Alpha Gal Allergy - What is it, what foods to avoid with alpha gal allergy syndrome, symptoms, diagnosis, and more.
Alpha Gal Syndrome (AGS), also known as alpha-gal allergy, red meat allergy, or tick bite meat allergy, is an allergic reaction to the alpha-gal molecules found in red meat. The reactions range from mild to life-threatening.
This article will break down what it is, the symptoms of alpha-gal allergy, how to be diagnosed, treatment, and what foods to avoid with alpha gal allergy.
What is Alpha Gal Syndrome
Alpha gal syndrome is a condition where the body has developed a mild to severe reaction to red meat products (including but not limited to beef, lamb, pork, rabbit, venison, etc). The cause is usually from lone star tick bites, though other ticks have been reported to transfer this disease.
The galactose-alpha-1, 3-galactose (alpha-gal) is a sugar molecule (carbohydrate) that is found in every mammal EXCEPT humans, apes, and old world monkeys. It also is not found in poultry, reptiles, and seafood.
The allergy happens when this alpha-gal molecule gets into your bloodstream and your own immune system thinks that it is under attack. Think of your immune system like an overactive security alarm! The immune response is what triggers the allergic symptoms. The best treatment is to avoid red meat and all mammalian products.
The good news is that alpha-gal syndrome is easy to treat and in some cases, can even be reversed.
The strange thing about AGS when compared to other food allergies, is that symptoms of AGS don’t happen until 3-8 hours after eating red meat. That means you can eat dinner the night before and wake up with a severe allergic reaction.
This delayed reaction is a main cause of misdiagnosis of other food allergies.
If you have frequent and seemingly random allergy attacks, including anaphylactic attacks, you should talk to your doctor or healthcare provider about being tested for AGS.
Symptoms of AGS include:
- Hives or itchy rash
- Nausea or vomiting
- Heartburn or indigestion
- Cough, shortness of breath
- Trouble breathing
- Drop in blood pressure
- Dizziness or fainting
- Severe stomach pain
- Swelling of the lips, eyes, throat, or tongue
For some people, a life-threatening reaction known as an anaphylactic reaction may occur after consuming, touching, or even smelling red meats, or products containing the alpha-gal molecule. If this happens, please call 911 or your local emergency number immediately. An anaphylactic shock reaction requires a trip to the emergency room to save your life.
Signs and symptoms of anaphylactic shock include:
- Swelling and tightening of the throat
- Difficulty breathing
- Chest pain or tightness
- Trouble swallowing
- Dizziness or fainting
- Change of normal coloring of the skin in the mucous membranes (inner lips, gums, around the eyes, and nail beds)
- Light skin, check for signs of a dark blue tint in the mucous membranes
- Medium skin, check for signs of a gray-green tint in the mucous membranes
- Dark skin, check for signs of a gray or white tint in the mucous membranes
Alpha-gal can cause these severe reactions. If you have had one before, talk with your doctor about getting an epinephrine (adrenaline) injector, commonly known as an Epi Pen.
When the lone star tick, or any tick, bites you, it has the possibility to transfer the alpha-gal molecule from a different animal to you.
When the molecule gets into your body, it reacts with an immune system response, making antibodies against this molecule. This happens with almost every tick bite. The immune system finds this “foreign” thing and eliminates it.
The allergic reaction happens to some people in that their bodies think that any animal product that gets digested is another attack of this molecule. That is what causes the allergic reaction.
The reaction is delayed because it takes that length of time to travel from the digestion to the blood which is where the alpha-gal molecule is first detected. Then, the antibodies attack, causing the reaction.
The majority of cases happen to adults in the South, East, and Central part of the United States. However, there are cases being found all over the world. Europe, Australia, and Asia have all had cases of AGS confirmed, in places where the lone star tick doesn’t live. Scientists now believe that any tick bite has the potential to transfer alpha-gal syndrome.
While people of all age groups can develop AGS, it primarily affects adults.
If you have alpha-gal allergies, you can not transfer it to other family members. It only enters a person's body after being bit by a tick and only then if you have a severe immune system reaction.
Researchers are not sure why some people develop alpha-gal syndrome after being bit by a tick and others do not. You are at an increased risk for this if:
- You spend a lot of time outdoors, especially in the South USA.
- Have received multiple bites from the Lone Star Tick (or other ticks)
- You have a mast cell abnormality (indolent systemic mastocytosis for example)
An allergy doctor can officially diagnose AGS. They will start with the taking of a patient’s history, eliminating other possible food allergies, and may call for more testing.
For many people with unexplained anaphylactic reactions, doctors are now seeing the possible link between them and alpha-gal syndrome.
First, the doctor needs to determine if there is an underlying allergy causing your symptoms. If not, or perhaps in addition to, then they can ask about AGS.
Additional tests may include:
A low risk blood test can be used where blood is drawn and then tested in a lab. This can measure the amount of alpha-gal molecules in your system. This is the key test for determining if you have AGS.
A low risk method where a small amount of meat is pricked under the skin. All reactions, if any, are monitored by a health professional. Reactions usually range from a light rash to hives. The severity of the allergy is determined by the strength of the skin reaction.
How to prevent AGS
Preventing tick bites seems to be the most effective method of preventing AGS.
The majority of the lone star tick reside in the southeastern United States. However, these tick are migrating to other parts of the US on deer, so use caution anytime you are outside. Also, cases are being seen in other parts of the world, not just the US.
