Alpha-gal syndrome - Diagnosis and treatment (2023)



Health care providers can diagnose alpha-gal syndrome based on your personal history and certain medical tests.

Your health care provider will likely ask you:

  • Whether you've gotten tick bites or you've gone to places where ticks live.
  • What symptoms you have.
  • How long it took for the symptoms to start after you ate red meat or certain other foods such as mammal food products.

Your provider also might give you a physical exam.

Other tests used to diagnose alpha-gal syndrome may include:

  • A blood test. A blood test can confirm and measure the amount of alpha-gal antibodies in your bloodstream. This is the key test for diagnosis of alpha-gal syndrome.
  • A skin test. A health care provider pricks your skin and exposes it to small amounts of substances taken from commercial or fresh red meat. If you're allergic, you get a raised bump called a hive at the test site on your skin. Your provider or allergist also may test your skin for an allergic reaction to certain types of red meat. That's because there are different kinds of allergies to meat.

More Information

  • Allergy skin tests
(Video) Alpha-Gal Syndrome: From Diagnosis to (Ingredient) Detective - FARE Webinar


Alpha-gal syndrome treatment involves avoiding the foods that cause your reaction. Always check the ingredient labels on store-bought foods. Make sure they don't have red meat or meat-based ingredients, such as:

  • Beef.
  • Pork.
  • Lamb.
  • Organ meats.
  • Gelatins.

Check soup stock cubes, gravy packages and flavor ingredients in prepackaged products. Ask your health care provider or allergist for a list of foods to avoid, including meat extracts used in flavoring. The names of some meat-based ingredients make them easy to miss.

Be extra careful when you eat at restaurants and social get-togethers. Many people don't understand how serious an allergic food reaction can be. And few people know that meat allergies exist. Even a small amount of red meat can cause a serious reaction.

If you're worried that a food may contain something you're allergic to, don't try it. Do what you can to lower your risk. For example, you could bring your own food to a party if guests are making food on a shared cooking surface.

For a serious allergic reaction, you may need a shot of epinephrine and emergency care. Many people with allergies carry a device called an epinephrine auto-injector. It's a syringe and concealed needle that injects a single dose of medication when you press it against your thigh. If you've been diagnosed with alpha-gal syndrome, your doctor or allergist likely will prescribe an epinephrine auto-injector.

Symptoms of alpha-gal syndrome may lessen or even disappear over time. This is especially true if you don't get any more bites from ticks that carry alpha-gal. Some people with this condition can eat mammal food products again after 1 to 2 years if they don't get any more tick bites.

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Preparing for your appointment

To get the most from your appointment, it's a good idea to be well prepared. Here are some tips to help you talk with your health care provider.

(Video) Alpha gal syndrome | Symptoms | Causes | Treatment | Diagnosis

  • Write down your symptoms. Be ready to tell your provider what happened after you ate red meat. Include how long it took for a reaction to happen. Be prepared to describe the type and amount of red meat you ate.
  • Make notes if you've had tick bites or you've spent time in places where ticks may live. Your provider will likely want to know where you've spent time outdoors and how often. Your provider also will likely want to know how many tick bites you think you've gotten.
  • Make a list of all medications you're taking. Include vitamins or supplements.
  • Take a family member or friend along if you can. Sometimes it can be hard to recall all the information your provider gives you during an appointment. Someone who comes with you may remember something you missed or forgot.
  • Write down any questions you have.

Some basic questions to ask your provider include:

  • Are my symptoms likely caused by a red meat allergy?
  • What else might be causing my symptoms?
  • What tests do I need?
  • What's the best treatment?
  • Should I see a specialist?
  • Is there a generic version of the medicine you're prescribing?
  • Are there brochures or other printed material that I can take with me? What websites do you suggest?
  • Do I need to carry an epinephrine auto-injector?

