This is a sidebar to Allergic Living’s feature: Red Meat Allergy: How One Tick Bite Can Upend Your Diet and Your Life
When should I suspect that I’m allergic to alpha-gal?
People with red meat allergy will have symptoms that range from hives to flushing and abdominal distress. Patients can have quite mild symptoms (itchy hives are common) or experience a full anaphylactic reaction including loss of consciousness. Abdominal symptoms tend to be severe, and can be in the form of cramping, vomiting, nausea and diarrhea, says Dr. Erin McGintee, an allergist in Southampton, New York.
Another telltale alpha-gal sign: the symptoms come on three to eight hours after consuming mammal’s meat, or a by-product like gelatin, which is found in foods from gravies to desserts and in some medications. Risk of the allergy is higher in the southeastern and eastern United States.
How do I confirm the allergy?
Get a referral to an allergist who will review your history of symptoms and conduct a blood test that looks for IgE antibodies to the alpha-gal carbohydrate. Skin-prick testing hasn’t been reliable for alpha-gal allergy, so it’s not commonly used.
One recent concern: in 2023, the CDC published a survey with U.S. health-care providers and found almost half were not aware of alpha-gal allergy, while others did not feel confident about diagnosing. Allergists, however, have been much better informed on this emerging condition, so remain the best choice for an informed diagnosis.
I have the red meat allergy. How did I get it?
In the United States, if you have a red meat allergy you probably got bitten by a Lone Star tick, which sensitized you to alpha-gal. But alpha-gal allergy is a global problem, with cases in Europe and Australia, where it is triggered by other species of ticks. Dr. Scott Commins, a University of North Carolina researcher, wonders if there are other blood-sucking insects that could also trigger the allergy, like mosquitos, but so far this is just a question to research. Currently under study: figuring out why some people bitten by Lone Star ticks get the allergy, while others don’t.
At the American Academy of Allergy, Asthma and Immunology meeting in 2018, two additional connections were revealed:
- People with alpha-gal allergy are more likely than others to also be allergic to stinging insects, such as wasps or hornets.
- Patients with blood types B or AB are five times less likely to develop red meat allergy than patients with other blood types.
Are there any treatments for alpha-gal allergy?
Currently, alpha-gal allergy is managed by avoiding consumption of red meat. Some people also have to avoid dairy products as well as gelatin. Your doctor will advise you to carry two epinephrine auto-injectors in case of a reaction.
Can you “lose” this allergy?
Red meat allergy, or allergy to alpha-gal, fortunately does resolve for many people over time, as long as they don’t get another tick bite. “We believe that, in most patients, if you can go long enough without getting bitten again, the allergy goes away,” says Commins. He is working on finding a way to desensitize a person to tick saliva, so that future bites won’t bring back the allergy.
I’ve been bitten by a Lone Star tick. Should I be tested?
McGintee doesn’t advise this, since many people won’t develop the red meat allergy, and even a positive test “doesn’t necessarily mean you’re going to have an allergic reaction.”
However, since those who do develop the allergy often report symptoms soon after the tick encounter, she recommends avoiding high-fat red meat a month or so after a bite. She calls this the “high-risk window,” and most severe reactions develop from fattier meat meals, such as a burger or a rack of ribs. After a month, McGintee advises adding small amounts of meat back into your diet. If symptoms develop, stop red meat and contact your doctor.
AVOID Those Ticks!
To prevent the bite of the Lone Star (as well as other ticks), experts recommend avoiding wooded and bushy areas. If you are in the woods, walk in the center of trails.
In areas known for ticks:
- Wear long sleeves and pants. Light-colored clothes help you to spot ticks.
- Tuck pants into socks, even tape clothes to prevent openings.
- Use a repellent on skin with DEET, picaridin or IR3535. (Parents must apply to kids.)
- Treat clothes and boots with repellents with 0.5% permethrin.
Once back home:
- Shower right away to wash off any ticks.
- Using a comb, check kids’ hair for ticks, and have someone check yours.
- Also check in the folds of skin and behind the ears.
- If you find a tick: Don’t panic. Use tweezers to grasp the whole insect, and pull it out.
- For washing clothes, either use hot water or spin dry for an extended period.
- Also check pets and gear closely for ticks.
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