- Tick bites are being linked to an additional condition called alpha-gal syndrome, which causes a red meat allergy.
- New guidance reports some patients with alpha-gal syndrome may only exhibit GI symptoms, rather than typical symptoms like a rash or difficulty breathing.
- Alpha-gal is a sugar molecule that is found in mammals, like cows, pigs, and sheep in addition to tick saliva.
Summer is just around the corner, and with that, unfortunately, comes a rise in tick bites.
Tick bites are one of the few unfortunate side effects of warmer months and they are linked to all sorts of illnesses including Lyme disease, Southern tick-associated rash illness, and Rocky Mountain spotted fever, among others.
But now tick bites are being linked to an additional condition called alpha-gal syndrome, which causes a red meat allergy.
The link between red meat allergies and tick bites is not new. What is new, however, is the depth of understanding of the allergy and how it manifests itself in people. Most notably, patients may only exhibit GI symptoms, rather than typical allergic symptoms like a rash or difficulty breathing.
This observation is detailed in a new clinical practice commentary published in Clinical Gastroenterology and Hepatology, a journal of the American Gastroenterological Association.
“The symptoms [we are now aware of] include nausea, vomiting, and diarrhea. People would normally think along the lines of a gastroenteritis picture,” said Dr. Lisa Ganjhu, gastroenterologist and clinical associate professor of medicine at NYU Grossman School of Medicine.
“Alpha-gal syndrome has been around for a while. What’s new is the increased attention and awareness of the condition,” said Dr. Sebastian Lighvani, an allergist at Lenox Hill Hospital. “At its core, it’s a unique type of allergy in that the individual that becomes allergic is reacting to a sugar found in non-primate mammals. When individuals ingest this meat, that may trigger a reaction.”
Alpha-gal is a sugar molecule that is
“When the tick bites a human, it inserts alpha-gal into the skin, along with other proteins from the tick, and it initiates an immune response,” explains Lighvani. “Then the individual becomes sensitized to alpha-gal.”
The sensitivity to alpha-gal is what triggers the red meat allergy, as well as allergies to meat derivatives like gelatin.
The red meat allergy that tick bite patients can develop is different from other allergies, which is why it can be a difficult connection to make and a difficult allergy to diagnose.
“The allergic reaction can be anything from hives or a rash to full on anaphylaxis, which may mean your blood pressure drops,” said Lighvani. “And sometimes people have isolated GI symptoms. They eat food and later they get abdominal pain, nausea, diarrhea, but don’t have a rash. They may go to their physician and are told that they have IBS or a food intolerance, and no one looks for the alpha-gal allergy.”
The other factor that makes it difficult to diagnose is the delay between ingestion and reaction. There could be a window of
According to the new commentary, patients who have a history of tick bites or like spending time outdoors are at higher risk for the allergy. Additionally, a research paper published in Annals of Allergy, Asthma & Immunology says that people who get multiple tick bites (more than four) are also at higher risk.
“We really recommend against tick bites because they can re-aggravate and re-sensitize the individual,” said Lighvani. “If you get bitten multiple times it reinvigorates your allergic response.”
The best way to treat alpha-gal syndrome is abstinence from triggers. This includes meat like beef, pork, and lamb. It also may include products that contain gelatin like marshmallows, Jell-O, gummy bears, or even medicines that contain gelatin ingredients or gel capsules.
“In general, I’d say if you’re sensitized and reacting you need to be strict about avoiding alpha-gal in forms that trigger reactions,” said Lighvani.
If you or your primary care physician suspect that you may have this allergy, it can be diagnosed via a simple blood test. An allergist will do a workup, including the blood test to detect specific antibodies to alpha-gal. If these antibodies are detected, the allergist will educate the patient about the best avoidance practices.
Lighvani suggests also having an EpiPen available, seeing as the degree of allergic reaction can vary from person to person. Ganjhu also recommends carrying Benedryl with you, as that can numb the allergic response.
The best way to avoid the allergy overall is to avoid tick bites. The Centers for Disease Control and Prevention suggests the following to
- Use EPA-registered insect repellents.
- Avoid wooded and brushy areas.
- Walk in the center of trails.
- Check your clothing for ticks after coming inside.
- Examine gear and pets.
- Shower soon after being outdoors.
- Check your body for ticks, particularly the underarms, in and around the ears, inside the belly button, back of the knees, in and around the hair, between the legs, around the waist.
- Treat clothing and gear with products containing 0.5% permethrin.