As awareness and information of Alpha-gal Syndrome and the ticks that are known to trigger it spread, the number of confirmed Alpha-Gal diagnoses climbs.
Many of those who are unknowingly affected have faced a challenging battle as descriptions of the various symptoms of Alpha-gal Syndrome are under published and misdiagnosed. Alpha-gal Syndrome is not yet listed as a differential diagnosis for a number of lookalike conditions in medical communities.
The story of misdiagnosis is especially common for those who do not recall previous tick bites, or those who live outside the most affected regions.
Those who have gone through a long quest for answers and suffered misdiagnosis frequently tell us things like:
“I wish I had known what to look for sooner.”
“I didn’t know that trace sources, like makeup, were behind my symptoms.”
and most of all “I hope that no one else has to suffer as long as I did.” once they uncover the extent and cause of their symptoms.
Ultimately the most common response is “I’m so glad YOU know and understand how to help me with this.”
What is Alpha-Gal Syndrome?
Alpha-gal syndrome (AGS) is a type of allergy to mammalian meat. Mammalian meat includes beef, bison, pork, lamb, wild game, rabbit, and unusual meats from other mammals, such as kangaroos.
AGS is unique because, unlike most food allergies, which involve the immune system mistakenly identifying specific proteins in foods as harmful, AGS is an allergy to a sugar molecule or carbohydrate found in mammalian meat called galactose-alpha-1-3-galactose. The immune response to this molecule, as opposed to a protein, makes AGS unique amongst food allergies.
What Causes Alpha-Gal Syndrome?
People are not born with Alpha-Gal Syndrome. It most often develops in adulthood although children can acquire the allergy, as well. The primary identified cause of AGS is a tick bite or more specifically, bites from the Lone Star tick or black-legged tick.
Ticks appear to synthesize alpha-gal carbohydrate inside their bodies with the help of enzymes called galactosyltransferases; it may be this endogenously-derived alpha-gal that triggers an immune response in the individual bitten by a tick.
When an individual is bitten by a Lone Star or black-legged tick, or presumably any vector-containing alpha-gal carbohydrate in its saliva, the individual’s immune system can start to react to alpha-gal, creating antibodies designed to attack the alpha-gal molecule. These antibodies are called “anti-α-Gal IgE antibodies.”
Anti-α-Gal IgE antibodies break oral tolerance or the active regulatory immune response that allows our bodies to tolerate ingested foods. This breakdown of oral tolerance causes the body to react to food allergens, namely the alpha-gal carbohydrate in mammalian meat.
The tick bite also skews the immune response more towards a T helper 2 (Th-2) response, the type of immune response more correlated with allergies.
Alpha-Gal Syndrome differs from other IgE-mediated food hypersensitivities in that the response to mammalian meat occurs 3-6 hours after consumption, rather than immediately post-consumption.
Once the reaction starts, the individual’s immune system may also begin to cross-react to alpha-gal present in dietary mammalian meat, releasing more alpha-gal antibodies. The release of these antibodies causes an inflammatory response, leading to the symptoms of AGS.
Common risk factors for Alpha-gal Syndrome include:
- A known bite from a Lone Star or black-legged tick
- History of chigger or mite bites
- Hiking, hunting, birding, or engaging in other hobbies that involve spending lots of time outdoors
- Jobs that involve spending time outdoors, such as field biologist, farmer, or park ranger
What are the Symptoms of Alpha-gal Syndrome?
Alpha-gal Syndrome exists on a spectrum, so the symptoms of AGS vary. While some individuals with Alpha-gal Syndrome may manifest an anaphylactic reaction upon consuming beef, another individual may manifest gut discomfort and fatigue.
The most common symptoms of Alpha-gal Syndrome include:
- Gastrointestinal symptoms, including abdominal pain, cramping, diarrhea, and emesis
- Pruritus (itchy skin)
- Angioedema (swelling of the skin or body parts)
- Anaphylaxis (severe allergic reaction)
- Nasal congestion
- Improvement of symptoms when adhering to a mammalian meat-free diet
Alpha-gal Syndrome reactions are often delayed, beginning 3-8 hours after eating mammalian meat or meat-derived products. AGS may also “unmask” mast cell issues, causing people to demonstrate symptoms consistent with mast cell activation syndrome (MCAS).
Functional Medicine Treatment of Alpha-Gal Allergy
The first step in treating alpha-gal allergy is to remove mammalian meat products from the affected individual’s diet for some time. The length of this elimination period is at the discretion of your functional medicine healthcare provider.
It will depend on whether the underlying factors contributing to Alpha-gal Syndrome – chronic tick borne infections, immune dysregulation, compromised gut health – are simultaneously being addressed alongside the mammalian meat elimination.
If you test positive for alpha-gal syndrome, you will need to avoid the following mammalian meat-derived foods:
- Beef or bison bone broth
- Organ meats from mammals; interestingly, kidney and other mammalian organ meats may result in more severe and rapid AGS reactions due to their higher concentrations of alpha-gal antigen15
- Tallow and lard (These are fats derived from beef and pork, respectively. Research indicates that mammalian lipids can incorporate alpha-gal.)
- Some people with AGS may also need to avoid cow, sheep, and goat milk dairy products
People with Alpha-gal Syndrome may also need to temporarily avoid the following supplements, which contain ingredients derived from mammalian meat:
- Porcine-derived thyroid hormone medication
- Ox bile
- Betaine HCl from a bovine or porcine source
- Pancreatic enzymes from a bovine or porcine source
- Organ meat supplements
- Vitamin D3 made from lanolin (vegan vitamin D3 is fine)
- Magnesium Stearate
Finally, carrageenan is a source of alpha-gal, though it comes from seaweed, not mammalian meat. Carrageenan is present in many processed foods, so you’ll want to watch out for this item on ingredient lists.
Foods that are Alpha-Gal Safe:
As far as we know, alpha-gal is not typically found in:
- Birds, like chicken, turkey, quail, duck and emu don’t normally express alpha-gal, although alpha-gal has been found in the ocular tissue (eyes) of some birds
- Most reptiles, like snakes, crocodiles, and lizards, although Green Sea Turtles have high levels of alpha-gal epitopes and cobra venom also contains it
- Alligator meat does not seem to be a problem for most people with AGS
- Amphibians, like frogs, with the exception of some amphibian eggs
- Fish or seafood except for flounder eggs and the eggs of some other teleost (bony) fish
- Crustaceans, like shrimp, prawns, crawfish, crabs, and lobster
- Mollusks, like oysters, mussels, and clams
- Plants, including fruits, vegetables, and grains
- Note that algae are not plants, and red algae (seaweed) do contain alpha-gal.
- Edible fungi, like mushrooms
- Exception: koji, which is made from aspergillus fungi
Making dietary changes is beneficial for those with AGS because it allows the body to calm down the inflammatory response, making for smoother sailing during tick borne infection treatment.
By working with a Functional Medicine provider at Kare Health & Wellness, patients work on repairing and healing the gut in order to return to optimal health as quickly as possible.
We are currently working with many patients who have an Alpha Gal Diagnosis. By using the Functional Medicine approach of remove, repair, restore, patients are learning to manage symptoms, reduce triggers and exposures, and find a better way to live and feel better.
If you’ve suffered with symptoms and have been given zero answers to why, it’s time to dig deeper. Connect with our team to find out how we can help you get your life back.