What to expect from your doctor

Your health care provider will probably ask you questions, such as:

  • When did you begin noticing symptoms?
  • What type of meat did you eat and how much did you have before your symptoms started?
  • After you ate red meat, how long did it take your symptoms to appear?
  • Have you spent time outdoors in places where ticks live?
  • Have you been bitten by a tick in the past? How many times? What did the tick look like?
  • Did you take any allergy medicines that you can get without a prescription, such as antihistamines? If so, did they help?
  • Does red meat seem to trigger your symptoms? Do you get symptoms when you eat any other foods?
  • How bad are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to make your symptoms worse?

What you can do in the meantime

If you think you have alpha-gal syndrome, avoid eating red meat until your appointment. If you have a serious reaction, get emergency help.

By Mayo Clinic Staff

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Nov. 15, 2022

(Video) Doctor explains Alpha-Gal


  1. Steinke JW, et al. The alpha-gal story: Lessons learned from connecting the dots. Journal of Allergy and Clinical Immunology. 2015;135:589.
  2. Platts-Mills TA, et al. The discovery of IgE 50 years later. Annals of Allergy, Asthma & Immunology. 2016;116:179.
  3. Platts-Mills TA, et al. IgE in the diagnosis and treatment of allergic disease. Journal of Allergy and Clinical Immunology. 2016;137:1662.
  4. Commins SP. Allergy to meats. Accessed Feb. 25, 2020.
  5. Li JT (expert opinion). Mayo Clinic, Rochester, Minn. May 3, 2018.
  6. Meat allergy. American College of Allergy, Asthma & Immunology. Accessed April 13, 2018.
  7. Carter MC, et al. Identification of alpha-gal sensitivity in patients with a diagnosis of idiopathic anaphylaxis. Allergy. 2017; doi:10.1111/all.13366.
  8. Lone Star tick a concern, but not for Lyme disease. Centers for Disease Control and Prevention. Accessed April 13, 2018.
  9. Preventing tick bites. Centers for Disease Control and Prevention. Accessed April 13, 2018.
  10. Berg EA, et al. Drug allergens and food—the cetuximab and galactose-α-1,3-galactose story. Annals of Allergy, Asthma & Immunology. 2014;112:97.
  11. Anaphylaxis. American Academy of Allergy Asthma & Immunology. Accessed May 20, 2018.
  12. Sicherer SH. Management of food allergy: Avoidance. Accessed Feb. 25, 2020.
  13. Alpha-gal allergy. Centers for Disease Control and Prevention. Accessed June 2, 2020.
  14. Alpha-gal and red meat allergy. American Academy of Allergy, Asthma & Immunology. Accessed June 2, 2020.
  15. AskMayoExpert. Food Allergy. Mayo Clinic; 2020.
  16. Platts-Mills T, et al. Diagnosis and Management of Patients with the α-Gal Syndrome. Journal of Allergy and Clinical Immunology: In Practice. 2020; doi:10.1016/j.jaip.2019.09.017. Accessed Oct. 19, 2022.


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(Video) Walk with a Doc: Alpha-Gal Syndrome, Risk and Prevention


  • Alpha-gal syndrome


Alpha-gal syndrome - Diagnosis and treatment? ›

There's no treatment other than avoiding red meat and other products made from mammals. If you have a serious allergic reaction, you may need medicine called epinephrine and treatment at the emergency room. Avoid tick bites to prevent alpha-gal syndrome.

How do you diagnose alpha-gal syndrome? ›

AGS is diagnosed by an allergist or other healthcare provider through a detailed patient history, physical examination, and a blood test that looks for specific antibodies (proteins made by your immune system) to alpha-gal. Your healthcare provider may also recommend allergy skin testing.

What is the new treatment for alpha-gal? ›

Omalizumab may effectively treat food allergy symptoms in patients with alpha-gal syndrome, according to research from a small study that was to be presented at the American Academy of Asthma, Allergy & Immunology Annual Meeting.

What kind of doctor do you see for alpha-gal? ›

The Experts. If you can, make an appointment with an allergist who is an expert on alpha-gal syndrome.

