beef shish kabobs on the grill

When a new health threat emerges, it can sometimes take time before it is widely recognized and acknowledged. Sensitivity to a mammalian sugar called alpha gal can cause a life-threatening allergy. Health care providers are still learning about it.

Q. I have alpha-gal allergy that has put me in the emergency room on several occasions. The last time my blood pressure was dropping rapidly, and the ER staff administered an EpiPen. It was a jolt, but it brought me back. My primary care physician thinks this is all a bunch of hokum.

What Is Alpha-Gal Allergy?

A. Some doctors have been skeptical about alpha-gal allergy because it is unlike typical food allergies. A bite from a lone star tick (Amblyomma americanum) sensitizes the individual to a compound found in meat known as alpha gal.

Symptoms of an Alpha-Gal Reaction:

Someone with alpha gal sensitization can experience a life-threatening allergy reaction hours after eating beef, pork, lamb, venison, bison or any other mammalian meat. Symptoms may include hives, itching, digestive distress (nausea, indigestion, diarrhea), difficulty breathing and low blood pressure. This medical emergency requires immediate care.

The long delay between exposure and symptoms as well as the range of symptoms makes this reaction quite unlike other food allergies. Another peculiarity of the alpha-gal reaction is that it does not happen on every exposure. This also could contribute to physicians’ skepticism.

Preventing Alpha-Gal Reactions:

The only way to prevent such a reaction is to scrupulously avoid meat. Chicken or other fowl and any type of fish do not trigger alpha-gal reactions. People who are exceptionally sensitive may also need to avoid milk, cheese and other dairy products. Gelatin is derived from mammals and it too could trigger a reaction. This condition is not “hokum.”

Learning More About Alpha-Gal Allergy:

You may want to share some of the recent medical publications on alpha-gal allergy with your primary care physician. US doctors are not the only ones who have noted this problem. Here are case reports from Switzerland (European Journal of Dermatology, online Nov. 21, 2016), a review from Sweden (Allergo Journal International, online March 23, 2016) and research from Austria (Allergy, June 4, 2016). Perhaps the most useful publications, however, are by the doctors who first identified alpha-gal allergy: Scott Commins, MD (Current Allergy and Asthma Reports, Sep., 2016) and Thomas Platts-Mills, MD (Journal of Allergy and Clinical Immunology, June, 2016).

You may be interested in listening to our interview with Dr. Platts-Mills of the University of Virginia. In the same show we also interviewed a patient whose experience has been similar to yours, Mike Beck, along with his physician, Maya Jerath, MD, of the University of North Carolina. We have discussed alpha-gal allergy in some of our other radio shows as well: Show 1003 and Show 1031.

This life-threatening allergy has been noted more frequently in the South and Southeast, where lone star ticks are especially common. As the ticks spread to other parts of the country, however, alpha-gal allergy has become more common there as well. It is crucial that physicians learn to recognize it.

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  1. Laurie

    I think I’d find another primary care physician!

  2. Susan

    Isn’t this from Lyme Disease or one of it’s coinfections, or some other bacterial or viral disease transmitted by the tick bite? It’s not just the bite itself, right?

  3. William
    North Carolina

    Hi, I’m a physician in NC and seven months ago was bitten by a Lone Star tick that had Alpha Gal in its saliva and I now have the Alpha Gal disorder. I’ve had 25 significant allergic reactions since then as I’ve learn to cope by avoiding things that cause attacks. I had attacks for months before the diagnosis was made and because of a variety of symptoms consulted family physicians, an internist, an ear, nose and throat specialist, a health department physician and a neurologist before my wife made the diagnosis while listening to to a program about Alpha Gal on Peoples Pharmacy one Saturday morning.

    My symptoms were just as described on the program and I had had a tick bite. I went to see an allergist and he told me I probably didn’t have Alpha Gal because my symptoms were not typical despite the fact that my Alpha Gal blood test was 15 times normal. When I spoke with each of the other physicians and told them what I had . . . they had never heard of the problem. What is wrong with this picture and our public health system that when a life threatening problem exists there is little professional education or knowledge of how to prevent getting, diagnosing or treating the problem. My symptoms for a typical attack include face, head, tongue and lip swelling to the point of bursting open (requiring ice packs for six or so hours), cloudy thinking, visual disturbances (I bought two different pairs of glasses thinking it was an eye problem), shortness of breath and increased phlegm, abdominal swelling, pain and eventually diarrhea.

