A TV station in Indiana recently profiled a local family that claims to have cured their son’s egg allergy by raising chickens at home. The segment tries to be uplifting news but it inadvertently demonstrates why a registered dietitian should not substitute as an expert for a board certified allergist.
For Scott May and his wife, they believe their love for their chickens has helped cure their son of one of his allergies.
It goes like this: their child has a host of food allergies including an allergy to eggs. They started raising their own chickens and feeding their son the eggs.
“You can tell a difference,” says Scott. “He didn’t break out right away. He didn’t start itching and we weren’t running for the Benadryl.”
This father thinks his son’s tolerance for homegrown eggs has to do with the chickens’ diet. The report switches from there to an interview with a dietitian who speaks in general terms saying the causes of allergies are not well understood, then concludes with the parents’ plan to start raising produce next season in hopes of curing their son’s strawberry allergy.
But wait — is this child actually cured of anything?
No medical doctor weighs in at this news report. The station relies on the father’s report about symptoms, not on any formal testing, and that makes a difference because of something dietitian never mentions: there are two major types of egg allergy and they behave differently.
One form of egg allergy is heat labile, which means household cooking temperatures can render an egg safe to eat for those people. In layman’s terms a person can either develop an allergy to egg whites or to egg yolks. The egg yolk allergy is heat stable — no amount of cooking makes any difference — but the egg white allergy is heat labile. You know how egg whites turn from clear to white during cooking: it is the albumen protein changing shape that causes that change in color. When someone has an allergy to the albumen in eggs the antibodies in their bloodstream no longer interact with cooked egg whites.
Technically, the difference is between an ovalbumin and an ovomucoid allergy. The medical journal articles on this subtopic are their own rabbit hole; several laboratories have run experiments to determine exactly how much cooking is needed to denature the egg albumen protein completely. In practical terms baking usually works. This does not cure the allergy but it is a way to manage the condition. Of course, an individual has to have the heat labile allergy for this approach to do any good. A board certified allergist is the route to go for further information (as always, I am not a medical doctor and nothing here constitutes medical advice).
So getting back to this news in Indiana, the thing I wonder is whether anyone surrounding this child is aware that maybe a difference in how the family cooks eggs explains the boy’s subsiding symptoms? If that is what has happened then I shudder to think this child might need an ambulance next time the family serves a soft boiled egg.
Journalists are supposed to get to the bottom of matters. So I wrote four questions to the reporter who covered this story:
1. Have the May family’s claims been confirmed through medical testing?
2. Egg allergy exists in at least two different forms. One of these forms is heat labile, which means a person who has an egg allergy can eat eggs that are cooked in certain ways. That is not a cure; the person could still be at risk of a life threatening reaction without the right precautions. Are the Mays aware of this?
3. If so, have they changed cooking procedures or recipes lately?
4. A registered dietitian is not a medical doctor. Was there no board certified allergist available to interview for an expert opinion?
The station did not respond to that query.
I do not doubt the parents’ good intentions. I do worry about the judgment of a news station that fails to interview the proper expert before airing a report on a potentially deadly childhood ailment. A news anchor states a disclaimer that, “You should check with your doctor before making drastic changes…” Would that they taken their own advice and checked with a medical doctor before broadcasting this report.