Learning about alpha-gal

You may have heard about the increase in alpha-gal cases in southern Indiana earlier this year. What you may not know is how much it can affect individuals.

Check out the Q&A below from dietitians with the IU Health Endocrinology team in Bloomington to learn more.

What is alpha-gal?

Alpha-gal syndrome (AGS) is caused by a sugar molecule in the saliva of certain ticks that makes people allergic to red meat and other products made from mammals.

This is a serious food allergy, and the treatment is to avoid mammalian meat and products made from the byproducts of mammals, such as lamb, beef and pork.

What are the symptoms?

Symptoms include an itchy rash or hives, swelling of the lips, tongue, throat or eyelids, stomach pain, diarrhea nausea or vomiting, heartburn or indigestion, coughing, shortness of breath or difficulty breathing and a drop in blood pressure.

Symptoms usually appear 3 – 6 hours after consuming red meat or other mammalian products, and they can lead to life threatening issues.

How common is it, especially in this area?

An estimated 450,000 people in the United States have AGS. In Indiana, this is not a state reportable condition so there is no data.

Below is a map from the Centers for Disease Control and Prevention showing the geographic distribution of suspected AGS cases per 1 million population per year from 2017 – 2022.

How is it diagnosed?

AGS is diagnosed with a blood test looking for the presence of immunoglobulin- E (IgE) antibodies specific to alpha-gal. A skin test may also be performed for allergic reaction to red meat.

Is it something you will have for the rest of your life?

This is a lifelong condition for most people, but it can go away for some. Antibody levels against alpha-gal decrease over time and some people can eat meat again after a few years.

The recovery period can take 8 months to 5 years.

Why would you need to work with a dietitian if you have alpha-gal?

A dietitian can recommend an AGS avoidance diet that is nutritionally complete and includes protein options like fish, poultry and seafood.

They can also teach individuals how to read food labels and identify ingredients that trigger AGS. Additionally, they can educate patients, families and foodservice teams about AGS.

Is there anything else you’d like to share about alpha-gal?

Alpha-gal is becoming more common as a diagnosis and there is a need for education about it so we can reduce the risk of misdiagnoses.

Please reach out to your primary care provider if you have symptoms of AGS.