    I take a course of steroids for the worse episodes and I take an anti-histamine (daily now). I keep an Epipen handy but have only come close to using it twice. I now go to Dr. Commins in Chapel Hill and have learned what causes the episodes and in my case that includes in addition to all mammalian meats, at least these following ingredients: magnesium sterate (as in Advil and a lot of pills and I have the medicine I do take made in vegetable capsules), mono, di and triglycerides, glycerine, whey, milk, cheese, butter, gelatin, Vit D3 (cholecalciferol) in orange juice (yep, made from sheep wool and containing lanolin), and cement that can contain animal products (yep, hard to believe but true . . . I had a bad reaction from sawing out cement grout in my patio and replacing it the cement). Oh yes, Natural Flavors that can be made from meat products are in lots of foods and almost all candy, breads and crackers contain meat products. I could write pages more on the difficulty in getting a food company to admit if their food does or does not contain meat products . . . and it can change with each bar code change.

    I could write how I’ve found out what I can eat and the safe antihistamine to take . . . and you don’t want an anti-cholinergic type. I have a set of foods that I can eat safely and I stick with them very carefully because a simple mistake will make me sick for a week. I’ve found great fish and fowl, excellent butter, cheese, and okay ice cream. No good yogurt yet. We use a lot of eggs and vegetable oil but be careful to read the ingredients . . . one all natural vegetable oil also contained buttermilk we later discovered . . . after I swelled up at two o’clock in the morning. A really good life can be lead, with education, with Alpha Gal but a causal approach to food won’t work. Guessing is a bad idea. Good luck. Best, Bill

  4. Mary

    Another reason to become vegan. If one has landed in the ER several times that close to death it seems cutting out the cause would be the logical step.

  5. Joan

    My advice: get the blood test done and have report sent to your physician. And in my case, my physician brother, who was most skeptical of all! And keep a copy of report for yourself. And show it to every specialist you ever see. Alpha-gal allergy needs to be in your medical file. Also I am considering a medic-alert device because there are some emergency room drugs in Europe that trigger alpha-gal responses.

    I want to know whether the -mab drugs (mono-clonal infusions and sometimes shots for cancer and autoimmune diseases, derived from nonprimate cells) cause a reaction as well. These are sometimes called “targeted therapies “. Maybe people’s pharmacy can find out the answer to this question; I have been unsuccessful in finding out.

  6. Barry

    It really “ticks” me off that a lot of doctors are unwilling to learn from their own experience and observation. Preferring to only believe what has been proven by scientific method in an “ivory tower”. Seems like there should be more middle ground. Any idea how prevalent is Alpha-Gal Allergy? …. Still a lot we don’t know about medicine, physiology and just how complicated and variable the disease processes are.

  7. Di
    NW IL

    I am one who has had this allergy since long before it was recognized, and then have spent a couple years exchanging information with a growing number of others who either have it, have relatives with it, or are health care workers researching it. Our group has over 3000 people who spend a lot of time learning about, and spreading information about, this Alpha-gal allergy (AG). We have found that people who have severe cases of the allergy can also react to the hidden mammal by-products that are everywhere. Hidden things include, whey, magnesium stearate, products treated with bone char like some sugars and salts, even the coating used to release pills from the molds. There are so many more, too.

    I married into a family of pharmaceutical/medical researchers, so I know something about the complexities of trying to find out what is in medications. So pharmacists, when a customer asks about what’s in a medication, they are not trying to give you a hard time – they are trying to protect themselves from a wide range of nasty reactions, which include much more than just trips to the ER.

  8. Mary A.

    This is not hokum. After eating pork for dinner, I woke up at 2 in the morning, itching. The hives had spread to my throat by the time we found a 7-11 open, where I bought Benadryl and Zantac. The antihistamines worked, but an allergist later gave me an Epipen to carry at all times and told me to go to the ER next time, and not risk suffocating. I had never heard of alpha-gal and had no idea what was happening to me.

  9. Debra

    Thank you for informing on this condition. It’s the life threatening allergy most people have never heard of. I was fortunate to have heard one of your programs on the allergy when symptoms began following a lone star tick bite. My internist agreed testing should be done after the first reaction but did not think it likely to be alpha gal. Another reaction sending to urgent care led to testing and restriction from mammal sources. I drive to UNC for care because the allergist seen closer to home knew nothing of this condition. Others don’t understand all labels have to be read for hidden mammal products that are everywhere. There is nowhere I feel safe to eat out due to cross contamination or hidden mammal ingredients. It is a life changing condition but can be dealt with when informed and careful. Thank you for shining a light on this again.

  10. Happytiles

    I came down with the alpha gal allergy in 2001. It took me a spring and summer to figure out what was causing me to be so sick. Then in August of that year, I broke out in big purple hives all over and was shivering uncontrollably. I went to the emergency room. My allergist said to avoid red meat. So I did and all went well except that I was losing a pound each year. Then in 2013, on vacation, I was enjoying smoothies and oyster stew, things with milk, ice cream and cream, doing just fine. When I got home and tried to eat these delicious foods, my allergies acted up. My allergist said that I had become much more allergic, and to avoid all mammal products, no milk, no cheese, no butter , no cream. I am a walking skeleton. It has ruined my life. Stay out of the tall grasses and weeds and trees. Avoid chiggers, because they can cause the alpha gal allergy, also.

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