Alpha-gal syndrome is a recently identified condition that has gained attention due to its unusual dietary restrictions and unique cause. This syndrome results from an allergic reaction to a sugar molecule found in red meat and other mammalian products. It is a serious and potentially life-threatening allergic condition. It is poorly understood, even by many physicians, and often goes undiagnosed for years. My brother-in-law developed it several years ago, so I made a point to learn as much as I could about it. Let’s talk more about it.
What is Alpha-Gal Syndrome?
Alpha-gal syndrome is a type of food allergy caused by a reaction to a carbohydrate known as galactose-alpha-1,3-galactose (alpha-gal). Alpha-gal is found in most mammals, but not in humans. Consuming mammalian meat, dairy products, or other products derived from mammals results in an allergic reaction. Unlike many food allergies that cause immediate symptoms, alpha-gal syndrome typically results in delayed allergic reactions, which can occur hours after consuming the allergen.According to the CDC, more than 110,000 cases were identified in the US between 2010 and 2022. It often goes undiagnosed, so an estimated 450,000 people in the US may be affected.
What Causes Alpha-Gal Syndrome?
Alpha-gal syndrome is linked to bites from the lone star tick found in the US. When these ticks bite humans, they can transfer alpha-gal into the bloodstream. This exposure triggers the immune system to produce antibodies against the alpha-gal molecule. Subsequent consumption of red meat or mammalian products containing alpha-gal can lead to an allergic reaction.
What Are the Symptoms of Alpha-Gal Syndrome?
The symptoms can vary greatly between individuals but often include:
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Hives or itchy, raised bumps on the skin
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Swelling of the lips, face, tongue, and throat
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Difficulty breathing or shortness of breath
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Gastrointestinal symptoms such as stomach pain, nausea, vomiting, or diarrhea
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Anaphylaxis, a severe, potentially life-threatening allergic reaction
Symptoms usually appear 3 to 6 hours after consuming red meat or other mammalian products, making it challenging to identify the cause without proper medical evaluation.
Who Gets Alpha-Gal Syndrome?
Alpha-gal syndrome can affect anyone bitten by a tick that carries the alpha-gal molecule. However, individuals living in regions with higher tick populations, such as the southeastern and eastern United States, are at increased risk. Outdoor activities that increase the likelihood of tick bites, such as hiking, camping, or hunting, can also elevate the risk of developing alpha-gal syndrome.
How is Alpha-Gal Syndrome Diagnosed?
Diagnosing alpha-gal syndrome involves a combination of patient history, symptom assessment, and specific medical tests. Your physician may ask about recent tick bites, dietary habits, and the timing of symptoms in relation to red meat consumption. You may not remember a tick bite, as ticks can sometimes bite and fall off without being noticed. Blood tests can detect the presence of alpha-gal antibodies. Skin prick tests may also be used to identify other potential allergies. The presence of specific alpha-gal IgE antibodies in the blood, in combination with the typical symptoms makes the diagnosis.
How is Alpha-Gal Syndrome Treated?
The primary treatment for alpha-gal syndrome involves strict avoidance of red meat and other mammalian products. This includes beef, pork, lamb, goat, venison, rabbit, dairy products from any mammal, and products containing gelatin or other mammalian derivatives. It may also be in some medications. Patients should read labels carefully and be aware of hidden sources of alpha-gal. This requires careful management and awareness.
Good mammalian meat substitutes include birds, such as chicken, turkey, ostrich, quail, etc. There are many dairy substitutes available now as well.
In cases of accidental exposure or severe allergic reactions, medications such as antihistamines, corticosteroids, and epinephrine may be necessary. Patients with alpha-gal syndrome should carry an epinephrine auto-injector (such as an EpiPen) and wear medical alert identification indicating their allergy.
If you have experienced allergic reactions after consuming red meat or dairy, or wake up in the middle of the night with hives or other allergic symptoms, see your physician for proper diagnosis and guidance.
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Dr. Anita Bennett MD – Health Tip Content Editor