We have all heard of Lyme Disease and Rocky Mountain Spotted Fever, but have you heard about Alpha-gal? It’s sometimes referred to as the dreaded red meat allergy.
Alpha-gal syndrome (AGS) is a very serious allergic reaction caused by Lone Star tick bites (other ticks are possible carriers). The specific pathway by which ticks cause this allergy in people is not fully understood. Following exposure to tick saliva through a tick bite, Alpha-gal symptoms may occur after people consume the Alpha-gal sugar molecule that’s found in most mammals, a carbohydrate known as galactose-alpha-1,3-galactose, or “alpha-gal” for short.
Unfortunately Alpha-gal is a severe and often life-threatening allergic reaction and the allergy can last a lifetime.
Alpha-gal is not found in fish, reptiles, birds, or people.
Alpha-gal can be found in meat (pork, beef, rabbit, lamb, venison, etc.) and products made from mammals (including gelatin, cow’s milk, and milk products).
The following foods may contain alpha-gal, though this is not a comprehensive list of all foods that may contain alpha-gal.
Mammalian meat such as beef, pork, lamb, venison, elk, moose, rabbit, etc. can contain high amounts of alpha-gal. In particular, the organ meat including liver, lung, heart, kidneys, intestines (tripe), sweetbreads, scrapple, and scrotum generally contain high amounts of alpha-gal.
Mammal by-products such as milk and milk products typically contain alpha-gal. While many individuals with AGS can tolerate milk products, it’s something to be aware of. Additional by-products that contain alpha-gal include fat/lard, gelatin, broth stock and gravy made from beef or pork.
Some people with AGS also react to carrageenan, a common food additive made from red algae, which also contains alpha-gal.
Foods that do not contain alpha-gal include: Poultry, such as chicken, turkey, duck, or quail, eggs, fish/seafood, fruits and vegetables.
Where is Alpha-gal geographically?
Here in the U.S., the tick species most often associated with AGS is the Lone Star tick (Amblyomma americanum) as it’s found from the midwest through the eastern states. Recent research suggests that the Blacklegged tick (Ixodes scapularis and Ixodes pacificus) may now also be implicated in alpha-gal syndrome.
The Asian Longhorned tick (Haemaphysalis longicornis), the primary trigger of AGS in Asia, and only recently has been found here in the US. Thankfully, it yet to be implicated in AGS here in the states. The Cayenne tick (Amblyomma cajennese) found in southern Texas and Florida has also been linked to AGS in Central America, but not yet in the U.S.
Ongoing research will hopefully identify the mechanism behind the Alpha-gal allergy and specifically the role that ticks play. There is much still to learn. For now, the best option is to protect yourself from tick bites.
Talarik line-up of SickTick tick and chigger repellent bands
Alpha-gal syndrome is a much more common allergy in the U.S. today than it was just 10-15 years ago. With over 34,000 diagnosed cases in 2019, it’s slowly becoming more well-known and recognizable by doctors and physicians nation-wide. Unfortunately, as of now, AGS is not a reportable illness to the CDC and many in healthcare are still learning about AGS and how to diagnose it.
Experts agree alpha-gal syndrome is under-reported in geographic areas where tick bites are common. The best protection is to prepare ahead of time and use products designed to repel and kill ticks before they have a chance to bite.
Jim Shockey has traveled world-wide and is 100% behind SickTick efforts to reduce tick bites and tick-borne diseases such as Alpha-gal, Lyme Disease, Rocky Mountain Spotted Fever, Anaplasmosis, Babesiosis, Ehrlichiosis and other insect-borne diseases that can have serious life-altering consequences.
According to the CDC, the biggest risk factor for AGS is repeated bites by ticks that contain alpha-gal in their saliva and salivary glands. While the mechanism of action is not fully understood, it’s important to know that not everyone who is bitten by a tick containing alpha-gal will develop AGS. While both children and adults can acquire AGS, most cases have been reported in adults.
If you live, work or travel in a place where ticks are prevalent and you ever present with sudden onset anaphylaxis and/or recurrent gastrointestinal symptoms, AGS should be considered and mentioned to your health care provider.
Engorged deer tick (Blacklegged tick). While deer ticks are not yet associated with Alpha-gal, about 50% of deer ticks are infected with Lyme disease.
According to lymedisease.org, common symptoms of AGS include:
90% have skin symptoms: itching “pruritus,” flushing “erythema,” hives “urticaria” (swollen, pale red bumps or “wheals” on the skin), angioedema (swelling in deep layers below the skin)
60% develop anaphylaxis (a potentially deadly reaction that can restrict breathing)
60% have gastrointestinal symptoms (abdominal pain, diarrhea, acid reflux, cramping, vomiting)
30-40% experience cardiac symptoms: rapid decrease in blood pressure (hypotension, POTS); palpitations (atypical chest symptoms)
30-40% experience respiratory symptoms (wheezing, coughing, shortness of breath)
20% of patients will have GI symptoms alone (may present like irritable bowel syndrome)
3-5% develop mast cell activation syndrome
arthritis (rare)
mouth swelling, sores (rare)
Getting Tested
Even if you cannot recall a tick bit, if you experience new symptoms after eating mammalian meat or by-products, contact your primary care physician or allergist. Different than other tick-borne illnesses, the onset of AGS can take 4-6 weeks or more from the time of the tick bite.
Your doctor should be able to determine if you have AGS based upon your clinical symptoms and a positive blood test for Immunoglobulin E (IgE) to the oligosaccharide glactose-alpha-1,3 galactose (alpha-gal.) In the U.S., Viracor is the main laboratory for AGS testing. The Viracor “specific IgE galactose-alpha-1,3-galactose” test can be taken at most commercial laboratories like Labcorp and Quest and shipped to Viracor.
What if you haven’t been around ticks for a while, you don’t remember being bitten and none of this makes any sense except for the allergic symptoms?
Unfortunately mammalian proteins and parts can be found in many medications and medical products and if you have AGS and are unaware of it, you may react to these products if they contain Alpha-gal. Because the source of many ingredients is not listed on product labels, your pharmacist may need to contact the manufacturer. Have your pharmacist ask specifically if it contains galactose-alpha-1,3-galactose, alpha-gal, mammalian meat, or any animal by-products.
If you’re looking for more information on tick-borne diseases, check out our previous blog articles:
Chigger Expansion, Chigger Bites and Protecting Yourself
Why We all Need to be Aware of Tick Expansion
Tick-borne diseases are serious and they are spreading. Help share this information with family and friends today.
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