When you go outdoors, avoid bushy, woody areas when possible. Treat your clothing or skin with approved bug repellent. Wear long pants, socks, thick shoes, long-sleeved shirts, etc to protect your skin. Always use insect repellents on you, your clothing, and your pets when in the woods, especially the deep woods.
After you have been outside, always check yourself and others for tick bites.
Make sure that your pets are also protected against ticks and prevent them in your yard.
One of the best things to do is have a thick layer of approx 3 feet of mulch surrounding your yard. Ticks do not like mulch and will not cross it. A tick’s favorite hiding spot is dark, damp, and with shelter.
If you live in an area with a high deer population, make sure to take extra precautions as deer are a common animal with ticks.
One of my favorite non-toxic and pet safe methods of controlling ticks is to first keep your grass cut shorter. No tall grass to hide in means fewer ticks! Next, cedar oil is a natural, non-toxic tick repellent. If you are going hiking, you can spray cedar oil directly onto your clothes and skin. Eucalyptus and neem oil are also safe and effective.
Finally, plant tick repelling plants around the edges of your yard. Garlic, sage, mint, lavender, rosemary, marigolds, and beautyberries are all effective at deterring ticks! Plus, you can use the plants in cooking!
Treatment for AGS begins with avoiding any and all triggers for you. The foods that you need to avoid are different for every person, so you may not need to avoid everything on this list!
Make sure that you are careful when dining out at restaurants, friend’s and family’s homes, and any place where you are not in control of preparing the food. Cross contamination can occur anywhere.
Always check ingredient labels to make sure they don’t contain any of your unique triggers.
If you are concerned that something contains meat or a meat by-product, don’t eat it. Your health is more important than eating something in the moment.
For severe reactions, you may need to ask your doctor about getting an Epi-Pen or similar epinephrine autoinjector for those life-threatening reactions. This is a medication to always keep with you no matter where you go. In the event of a severe anaphylactic reaction, you can administer this medication before calling your local emergency number.
The good news is that if over a period of time you do not get bit by another tick, and you manage your symptoms by avoiding all triggers, it is reversible. Some people have managed to safely eat meat and meat by-products again after a few years of avoiding tick bites and avoiding their trigger foods.
What foods to avoid
Not all people who have alpha-gal will have a reaction to all foods listed. Listen to your body and avoid the foods that are triggering to you.
The following are foods to avoid with alpha-gal syndrome:
- Red meat products
- Beef, pork, lamb, venison, rabbit, etc
- Muscle meat and organ meats
- Animal Products
- Dairy products including: Cow’s milk, goat’s milk, etc
Make sure to pay extra attention to ingredient labels for foods such as:
- Soup, stews, broths, stocks
- Natural flavors
Avoid eating at fast food or other restaurants where they deep fry the french fries with the meats. While the chicken and fish sandwiches are safe, many times fast food places will use the same oil for everything including fries with a meat coating, and other deep fried products that contain red meat.
- Gelatin coated medications
- Lactose or dairy in medications
- Used as a thickener or stabilizer in some medications
- Some vaccines use a small amount of alpha-gal to stabilize the vaccine. Not all vaccines use this. Please talk with your doctor about safe vaccines.
- Heart transplant or heart valves from pigs or cows
- Monoclonal antibodies
- Certain anti-venoms
- The cancer drug cetuximab
- White sugar
- Uses bone char from bovine sources
- Gelatin in candy
- Altoids, jello, candy corn, rice crispy treats, marshmallows, gummy candy, etc
- Keratin hair products
- Shampoo, conditioner, deep conditioning treatments
- Oleic acid
- Margarine and processed butter
- French onion soup
- Beef stock
- Refried beans
- Corn bread
- Glue on the flap
- Stickers, glue, tape
- Gelatin can be used in these products as a glue
Foods that do not contain alpha-gal
The list of foods to avoid and things to avoid can become so overwhelming that sometimes it is important to keep a list of what is safe to eat.
Products that do NOT contain alpha-gal and are safe to eat include:
- Chicken, turkey, duck, quail,
- Fish and Shellfish
- Fruits and Vegetables
Visiting a Doctor
If you believe that you or someone you know has alpha-gal syndrome, it is important that you set up a doctor appointment. Here are some things to prepare and questions to ask the doctor to make sure that you are getting the best help you can receive.
I am a BIG fan of bringing a notebook to write down any history, questions you have, and answers the doctor gives you. It helps so much to help you remember everything!
Description of your symptoms
Write down any and all symptoms you are experiencing, especially after you have eaten red meat. What did you eat, what reactions did you have, how long after eating did you have the reaction, etc. These are all good clues to help you solve your health.
If you have been bitten by a tick, spent time outdoors recently, traveled to an area where the lone star tick is prevalent, etc.
Any other medical issues
If you have a history of food allergies, lyme disease, etc. Do you take any other medications for other unrelated health issues?
Bring a person with you
If you can, having another person to help you remember questions to ask and to listen to what the doctor is saying can be invaluable.
Questions to ask the doctor
- Are my symptoms caused by the red meat allergy, aka, alpha-gal allergy syndrome?
- Do I have other food allergies?
- What tests do I need to determine this?
- Is there a specialist I can see for care?
- If you don’t think it is alpha-gal allergy, what other alternative diagnosis can you give me?
- If it is alpha-gal allergy, what are my next steps for treatment?
- Do I need to carry an epinephrine auto-injector?