Individuals who tend to follow the advice of mainstream nutritionists likely find the on-again, off-again demonization of red meat rather confusing.1 Weston A. Price Foundation members know better, recognizing that red meat—when sourced from healthy animals raised on healthy farms—is not only innocent of the many crimes of which it is often accused but is a nutrient-rich powerhouse.2
But what if you are a nutritionally informed red meat lover—enjoying animal fats, organs and bone broth as well as varied cuts of meat— and you suddenly cannot eat anything red-meat-related without developing hives, rashes, excruciating stomach pain or life-threatening anaphylaxis? In the past, allergy experts considered red meat allergy to be unusual,3 but by 2012, a red meat allergy dubbed “alpha-gal syndrome” or simply “alpha-gal”—named after a carbohydrate molecule (galactose-alpha-1,3- galactose) present in non-primate mammalian meat and high-fat dairy products4—had made it into the pages of Science magazine, which colorfully described it as “a carnivore or BBQ lover’s worst nightmare.”5
Since then, the number of individuals allergic to red meat—both adults and children—has continued to climb.6 In the U.S., one specialist sees five new patients a week and reports having treated nine hundred individuals over the past decade.7 The same trend is apparent in numerous other countries—including various European nations, Japan, South Korea, Panama, Brazil, the Ivory Coast and South Africa7—with the result that a lot more carnivores are coming face to face with their “worst nightmare.”
A MODERN MALADY
As medical historians remind us, allergies are a “modern malady.”8 Hay fever became a recognized condition only in 1870,9 and the term “allergy” did not come along until 1906, following on the heels of French physiologist (and eugenicist) Charles Richet’s 1902 invention of the term “anaphylaxis.”10
Around that time, injected antitoxins and vaccines—new on the scene—were causing “new diseases and strange reactions that physicians could not explain.”10 Observing these “hypersensitivity reactions” that seemed to involve the “collision of antigen and antibody,” particularly with repeated injections, Austrian pediatrician Clemens von Pirquet coined the term “serum sickness” and later elaborated the concept of allergy.10
Over subsequent decades, professionals continued to debate the meaning of various allergy terms and concepts, and even today, these are not necessarily agreed upon or used in a consistent and precise manner.10 There is a firm consensus, however, that allergic conditions—and especially food allergies—exploded beginning around 1990.9 The alarming increase in allergies over a relatively short period of time is, in most experts’ view, a strong clue that environmental factors are a leading allergy trigger11—and researchers believe that this holds true for the rise in red meat allergy as well.7
A MEDICAL MYSTERY
In 2009, several simultaneous case reports appeared in the scientific literature describing the mysterious red meat allergy, with research teams from the U.S.,12 Australia13 and France14 all converging on similar assertions about the presence of alpha-gal immunoglobulin E (IgE) antibodies in their patients. Researchers were somewhat puzzled by the new syndrome, however, because it “defie[d] some of the bedrock tenets of immunology”7 and “challenge[d] the current paradigm for food allergy.”15 For example, while IgE antibodies typically are associated with immediate allergic reactions,16 these investigators’ patients were exhibiting delayed symptoms—usually several or more hours after ingestion of the offending food. Moreover, although the National Institute of Allergy and Infectious Diseases (NIAID) defines food allergies as “a specific immune response that occurs reproducibly on exposure to a given food” [emphasis added],16 individuals with the new form of anaphylaxis were showing hit-or-miss reactions not just to meat but also to dairy and other mammalian-origin products.6 Some individuals were able to get by with an “alpha-gal-reduced” diet that included small quantities of red meat.17
Ordinarily, food allergies “are overwhelmingly caused by proteins.”7 The allergy literature has not supported the notion that carbohydrate antigens “contribute significantly to the induction of allergic reactions,”18 and yet alpha-gal is a carbohydrate. Conceding that “the IgE response to alpha-gal is different from typical IgE responses directed towards protein allergens,”6 alpha-gal researchers have, therefore, hypothesized that alpha-gal somehow “changes the immune response. . . so that it is possible to have these allergic reactions.”19
One reason that investigators chose to zero in on alpha-gal antibodies was that other research had previously described a severe and sometimes fatal hypersensitivity reaction in up to 20 percent of patients receiving a recombinant (genetically engineered) cancer drug called cetuximab, a drug produced in a mammalian (murine) cell culture in which alpha-gal is present.20 The cetuximab research found that IgE antibodies specific for alpha-gal were present in most of the people who went on to react to the drug.20
The French authors writing in 2009 were not entirely convinced of the “clinical relevance” of the IgE antibodies against alpha-gal, describing their relevance as “unclear.”14 A new report in the International Archives of Allergy and Immunology suggests that for some, this is still the case; the article states that the diagnostic value of alpha-gal IgE antibodies “has yet to be clarified” and that a finding of positive antibodies generally “has limited predictive value for the characteristics or severity of this allergy.”21 Nonetheless, most researchers have embraced the notion that the presence of alpha-gal IgE is at the root of the cetuximab and red meat hypersensitivity reactions.6
ENTER THE TICK
Suspecting an environmental trigger, what alpha-gal researchers needed next was an explanation as to “what causes or leads to the development of the IgE response to α-gal” to begin with.22 Ticks offered a ready scapegoat. Admittedly, ticks are a nuisance, and since the advent of Lyme disease in the 1970s, they are easy to cast in the role of villainous disease vector. The U.S. paper published in 2009 tentatively launched the tick hypothesis, mentioning that about 80 percent of the study cohort had reported a tick bite prior to onset of symptoms.12 The Australian paper (also published in 2009) then took the tick hypothesis further, postulating “a novel association between tick bite reactions and red meat allergy” and hypothesizing that components of tick saliva were “cross-reactive with proteins found in various red meats.”13
In 2015, two of the newly-made alpha-gal experts in the U.S. shored up the tick hypothesis by citing a tenuous evidentiary trail dating back to 1989, noting that professionals in Georgia had “collected ten cases of delayed reactions to mammalian meat and made a connection with the occurrence of tick bites several weeks or months prior to the first episode of hives or anaphylaxis.”6 The Georgia professionals reportedly presented their information to the state’s Allergy Society as well as to the Centers for Disease Control and Prevention (CDC), but the tick-meat allergy “connection” remained unpublished and unheeded, sitting on the shelf for over two and a half decades before alpha-gal researchers apparently decided they could make use of it.