What medications trigger alpha-gal? ›

For instance, magnesium stearate and gelatin are found in formulations of acetaminophen, naproxen, lisinopril, clonidine, and hydrocodone, and allergic reactions to these medications have been potentially linked to alpha-gal.

How do you test positive for alpha-gal? ›

At the time this is being written, antibody levels > 0.10 kU/L are typically considered a positive test result (10). Antibody levels >2 IU/ml or >2% of total IgE make the diagnosis of alpha-gal syndrome very likely (1). As with any allergy, false negatives also occur, although they are less common.

When do alpha-gal symptoms start? ›

Symptoms usually appear 2–6 hours after eating meat or dairy products, or after exposure to products containing alpha-gal (for example, gelatin-coated medications). People may not have an allergic reaction after every alpha-gal exposure. If you think you may have AGS see your healthcare provider.

Does alpha-gal eventually go away? ›

Symptoms of alpha-gal syndrome may lessen or even disappear over time. This is especially true if you don't get any more bites from ticks that carry alpha-gal. Some people with this condition can eat mammal food products again after 1 to 2 years if they don't get any more tick bites.

Does Benadryl help with alpha-gal? ›

Treating and preventing alpha-gal allergy

Allergic reactions to alpha-gal can be treated with an over-the-counter antihistamine such as diphenhydramine (Benadryl).

What makes alpha-gal worse? ›

Exercise, alcohol, recent tick bites, and nonsteroidal anti-inflammatory drugs (NSAIDs) may increase risk and/or severity. For patients with alpha-Gal Syndrome, there are several co-factors that may further increase the risk for a reaction or the severity of symptoms upon exposure to alpha-Gal.

What foods should you avoid if you have alpha-gal? ›

Food products that may contain alpha-gal
  • Gelatin made from beef or pork.
  • Products made from or cooked with mammalian fat (such as lard, tallow, or suet)
  • Meat broth, bouillon, stock, and gravy.

Can you eat cheese with alpha-gal? ›

Some individuals with alpha-gal allergy must also avoid dairy products made from cow's, sheep's or goat's milk. The good news is that all fruits, vegetables, grains, nuts, legumes, poultry, and seafood are appropriate for alpha-gal allergies.

What does alpha-gal feel like? ›

As with other food allergies, signs or symptoms of an allergy to alpha-gal may include: Hives and itching. Swelling of your lips, face or eyelids. Shortness of breath, cough or wheezing.

How do I get rid of alpha-gal? ›

Treatment for alpha-gal (AGS) syndrome typically involves avoiding foods with alpha-gal and taking medications to manage symptoms that may occur with accidental exposure. Your healthcare provider can work with you to help you avoid products and medications containing alpha-gal.

Does alpha-gal affect the brain? ›

Although the main function of the alpha Galactosidase A (alpha-Gal A) enzyme is to help the cell process lipids, it is also known to affect the level of alpha-synuclein, the sticky protein that clumps in the brains of people with Parkinson's disease (PD).

How long does it take to get over alpha-gal? ›

In most cases, alpha-gal syndrome is a lifelong condition. However, it does go away from some patients, sometimes after a few years.

Can alpha-gal be misdiagnosed? ›

Alpha-gal syndrome initially misdiagnosed as chronic spontaneous urticaria in a pediatric patient: a case report and review of the literature - PMC.

How long after a tick bite do you get alpha-gal? ›

Unlike most tick-borne pathogens, the onset of AGS usually takes at least 4-6 weeks from the time of the tick bite.

Can you eat eggs with alpha-gal? ›

For example, fruits, vegetables, nuts, seeds, grains, eggs, poultry, fish, and shellfish are all safe to enjoy on an alpha-gal diet.

Is alpha-gal syndrome an autoimmune disease? ›

Alpha-Gal Allergy Syndrome (AGS) The first alpha-gal allergy was reported in 2002 in the USA. Alpha-gal allergy syndrome (AGS) is not congenital or autoimmune. It is an acquired allergy that usually develops in adulthood primarily due to a Lone Star tick bite.

