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What is Alpha-gal Syndrome? · Talking FACS

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  Welcome to Talking FACS, what you need to know about family,
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  food, finance, and fitness.
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  This nationally recognized, award-winning podcast is hosted by the University
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  of Kentucky Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals, families,
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  and communities to improve quality of life.
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  Hello, and welcome to Talking FACS, what you need to know about family,
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  food, finance, and fitness.
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  I am your host, Mindy McCulley, Extension Specialist for Instructional Support
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  with Family and Consumer Sciences, Extension at the University of Kentucky.
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  We are housed in the Martin-Gatton College of Agriculture, Food, and Environment.
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  It's summertime, and with summertime comes ticks.
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  So you may have heard of this somewhat new syndrome called Alpha-gal.
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  And so my guest today, Dr. Heather Norman-Burgdolf, who is our Extension Specialist
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  for Food and Nutrition is here to talk about alpha-gal, which is a red meat
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  allergy, but it is related to ticks.
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  And so let's just dig into this.
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  Heather, help me understand. First of all, we're hearing more about alpha-gal, the red meat allergy.
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  So what is this and how do we get it?
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  You know, extension is crazy because you never know what you're going to talk
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  about. So here I am food nutrition, but talking about a tick-borne condition.
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  And you're exactly right. The number of questions we're getting about alpha-gal
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  just keep going up when it comes to extension across the state.
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  So like you said, alpha-gal syndrome is also known as the red meat allergy,
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  and it's an allergic condition, an allergic reaction.
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  And it's relatively new. Like you mentioned, it was actually first identified
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  in 2002 and then independently confirmed in 2007.
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  So really that's not that long ago.
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  And even though we've known about it for a little bit, there's still a pretty
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  big lag in people knowing about it, understanding it, and even our own healthcare
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  providers diagnosing and helping our patients manage it.
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  Now, like you said, it starts with ticks. So the current data suggests that
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  it is spread by bites specifically from lone star ticks.
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  We haven't seen any other ticks that have been associated so far.
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  And so what actually happens is that these lone starticks,
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  they're going to bite an animal, ending up with the alpha-gal sugar molecule.
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  In their mouth, in the tick's mouth.
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  And alpha-gal is actually short for that specific sugar molecule,
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  which is actually galactose alpha-1,3-galactose.
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  So I don't expect you to remember that, but that's where alpha-gal comes from.
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  So then when they bite that person, they may accidentally inject that sugar
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  molecule into the bloodstream, the human.
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  Now, humans don't normally have alpha-gal in our blood. And so when a tick passes
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  it to a person, that body could potentially mount an immune response,
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  thinking that sugar is a foreign invader.
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  Now, alpha-gal is present in a lot of red meat and animal products that humans
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  eat, even after we cook it. So cooking food doesn't remove it.
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  And so if the body encounters alpha-gal again in the future,
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  in the stomach after eating, it's going to mount that same immune response,
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  kind of causing that allergic reaction.
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  Now, I'm not an entomologist. You know that.
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  You know, I don't study ticks, but UK does have a lot of resources through our
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  UK entomology department within the College of Agriculture that also will be helpful.
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  So maybe at the end of the show, we could link to some of their resources that
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  gives a little bit more information specifically about the TIC.
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  However, I am happy to kind of talk about the health side of things,
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  the management strategies, and the dietary changes that are required.
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  Definitely. And we definitely will link in the show notes to those additional
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  resources that we do have.
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  I get tickled because alpha-gal sounds to me as you talk about it like it's
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  something from outer space. And then you call it a foreign invader.
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  And so it really does have that otherworldly sound. There's a lot of unknowns still to that.
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  So it kind of goes right along with it.
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  So what are some of the symptoms that we might see in someone who is experiencing alpha-gal?
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  So as with other allergic reactions, alpha-gal can cause symptoms such as skin
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  irritations, hives, gut issues, even breathing problems. In serious cases,
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  it can cause anaphylactic shock.
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  So the severity of the condition is really different for everyone.
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  But I will say, unlike a typical food allergy you might be familiar with,
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  a person with alpha-gal usually has a delayed allergic reaction anywhere from
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  like three to six hours later after they've eaten meat or any other product
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  that may come from a mammal.
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  And so this is one of the reasons why it's been difficult to diagnose is because
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  you You don't have those allergic reaction symptoms immediately after you eat. So how is it diagnosed?
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  You can't self-diagnose this one. So you've got to work with a healthcare provider.
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  They're going to take a patient history, most likely do a physical exam,
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  and you will have to do a specific blood test in order to be diagnosed. Okay.
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  So what are the best ways to manage alpha-gal once you've found out that you
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  have it and you have to live with it? I wish I could say there's a treatment, but there's not.
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  So really what we've got to do is make,
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  some lifestyle changes in order to manage the symptoms or to reduce the symptoms
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  that someone may be experiencing.
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  So if you have alpha-gal, you must remove all red meat.
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  So this is going to include beef, pork, and lamb from the diet to avoid allergic reactions.
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  We also know that certain cuts and types of meat actually have higher amounts
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  of alpha-gal and can cause worse reactions. So this is usually true of organ meats.
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  So if people actually eat liver, heart, tripe, those types of of things,
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  it actually has higher levels and can have a more severe reaction.
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  And then there are a lot of other foods that are made with ingredients from
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  mammals that can cause reactions. So thinking about broths and bouillon and
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  stocks and gravy, even items that are made with lard or tallow could cause reactions.
