Alpha-gal syndrome is a food allergy triggered by an immune response to a sugar molecule called alpha-gal, which is found in the meat of mammals such as beef, pork, and lamb. The condition is most often associated with certain tick bites, which can sensitize the immune system to alpha-gal and lead to allergic reactions after eating mammalian products.
What Is Alpha-Gal Syndrome?
Unlike most food allergies, alpha-gal syndrome involves a delayed allergic reaction. Symptoms may occur several hours after eating red meat or products containing mammalian ingredients. The delayed timing and range of possible symptoms can make diagnosis challenging without specialized evaluation.
Symptoms and Delayed Reactions
Symptoms of alpha-gal syndrome can vary in severity and may include:
- Hives or itching
- Swelling of the lips, tongue, or throat
- Gastrointestinal symptoms (nausea, abdominal pain, vomiting)
- Respiratory symptoms (wheezing or shortness of breath)
- Dizziness or fainting
Because reactions may not appear until hours after eating, alpha-gal syndrome is often mistaken for other conditions.
Why Alpha-Gal Syndrome Is Often Missed
Alpha-gal syndrome is frequently underrecognized because the delayed timing of reactions does not follow the typical pattern of immediate food allergies. Symptoms that occur hours after eating may be mistaken for gastrointestinal illness, food intolerance, or unrelated health issues. Accurate diagnosis requires familiarity with the condition, a detailed clinical history, and appropriate testing.
When to Seek an Allergy Evaluation
Consider an evaluation if you or your child:
- Experience delayed reactions after eating red meat
- Have a history of tick exposure
- Notice unexplained nighttime symptoms after meals
- Develop symptoms involving skin, breathing, or gastrointestinal distress
Early and accurate evaluation helps ensure appropriate testing and safety planning.
How Alpha-Gal Syndrome Is Evaluated
Evaluation for alpha-gal syndrome includes a comprehensive review of symptoms and exposure history, along with blood testing when appropriate. Diagnosis is made based on clinical history and test results. A careful evaluation helps tailor avoidance strategies and emergency planning.
Safety, Avoidance, and Emergency Planning
Management of alpha-gal syndrome focuses on:
- Avoiding triggering foods and products with mammalian ingredients
- Recognizing hidden sources of alpha-gal (e.g., gelatin in medications or processed foods)
- Having an emergency action plan and access to medications such as epinephrine
- Ensuring asthma, if present, is well controlled to reduce overall risk
Asthma control is an important part of allergy and food allergy safety for patients with alpha-gal syndrome.
Alpha-Gal Expertise at Midwest Allergy & Asthma
Dr. Alice Knoedler has specialized expertise in the evaluation and management of alpha-gal syndrome. She trained under Dr. Thomas Platts-Mills at the University of Virginia, where alpha-gal syndrome was first identified. Dr. Knoedler’s experience includes recognizing atypical and delayed allergic reactions, guiding appropriate testing, and developing individualized management and safety plans for patients with suspected or confirmed alpha-gal syndrome.
Next Steps
If you suspect alpha-gal syndrome or have experienced delayed reactions after eating red meat, schedule an allergy evaluation. Your allergist can assess symptoms, review testing options, and help develop a personalized safety and management plan.
Call Midwest Allergy & Asthma at (651) 702-0750 for more information or to schedule an appointment.