Sep
23
2023

Allergies to Red Meat after a Tick Bite

By | Allergies, anaphylactic reaction, food, Prevention, red meat

A new disease has arrived, allergies to red meat after a tick bite. This condition has surfaced in Australia and in the southeast of the US. It is linked to the bite by a lone star tick. Researchers determined that alpha-gal, which is galactose-α-1,3-galactose from the saliva of the tick is responsible for causing an allergy. Meat from mammals also contains alpha-gal. Due to a cross reaction between a lone star tick bite and alpha-gal in beef and other meats a person can develop a sensitivity to alpha-gal. This has the name alpha-gal syndrome (AGS). Between 2010 and 2022 the CDC recorded about 110,000 suspected cases of AGS in the US.

Symptoms of alpha-gal syndrome

A person who was previously sensitized by a lone star tick bite often only gets symptomatic after eating beef. The symptoms are hives, a skin rash, nausea or vomiting, heartburn or indigestion and diarrhea. Other symptoms could be a cough, shortness of breath, difficulty breathing or a drop in blood pressure. Some patients develop swelling of the lips, throat, tongue, or eye lids. Others complain of dizziness, faintness or severe stomach pains. These symptoms usually develop 2 to 6 hours after eating a meal with beef or dairy products. The person who was previously bitten by a lone star tick was sensitized following this encounter and produced specific antibodies against alpha-gal. The second encounter of the body from ingested alpha-gal containing food is the reason why the allergic reaction takes place. The more alpha-gal is ingested by different foods that contain it, the more severe the allergic reaction becomes.

Diagnostic tests for alpha-gal sensitivity

Allergists have the following tests available to them to check your immune system.

  • One test is called the alpha-gal U953 immunocap, a blood test.
  • The mammalian meats immunocap (Beef, Lamb, Mutton, Pork and Rabbit are available) shows specific antibodies as a result of exposure to these meats.
  • In severe cases of alpha-gal sensitivity blood tests for a mast cell tryptase level may also be necessary. This test can distinguish between a higher or lower risk of alpha-gel sensitivity. Tryptase is an enzyme, which is higher in people with mastocytosis. There is often an elevation of tryptase in patients who have allergies to both insect bites and tick bites.

Foods that contain alpha-gal

The Australasian Society of Clinical Immunology and Allergy describes in great detail what foods contain alpha-gal and what not. The main culprit in developing alpha-gal syndrome is mammalian meat. The most popular among these is beef, but veal, pork, lamb, buffalo, venison, rabbit and guinea pig also belong into this category. Other meats are deli meats like bacon, ham, salami, silverside, chorizo, prosciutto and others. When a person reacts to eating one or more of these items, we are dealing with a cross reaction. It is between the alpha-gal from the original tick bite and alpha-gal from the meat the person ingested.

There are more obscure mammalian meats that contain alpha-gal: whale, dolphin, seal, goat, kangaroo, wallaby and possum. But gelatin products and fats from mammals also contain alpha-gal.

What foods do not contain alpha-gal?

The following foods are OK to eat for people with alpha-gal sensitivity: chicken, mollusks, crustaceans, turkey, quail, goose, fish, duck, eggs, legumes, lentils and soy products (tofu, tempeh). According to the allergy.org website, you have to be careful about jams, soups and gravies, as merchants often mix gelatines into their products. Stay away from energy drinks with taurine, sausages (even chicken sausage) and cheese spread. Avoid rennet, jelly-based lollies, mousses and desserts. All of them contain alpha-gal.

Treatment for alpha-gal syndrome

There is no known treatment for sensitivity to alpha-gal. However, experience has taught allergists that strict avoidance of alpha-gal in food improves the symptoms. After about 3 to 4 years of a strict diet that excludes alpha-gal many patients are no longer sensitive to alpha-gal and can tolerate a certain amount of alpha-gal in their diet. But others continue to be sensitive to alpha-gal. They have to adhere to strict avoidance of alpha-gal in food and stay away from tick bites.

Allergies to Red Meat after a Tick Bite

Allergies to Red Meat after a Tick Bite

Conclusion

A new condition, alpha-gal syndrome has joined the rare, but important group of new diseases. It is a sensitivity to a sugar, called galactose-α-1,3-galactose, or alpha-gal. It is present in the mouth and saliva of the lone-star tick in the US and Australia. A bite from this tick can be the first sensitizer in a human. But unfortunately, alpha-gal is also present in many foods as mentioned in detail above. Repeated exposure to alpha-gal regardless of the origin causes hypersensitivity, which can get life-threatening. There is no treatment for this condition other than to adopt a very meticulous avoidance of alpha-gal in the diet. After 3 to 4 years of such a diet the hypersensitivity to alpha-gel disappears in many, but not in all patients. When the hypersensitivity persists, the patient has to continue with the alpha-gal avoidance diet.