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  And then also since we're in Kentucky, we really need to be mindful for those
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  who hunt because wild game are also sources of alpha-gal. So this includes everything
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  from venison to squirrel.
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  So what about those products that contain red meat or the byproducts?
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  Do they cause those severe reactions as well?
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  Yeah. So just within the way our food system and how food is manufactured,
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  we have lots of food additives that have ingredients from animals that could also cause a reaction.
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  So some key words to kind of look for would be gelatin, glycerin,
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  bovine, or bovine extract.
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  So if you are living with alpha-gal, you're going to have to really look at
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  those ingredients labels and the ingredients list to see if you see any of those keywords.
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  And then not necessarily food, but some prescribed medications and medical treatments
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  can also cause reactions.
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  This could be heparin, antivenoms, certain chemotherapy drugs,
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  even heart valves are derived from pigs or cows could cause reactions.
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  So always ask if that prescribed medication or suggested treatment causes a
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  reaction for those living with alpha-gal because you just don't know.
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  And that's a great question just to kind of be informed when you're having a
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  conversation about your care with your provider.
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  And then I'll bring up dairy really quick too, because what we see in the literature
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  is that some people with alpha-gal can still tolerate dairy,
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  but it's different from person to person.
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  I haven't personally met someone who can actually tolerate dairy very much,
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  but if you have a mild case of alpha-gal, you still may be able to include some
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  types of dairy within your diet. It's just different from person to person.
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  So once someone has contracted alpha-gal, is it something that they are going
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  to live with for the rest of their lives or are they going to kind of outgrow it?
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  It's a good question. And I think we do need a lot more science to kind of have
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  a better understanding.
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  But what we have seen is that symptoms of alpha-gal may decrease over time,
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  particularly if further bites from lone star ticks are prevented.
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  And so maybe over the course of one to two to three years, you might actually
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  see that symptoms are reduced and that you could slowly introduce some of those
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  foods back into your diet.
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  Again, we really need more science to better understand.
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  And then also I just want to bring up that we're hearing lots of stories and
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  experiences from people who have negative side effects with things that aren't food or medication.
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  So personal care items that include ingredients from mammals are even causing issues.
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  So again, I think there's a lot for us to still learn and every person's experience
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  with the syndrome is going to be really different.
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  Well, and as you said at the beginning of the show, it's relatively new.
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  So there's always more to learn. Absolutely.
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  As you mentioned, there's a lot of red meat and dairy that people aren't able to eat.
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  So I'm guessing that people are concerned about how they can get protein into their diets.
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  Yes. I'm glad you brought this up because this is probably the number one question
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  we've been getting, our extension agents have been getting, is about what about protein? What's left?
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  It seems like everything that's high in protein is taken away.
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  But luckily, there are high protein foods that do not contain alpha-gal.
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  So yes, you're going to have to shift your diet.
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  And these foods include poultry. So all forms of poultry are still safe.
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  So that includes chicken, turkey, duck, quail. It does not have alpha-gal.
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  So it is not going to cause those same reactions.
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  So right there are some great options. And seafood also is still safe,
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  as well as eggs, beans, nuts, and seeds.
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  So yes, still some high-protein foods out there. And then always we can incorporate
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  whole grains, vegetables, fruits.
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  I've gotten lots of questions about recipes and how to prepare food for people who have alpha-gal.
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  And if you have access to the internet, it may be helpful when you're looking
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  for recipes to look for dairy-free or vegan recipes, which likely eliminate
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  any ingredients that are going to cause a reaction.
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  And if anything that could be helpful in teaching you or showing you ideas or
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  suggestions on how to adapt recipes, or what are some substitute ingredients you could use?
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  If you really like cheese, but you can't tolerate dairy, what are vegan mac
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  and cheese recipes using in order to make that experience of cheese?
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  So you could learn a little bit from those as well. But I really encourage anyone
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  if they know they're diagnosed with alpha-gal to to work with a healthcare provider,
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  ask for a registered dietitian that can really help you make that major shift in your diet over time.
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  And for those who may be concerned, what are some ways that we can prevent alpha-gal?
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  Yeah. So Kentucky is one of the states with the most cases of alpha-gal in the
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  U.S. It's according to the CDC.
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  Like I can't believe my own parents don't have this, knowing how much time they spend outside.
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  So yeah, we can be proactive. We can be safe about it.
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  Wearing repellents while outdoors. So this could be DEET or picardin.
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  Oil of lemon eucalyptus has actually been shown to prevent tick bites.
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  Treating your clothes with permethrin can also help. And we do know that Lone
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  Star ticks are most active as adults and nymphs from March to August.
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  So specifically being mindful in those warmer months when you're outside,
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  because especially if you're going to be in an overgrown, weedy area or even
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  along trails or paths, being mindful.
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  Just some simple steps to be proactive.
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  And also, I would say if you're out with the animals, you know,
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  if you've got your pets with you, make sure they've probably been treated for
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  ticks. And so the pigs aren't going to latch onto them, but they're going to
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  find the next most willing victim. So that's probably you.
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  Good point. Good point. Yeah. And I have several resources I'm happy to share that we can link.
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  We have a brand new fact sheet on AlphaGal that might be useful for people to
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  kind of use as a reference tool and some helpful websites that we can share as well.
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  Yes. And we will definitely link those in the show notes.
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  Well, I have learned a lot today, Heather. So I really appreciate that you have joined us,
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  and I'm hoping that our listeners have learned something new today and will
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  actually take this information and use it to benefit their summer activity and
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  try to avoid those Lone Star ticks.
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  Thank you for having me back. If you are just tuning in, you're listening to
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  Music.