Alpha-gal Syndrome, Ever Heard of It?

Alpha-Gal Syndrome - Ever Heard of It?

Alpha-Gal is not a late-night comedian's joke about your wife? It's a real disease that comes about in an unusual way. It all starts with a tick bite. That tick injects a tiny bit of "alpha-gal" sugar into its victim, and that induces an allergy to a sugar called alpha-gal from any other source. Its chemical name is galactose-alpha-1,3-galactose, two galactose molecules hooked together. It is naturally present in all mammalian meats, except hominids.

When humans, injected with "alpha-gal" and now immunologically sensitized to that sugar, eat beef, pork, lamb, goat...they get an allergic reaction. It may take a couple of hours to get wound up, but it can be very severe, even fatal. And it's not just the meat. Any mammalian food products like milk, cheese, and gelatin can set it off.

What are the symptoms? They may include hives; swelling of the lips, tongue, throat, or eyelids; cough; difficulty breathing; wheezing; heartburn; nausea or vomiting; abdominal pain; diarrhea; or decreased blood pressure.

Well, who cares? It's such a bonkers diagnosis, it's way too rare for me to worry about. Is it? Whoa, Nellia, it has been reported in over 110,000 people in the last decade. That's not all so rare. So, explain, how was it discovered.

Remember that animal protein connection? Well, if you want to read a real medical detective story, this is it. The monoclonal antibody, cetuximab, was approved in 2006 for the treatment of head and neck cancers. Some of the patients given it developed allergic reactions. A Dr Tina Merritt, at Fayetteville, Arkansas, had two severe cases and the detectives were off and running. When they looked at other cases of allergy to cetuximab, they found those patients had pre-existing IgE-specific antibodies for cetuximab and that the target of those antibodies was the oligosaccharide, galactose-alpha-1,3-galactose .

The researchers were puzzled. They found the allergy to the cetuximab only in a limited region of the country. Tick country. When they asked patients with the allergic reaction if they had had tick bites, they lit up and related that they had been bitten by Lone Star ticks and had had reactions to them. How's that for good detective work? (Sounds like a 60 Minutes story in the making...expect to see it come up some day.)

www.What will Work for me. This sounds arcane and trivial, aside from the fact that I was bit by a Lone Star tick at a family reunion in New York. We foolishly went for a walk, waiting for our family to arrive. We thought it would be nice to explore the local state park for possible future walks. We came back and had some 40 ticks on us and were frantically brushing them off. I found one embedded in my leg the next morning and pulled it out. Except, it didn't all come out. I was sick off and on for the next month, with fevers up to 101 every day and extreme fatigue, until the tick wound scab fell off and within hours, my fatigue cleared and fever disappeared. I was on Doxycycline the whole time, to no effect. It wasn't Lyme disease. I eat very little animal meat except chicken and fish (not mammals). There is something about ticks we don't fully understand. They carry more than just Lyme disease. Did I have a mild form of alpha-gal? We are at the end of summer. Ticks are everywhere. Please, please, please, get some DEET and wear long pants when you go in the woods. Or stay home with your real Alpha-Gal. Ditch the woods with grassy edges until the first frost.

References: Yale Medicine, JAMA Open Network, Jr Aller Clin Imm.,

Pop Quiz

1. What is alpha-gal?                          Answer: A sugar composed of two galactose molecules present in all mammals except hominids. 

2. What foods have galactose in them?                        Answer: Milk has lactose which is a sugar made by combining galactose and glucose. Celery has it. Cherries and avocados have it.

3. What is the syndrome?                         Answer: Allergic up to severe anaphylaxis

4. How is it caused?                         Answer: The Lone-Star Tick injects the alpha-galactose molecule on biting a person. That person then becomes allergic to animal products.

5. Is this worth-while talking about when it might be the rarest thing on earth?                            Answer: Time out. It's a new diagnosis but there have been 110,000 people diagnosed with it in the last 10 years. There are likely multiple of that who have had it. If you have weird, allergic type reactions to animal protein, including milk, gelatin (all those supplement capsules), you may have a mild form of it.