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Dec
17
2022

Mast Cell Activation Syndrome

By | alcohol, Allergies, anaphylactic reaction, diet, immune system, Inflammation

Mast cell activation syndrome (MCAS) also goes by the name of systemic macrocytosis. That is to say it is a syndrome where mast cells are multiplying abundantly and secreting the inflammatory substances histamine, leukotrienes and cytokines. Certainly, people who suffer from MCAS can get severe anaphylactic reactions, but an epinephrine injection can often stop this.  Indeed, the physician must look for potential triggering factors like alcohol, spicy foods, exercise, insect stings, possible heavy metal accumulation or certain medications. In some cases heavy metal accumulation could also be a factor that triggers mast cells to release histamine.  In these cases a series of 20 chelation therapy sessions would be stabilizing.

Symptoms of mast cell activation syndrome

  • When there is skin involvement in patients with mast cell activation syndrome, they get flushing, itching and skin rashes.
  • With gastrointestinal involvement patients experience nausea and vomiting, bloating, abdominal pain, diarrhea and reflux (GERD).
  • Patients with neurological symptoms develop brain fog, headaches, cognitive problems, tremors and anxiety/depression.
  • When MCAS affects your endocrine glands, you may develop bone pain, bone lesions or weak bones.
  • Patients where the heart is affected may be fainting, their blood pressure may fluctuate between with high or low readings and they may experience heart palpitations.
  • When your respiratory system is affected, your lungs may be wheezing and you may develop nasal congestion.
  • More symptoms
  • The most dangerous symptom is anaphylaxis. This is a life-threatening allergic reaction where your air way entry could close off.
  • Any of these symptoms can get triggered by heat, cold or temperature changes. Stress, friction, insect bites or stings can also trigger a reaction. Additional factors can be environmental odors or perfumes, certain foods or medicine, alcohol and contrast dyes.

Diagnosis of mast cell activation syndrome

The most appropriate specialist to see is an allergist or immunologist. Other specialists could be a dermatologist, gastroenterologist, hematologist or endocrinologist. You will need blood tests like a serum tryptase level, which is a marker for mast cell burden. It is best to get a baseline tryptase level and also get a tryptase level after a mast cell reaction. In addition, you need a 24-hour urine collection for a number of mast cell activators. Depending on where your mast cell activation syndrome is located you need a skin or bone marrow biopsy.

More possible tests

The physician may decide to do an endoscopy or colonoscopy of the gastrointestinal tract. The pathologist can do several staining procedures with biopsy material to specifically look at mast cells. If there is a strong family history of mast cell activation syndrome the physician may decide to do genetic tests. In order to assess mast cell damage, your doctor may order a bone density test and bone scans including CT scans of the abdomen and chest.

Treatment of mast cell activation syndrome

The treatment of mast cell activation syndrome consists of a combination of multiple steps. First, if there is a life-threatening anaphylactic reaction, the patient applies an epinephrine injection. The physician taught the patient earlier how to do an epinephrine injection. This stops the sudden, rapid release of mediators from mast cells. After the epinephrine injection the patient needs transport to the nearest ER of a hospital for follow-up care. It is important that any patient with this syndrome should carry injectable epinephrine( an Epi-Pen) at all times.The purpose of treatment against mast cell activation syndrome is to block reactivity of mast cells or to stop the effects of mast cell mediators.

A number of medications are available to do this.

You can lower your risk of getting mast cell activation syndrome by watching your diet. Here is a list of the foods that will protect you:

Mast Cell Activation Syndrome

Mast Cell Activation Syndrome

Conclusion

Mast cell activation syndrome is a complex disease entity. Often there are several factors that contribute to this. Conventional medicine still cannot offer a treatment modality that will cure this condition, the only possibility is to control it. The physician must therefore use a combination of treatment modalities in order to help the patient with this condition. In cases of heavy metal accumulation several treatments with chelation therapy are beneficial. With an acute anaphylactic reaction, the

Mast Cell Activation Syndrome applies an epinephrine injection, which will stabilize the condition. But the patient should now follow this up with a series of blood tests in the emergency department of a hospital.

