • Baked Goods and Baked Foods (including foods such as pretzels.)
  • Batter Fried Foods
  • Breaded Foods
  • Breads – may contain an Egg Wash
  • Candy
  • Chips
  • Coffee Beverages (Foam toppings may be made from egg.)
  • Crab Cakes and Salmon Cakes
  • Crackers
  • Cream Pies, Cream Filling, Cream Puffs, and other fillings in baked goods
  • Custard and Puddings
  • Dried Eggs
  • Eggnog
  • Egg Rolls – although many do not contain egg.
  • Egg Sandwich / Breakfast Sandwiches
  • Egg Substitutes (May contain some egg ingredients with a different nutrition profile.)
  • Fried Foods
  • Gluten Free Bread & Other products (Eggs are used to give structure and texture.)
  • Hollandaise Sauce
  • Ice Cream & Frozen Desserts
  • Icings and Frostings
  • Low Carb & Keto products
  • Mayonnaise and Mayonnaise based sauces such as Tartar Sauce
  • Meatloaf & Meatballs
  • Meringue & Meringue Powder
  • Noodles & Pasta (Some are egg-free; others are made with egg.)
  • Pancakes and similar foods such as waffles and crepes
  • Salads such as Egg Salad, Tuna Salad, and Chicken Salad
  • Soups, broths, and consommés (Egg may be an ingredient or topping.)
  • Vegetarian Burgers / Patties
  • Marzipan
  • Nougat
  • Salad dressings (Such as Caesar Dressing.)
  • Surimi (Imitation Crab Meat)
  • Wine (Egg Whites may be used in processing.)
Sliced hard boiled eggs in a green bowl on a wooden table with a cutting board and cilantro in the background. Blog image about egg allergy for Single Ingredient Groceries.

Meals and Recipes Made from Eggs

  • Deviled Eggs (Also known as Angel Eggs)
  • Egg Drop Soup
  • Egg Salad
  • Egg Stew
  • Fried Rice
  • Huevos Rancheros
  • Soufflés
  • Omelets
  • Quiche

Ingredients Made from Eggs

This is not an exhaustive list by any means, but it indicates some possible sources that may contain egg proteins. Some ingredients on this list may be made from other ingredients as well. You may contact the manufacturer for more information about the ingredients. It is best to avoid products with known or suspected allergens as ingredients when in doubt.

  • Albumin (also spelled albumen)
  • Apovitellin
  • Artificial Flavoring
  • Avidin globulin
  • Dried Egg Solids
  • Egg White Protein
  • Egg Yolk Protein
  • Globulin
  • Fat Substitute – Denatured or microparticulated egg protein (source).
  • Lecithin
  • Livetin
  • Lysozyme
  • Natural Flavor
  • Ovalbumin
  • Ovoglobulin
  • Ovomucoid
  • Ovomucin
  • Ovotransferrin
  • Ovovitelia
  • Ovovitellin
  • Silici albuminate
  • Surimi
  • Vitellin

How to Read a Label for Egg

Since eggs are one of the major eight allergens, it is required by federal law that manufacturers list it in plain language on their packaging (source).

It is important to read food labels and look out for advisory messages that tell you a product may have come in contact with egg.

When in doubt, it is better to play it safe. Even small amounts of egg may trigger an allergic reaction.

Infographic for Single Ingredient Groceries blog post about egg allergy titled Hidden Sources of Egg. Photos of and list of: baked goods, mayonnaise, meringue, egg nog, quiche, souffle.

Cross-contamination

If you or your child has an egg allergy, there are several strategies you can use to help prevent cross-contamination:

  • Wash hands with soap and water when preparing foods to help remove residual egg proteins.
  • Wash hands with soap before and after eating. 
  • Inform staff at restaurants or other venues about your food allergies so that precautions can be taken to avoid any contact with egg or any foods that contain egg.
  • Set up your kitchen at home so that cross-contamination is avoided. If other people in the house eat eggs or foods made with egg, you may designate specific areas of the refrigerator, freezer or pantry as “egg-free” and / or “egg” areas.

Medications and Vaccines

Eggs and egg ingredients are used in the manufacture of some medical products. These may be contraindicated in the case of egg allergy, or they may be able to be used with additional precautions.

Always inform your healthcare providers about your egg allergy and ensure that it is documented in your medical record. Also, be sure to discuss these and any new medication with your health care team.

Vaccinations

Vaccines are shots that help prevent illness. Some contain egg proteins. In some people, these vaccines pose a risk of triggering an allergic reaction. Sometimes additional safety measures are needed in order to receive these vaccines.

Flu Shot

Some flu vaccines contain a small amount of egg protein (source). Some versions of flu vaccines are manufactured without the use of egg components.

The CDC recommends that people with egg allergy and any type of vaccine allergy ensure that their allergies are documented with their healthcare provider.

Vaccines should be received at an inpatient or outpatient setting under the supervision of a health care provider who can identify and handle severe allergic reactions (source).

Be sure to talk to your doctor to determine what is safest for you.

Measles-mumps-rubella (MMR) vaccines

MMR vaccines may be manufactured with the use of egg ingredients. Be sure to discuss egg allergy with your doctor if you need this vaccine (source).

Yellow fever vaccine

Yellow fever vaccine contains some egg proteins and has generally been considered contraindicated for people with egg allergy. However, some protocols have been developed that allow for vaccination in this population (source).

