In March, I introduced my readers to Alpha Gal Syndrome (AGS) including what it is, how it is contracted and the potential sequela that persons with AGS can experience if they ingest mammalian protein, mainly cow, pig and lamb products.
If you’re reading this blog series, you’re obviously interested in the topic. This is likely because either you, or someone you know experiences bad effects from eating cow, pig and lamb products. These adverse effects can include1:
Skin: Hives, itching, or a rash (especially on the palms and soles of the feet) and swelling of the lips, face, or throat.
Digestive: Severe stomach pain, cramping, nausea, vomiting, or diarrhea.
Respiratory: Coughing, shortness of breath, or wheezing.
Cardiovascular: A sudden drop in blood pressure, dizziness, or fainting.
Remember that all of these symptoms may not appear in every person as everyone’s immune system is unique to them. Also keep in mind that the aforementioned symptoms might not appear right away and can be delayed. People may not notice symptoms for hours, or longer, after eating a suspect meal.
Keystone Pharmacy is located in Michigan. AGS hasn’t quite reached epidemic levels in the northern United States yet. The disease is mostly spread by the Lone Star tick which is rare in Michigan. However, it can be passed by the blacked legged tick (aka the common deer tick) which is very prevalent in the northern United States including Michigan. In addition, people travel. People from the north love to travel south and may visit an endemic area for Lone Star tick infestation. They can contract the illness without even realizing it. This map shows the area in which the Lone Star Tick has been reported in 2026.
The following map shows suspected AGS cases from 2017 through 2022. One can notice that, although centralized in the mid to south eastern part of the United States, cases of AGS have been reported in the north and the syndrome seems to be spreading.
The question remains: How does someone know if they have AGS or simple indigestion? The CDC has a great site which addresses testing and diagnosis2. Diagnosis relies on:
- A detailed patient history
- Physical examination
- Symptoms
- Whether allergic reactions are delayed
- History of tick bites or outdoor exposure
- Testing
There are 3 basic types of testing to diagnose AGS including blood tests, skin tests and testing panels.
Blood tests:
The blood test looks for specific IgE antibodies the immune system produces in response to the protein Galacatose-alpha 1-galactose molecule. However, a positive alpha-gal sIgE test does not mean a person has AGS. False positive alpha-gal specific IgE tests may occur in people who do not have AGS, particularly in regions with lone star ticks. Conversely, false negative results can appear too. If a long time has elapsed since the tick bite or exposure to mammalian proteins, the IgE levels in the blood may not be at a high enough level for positive results to be realized. Several large laboratories such as Quest Diagnostics and LabCorp conduct these tests. Your physician or allergist can direct you to the best source of testing in your area.
Skin tests:
Your allergist would be able to conduct a skin test to determine if someone has an allergy to galactose-alpha-1-galactose molecule. The skin is a very sensitive organ to allergens. The allergist takes some allergen extract, applies it to the skin and then uses a needle to prick the skin. A visible reaction becomes present after the skin prick. Your allergist can interpret the test to determine the degree of allergy to the molecule.
Combination tests and testing panels:
Because IgE alone may not be adequate to diagnose AGS, some laboratories offer a combination test. LabCorp offers a combination IgE testing and red meat testing. Their website lists the cost of the combination test at $1493. Quest Diagnostics has a similar test that measures the combination of Beef (f27) IgE, Lamb (f88) IgE, Pork (f26) IgE and Galactose-Alpha-1,3-Galactose (Alpha-Gal) IgE. Pricing was not listed on their website4.
If in doubt which test to receive, contact your physician or allergy specialist. In the next article, we will examine how to manage AGS and in the final article of this series, we will explore what medications to avoid and how to obtain medications that are not shown to aggravate AGS. You can find our previous article on Alpha-Gal Syndrome right here.
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