Treating mast cell hyperactivity

The purpose of treating mast cell activation syndrome is to block reactivity of mast cells or to stop the effects of mast cell mediators. H1 and H2 antihistamines help for gastrointestinal hyperactivity. Cromolyn sodium and ketotifen are mast cell stabilizers. Leukotriene inhibitors such as montelukast help to stabilize the mast cells to not secrete cytokines, which cause inflammation. Aggressive mast cell disease may require chemotherapy treatment, similar to what is needed to treat cancer.

The purpose of treatment is to help the patient control the mast cell hyperactivity. At this time medical science does not have all the answers. Unfortunately, at this point conventional medicine has no cure for this syndrome, but it can be managed with a lot of attention to the symptoms.

Jun
18
2022

Tick Bites Can Render You Allergic to Red Meat

By | Allergies, anaphylactic reaction, immune system, red meat

Tick bites can render you allergic to red meat. This comes from the alpha-gal syndrome, which is a type of food allergy. It is a tick with the name of Lone Star tick that transmits this syndrome in the southeastern United States.

Deer carries the Lone Star tick into other parts of the US. The bite of the tick transfers a sugar molecule called alpha-gal into the person’s body. Subsequently the person develops a sensitivity to red meat, like beef, pork and lamb. Red meat membranes are rich in the sugar alpha-gal. The allergy can also be directed against other mammal-related products like milk protein. Often the person is unaware of this type of allergy, alpha-gal syndrome. In this case people continue to get exposed to red meat and mammal products, and the immune reactions become more severe over time. Anaphylactic reactions that are not due to food allergies have a high probability to be due to alpha-gal syndrome.

More details about the alpha-gal syndrome

Alpha-gal is the abbreviation for Galactose-alpha-1,3-galactose, which is a carbohydrate. It is part of most mammalian cell membranes, except for primates. The immune system in humans recognizes it as a foreign body and produces anti-alpha-gal antibodies. It is the bite of the lone star tick in North America or the castor bean tick in Sweden that can start the allergy to alpha-gal. If a person has frequent anaphylactic reactions, the physician should think of alpha-gal syndrome, which could be the underlying cause.

Sensitization of the human host

When the lone star tick bites mice, rabbits or deer it takes up alpha-gal sugar. Subsequently, when the tick bites a human, the alpha-gal sugar is injected into the human host together with its saliva. This alarms the immune system and antibodies are produced. When the human host later consumes meals with red meat, the body reacts to the previous sensitization to alpha-gal sugar by the tick bite. The antibody response to alpha-gal sugar from further red meat meals becomes even stronger than before. The only relief for human host from immune reactions is to switch to a diet that is free of red meat.

Allergic symptoms

The alpha-gal allergy can manifest itself by skin rashes, welts, skin itchiness, swelling, shortness of breath, headaches, belly aches, diarrhea and vomiting. In serious cases an anaphylactic reaction can occur, which in some cases can be lethal.

Protein allergies versus carbohydrate allergies

Until 2009 medical science believed that allergies would only be due to proteins. One such example are allergic reactions to peanuts. It is the peanut protein that can cause allergies. Subsequently, the alpha-gal allergy became known, which involves the sugar galactose-alpha-1,3-galactose. This was the first sugar molecule that researchers could demonstrate to mount an allergic reaction, from which the human host could turn sick.

Tick Bites Can Render You Allergic to Red Meat

Tick Bites Can Render You Allergic to Red Meat

Conclusion

The Lone Star tick in the southeastern US carries the sugar galactose-alpha-1,3-galactose (for short alpha-gal) which originates from bites of mammals that are not primates (cattle, pigs and lambs). When the tick bites a human, the immune system produces antibodies against alpha-gal. This can produce skin rashes, welts, skin itchiness, swelling, shortness of breath, headaches, belly aches, diarrhea and vomiting. But when the person recovers from the tick bite, a lifelong sensitivity against reed meats remains. Every time a sensitized person consumes a red meat meal the same symptoms, as originally experienced from the tick bite, return.

Abstinence from red meat

The only remedy for the alpha-gal syndrome is to abstain from red meat. The cell membranes of the muscle of red meat contain the sugar alpha-gal. Seafood, chicken, eggs and turkey meats are OK for consumption. But the patient has to be diligent about not making any dietary mistakes. If intermittent red meat exposure continues, a more severe allergy can develop. These have the name of “anaphylactic reactions”, where the patient is in danger of suffocating or even die from it.