If you have egg allergy and need yellow fever vaccine based on your travel plans or local conditions, it is best to talk to your doctor about this in detail.

Other Vaccines

We recommend talking to your doctor about the risk of allergic reactions to vaccines if you are allergic to egg, vaccines or other substances.

Propofol

Propofol is a medication used in anesthesia. There has been a suspected connection between egg allergy and propofol (source). Propofol contains egg lecithin.

However, research indicates that most allergic reactions to propofol are not related to egg allergy and people with egg allergy did not appear to have adverse reactions to propofol.

Propofol may be safe for people with egg allergy, but it is essential to discuss your allergy history in detail with your healthcare providers and Anesthesiologist.

Total Parenteral Nutrition

Total parenteral nutrition (TPN) is routinely used for patients that have dysfunctional gastrointestinal systems. A nutrition formula is given through a vein which bypasses the digestive tract. Intravenous fat emulsion is an essential part of TPN and contains egg-yolk phospholipids (source).

While being hypersensitive to TPN is rare, it is possible.

A study was done on a pediatric patient that presented adverse reactions to TPN due to egg-yolk phospholipids. The patient was tested for both egg white and egg yolk allergies and tested positive for both (source).

Other Reasons to Avoid Egg

Even when eggs are not a food allergen, people may avoid eggs for other reasons.

Vegans, vegetarians, and pescatarians may avoid eggs for health, religious, or ethical reasons.

Some people may avoid eggs due to digestive discomfort or personal preference.

Sensitivity and Intolerance

Egg intolerance is not usually life-threatening. Intolerance generally refers to an adverse food reaction that is not due to a response in the immune system. Symptoms may include abdominal pain, cramps, diarrhea, nausea, and vomiting.

Egg intolerance is different from an egg allergy.

Intolerance may be identified by observing symptoms after eating eggs, keeping a food journal, and following an elimination diet.

Avoiding eggs is generally the treatment for egg intolerance. Some people may tolerate egg whites but not egg yolks. Some people may tolerate egg yolks but not egg whites.

Sensitivity

Egg sensitivity is not usually life-threatening. Sensitivity generally refers to an adverse food reaction that involves the immune system but is not IgE mediated.

Allergic reactions usually occur quickly after exposure, but an intolerance may provoke symptoms up to three days after exposure.

Eosinophilic Esophagitis

Eosinophilic esophagitis is an adverse immune response to foods. People with this condition experience inflammation and other changes in their esophagus.

Symptoms include difficulty swallowing, difficulty eating, pain, and vomiting.

Eggs and other foods are associated with this condition (source).

Egg-Free Diet

If you avoid eggs due to adverse food reactions or other reasons, it may be helpful to consider the nutrients provided by eggs and consider if you need to identify other sources of these nutrients.

Eggs are a good source of protein as well as choline, lutein, omega-3 fatty acids, selenium, and vitamin D.

Because eggs are an ingredient in so many foods, it may be difficult for some people to eat enough food or eat a variety of foods. The difficulty can be even worse for people with multiple dietary allergies or other dietary restrictions.

People who avoid eating eggs may be at nutritional risk and we recommend working with a healthcare professional to address these risks.

Egg Substitutes

The following foods may be used in place of eggs when eggs are used as a functional ingredient in a recipe.

  • Agar Flakes
  • Apple Sauce
  • Bob’s Mill Gluten Free Egg Replacer
  • Ground Flax Seed / Flax Meal
  • JUST Egg Plant-Based Egg
  • Overripe Bananas
  • Peanut Butter
  • Soy Lethicin
  • Tofu (not egg tofu)Try This

Alternatives to Eggs as a Main Ingredient

The following may be used as alternatives to eggs as a main ingredient.

Instead of ThisTry This
Egg SaladTuna Salad, Chicken Salad
Boiled EggsDiced Chicken Breasts
Omelet & Scrambled EggsAckee (may be prepared with or without salt fish), Scrambled Tofu, JUST Egg Plant Based Egg Substitute, 
Eggs as a Protein SourceBeans, Peas, Lentils, Chicken, Fish, Beef, Shrimp, Goat, Lamb, Seafood, Vegan or Dairy-based protein powder

Help is Available

If you suspect you have an egg allergy, it is recommended that you contact your physician or allergist to get an accurate diagnosis. Blood tests and skin prick tests may be needed.

Specialized treatments may be available, including food challenges and oral immunotherapy. These treatments should only be done under medical supervision.

We also recommend talking to your doctor about emergency medications and safety plans.

Working with a Registered Dietitian, Certified Leap Therapist, or Certified Nutrition Specialist can help find foods that you like and can safely eat.

Final Thoughts

Choosing groceries when you have food allergies can be challenging. This is why we recommend choosing groceries made with a single ingredient and focusing on what you CAN eat, not just what you have to avoid.

This article is for informational purposes and is not medical advice.

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Authors

  • Lisa Hugh is a Registered Dietitian and Certified Leap Therapist. She has a Masters of Science in Healthcare Administration. As a a Food Sensitivity Expert, her passion is helping people with complex medical and nutrition needs find food and groceries that are safe and enjoyable. Lisa enjoys helping clients in her private practice.

  • Pamela Hawkins is a dietetic intern. She has a Bachelors of Science degree in Nutritional Sciences and a Masters of Science in in Human Clinical Nutrition Integrative Health. She is experienced in the nutrition care of women, infants, and children and is an experienced health coach.

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