Can you eat butter if you have alpha-gal? ›

Additional foods that may pose a risk for those with alpha-Gal syndrome include soup-stock cubes, gravy packages, flavor ingredients in prepackaged products, meat extracts used in flavoring, dairy products (e.g., milk, cheese, yogurt, butter), canned tuna (which can be contaminated by dolphin or whale), chicken or fish ...

Can you eat bread with alpha-gal? ›

While highly sensitive alpha gals may want to look for vegan options that substitute plant-based ingredients for milk and butter, and some alpha gals may need to select breads made with vegan sugar (more on that below), bread is generally alpha-gal friendly.

Can you drink alcohol with alpha-gal? ›

Drinking alcohol or exercising after you eat may slow down the reaction time. Sometimes the symptoms of a reaction from an alpha-gal allergy can even lead to death.

Does exercise make alpha-gal worse? ›

Exercise and alcohol seem to be the most important co-factors for alpha-gal reactions. According to expert Scott Commins MD PhD, University of North Carolina: Activity, alcohol consumption, and exercise can have profound influence on reactivity.

Does alpha-gal cause brain fog? ›

Alpha-gal syndrome (AGS) is an allergy to mammalian meat and meat byproducts that is spread by the Lone Star tick. It's often misdiagnosed, with symptoms ranging from severe stomach pain and brain fog, to anaphylactic shock.

Does alpha-gal cause stomach issues? ›

In our study, patients with alpha-gal meat allergy developed GI symptoms—most commonly episodic abdominal pain, nausea, and diarrhea—without more traditional manifestations of food allergy such as hives, angioedema, or anaphylaxis.

Does ice cream have alpha-gal? ›

Foods made from high fat content milk, such as ice cream and whole cream, also may contain alpha-gal. Plasma expanders used in Europe and other parts of the world, such as polygeline (Haemaccel) and succinylated gelatin (Gelofusine) are also potential, albeit unlikely, sources of alpha-gal.

Can people with alpha-gal eat ice cream? ›

Most alpha-gal allergic individuals tolerate gelatin and moderate, lean dairy products. Avoidance of these items is not routinely recommended. In general, if someone is able to tolerate dairy, they are very likely to tolerate vaccines and medications with mammalian-based ingredients.

Can you eat bacon with alpha-gal? ›

It is in muscle and fat, which means steaks, bacon, and lamb chops are obvious no-no's for people with alpha-gal syndrome. But for people who are more sensitive to alpha-gal, dairy can also trigger a reaction.

What triggers alpha-gal allergy? ›

Alpha-gal syndrome is a type of food allergy. It makes people allergic to red meat and other products made from mammals. In the United States, the condition usually begins with the bite of the Lone Star tick. The bite transfers a sugar molecule called alpha-gal into the body.

Can alpha-gal affect your heart? ›

α-Gal sensitization is independently associated coronary artery disease phenotypes including noncalcified plaque burden and obstructive coronary artery disease. α-Gal sensitization occurs at higher frequency in patients with ST-segment–elevated myocardial infarction than those with stable or no coronary artery disease.

How does alpha-gal start? ›

Alpha-gal syndrome is caused when a tick bites you, and that bite gives you the alpha galactose molecule. In the U.S., the lone star tick is the primary source of alpha-gal allergy. The lone star tick is concentrated in the eastern and south-central regions of the U.S. and is carried by deer.

How long does it take for alpha-gal to go away? ›

In most cases, alpha-gal syndrome is a lifelong condition. However, it does go away from some patients, sometimes after a few years.

Is alpha-gal an autoimmune disease? ›

Alpha-Gal Allergy Syndrome (AGS) The first alpha-gal allergy was reported in 2002 in the USA. Alpha-gal allergy syndrome (AGS) is not congenital or autoimmune. It is an acquired allergy that usually develops in adulthood primarily due to a Lone Star tick bite.


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