The tick hypothesis rapidly became unquestioned orthodoxy, although researchers even now admit that they do not understand what mechanism links tick bites to an IgE response. Nor do “all tick bite[s] per se or a tick bite from one particular species result in the problem.”6 A close reading of the 2009 Australian paper13 underscores the wobbly underlying logic:
- First, the Australian study participants’ history of tick bites in the preceding six months was far from unusual, given that the patients all resided in an area “endemically infested with several tick species” where they presumably encountered ticks on a regular basis. Moreover, “ticks have had millions of years to figure out how to bite without triggering their victims’ immune response” [emphasis added], and tick bites were never previously associated with allergic reactions.19 No one has offered a hypothesis to explain this “first example of a response to an ectoparasite giving rise to an important form of food allergy.”23 Clinicians shrug off this point, saying “no one knows why some people who are bitten are susceptible to developing IgE antibodies and why others are not.”17
- Second, of the twenty-five patients in the study, one participant reported a tick bite six months after the onset of meat allergy; in the 2009 study in the U.S., one in five participants reported no tick bite at all. In four reported cases of alpha-gal allergy in Switzerland, the researchers observed that only one out of four cases had a history of a tick bite and speculated that “other ways of sensitisation may also take place,” particularly in childhood-onset patients.24
- Third, the Australian researchers “inferred” that one species of tick was the likely culprit but admitted that they could not prove it because no laboratory method existed to check. In the U.S. and Europe, meanwhile, researchers blame entirely different tick species as the guilty parties.6 U.S. epidemiologists also note that “large numbers” of meat allergies are occurring “well outside” the areas populated by the tick species in question.5
- A fourth point is that the Australian researchers—and subsequent research efforts—have never been able to confirm that something in tick saliva is responsible for the development of alpha-gal antibodies. One of the world’s leading alpha-gal experts states, “Tick saliva is brilliant stuff. It has loads of substances, but if you ask me which substances are critical, I don’t know. It’s something we are working on.”5
THE ELEPHANT IN THE ROOM
Those who study the phenomenon of anaphylaxis are often frustrated by the sizeable proportion of cases that lack an identifiable cause, not least because it “makes standard allergen avoidance measures ineffectual.”25 In a 2013 survey of anaphylaxis prevalence in Americans, 39 percent of reported cases fell into the “idiopathic” (cause unknown) category.26 With the emergence of alpha-gal, allergy experts have breathed a sigh of relief, seizing on tick bites as a convenient explanation for some of the cases “that would previously have been classified as ’idiopathic.’”27
But have researchers properly considered other explanations? The fact that alpha-gal reactions are not limited to red meat but also include allergic/anaphylactic reactions to products with mammalian-origin ingredients such as gelatin—including cosmetics, medications and vaccines—provides a major clue that something else may be going on.28 A website for the allergy-afflicted is up-front in describing alpha-gal as a medication allergy as much as a red meat allergy and singles out gelatin-containing vaccines as a prominent suspect.29 (The article by Kendall Nelson on chickenpox and shingles vaccines in this issue of Wise Traditions points out that gelatin is used as a stabilizer in eleven U.S. vaccines.)
That vaccines might bear significant responsibility for the alpha-gal phenomenon warrants consideration for a number of reasons. First, the explosion in food allergies that started around 1990 coincides temporally with the dramatic expansion of the childhood vaccine schedule as well as the more gradual but steady expansion of vaccine recommendations for adults. Second, gelatin, according to a recent review, “is the vaccine component responsible for most allergic reactions to vaccine, for both IgE and non IgE mediated reactions,” even in individuals without a gelatin allergy.30 Third, Japan has produced a wealth of documentation about the connection between gelatin-containing vaccines and anaphylactic reactions, in particular.31 One Japanese study traced “a strong causal relationship between gelatin-containing DTaP [diphtheria, tetanus and pertussis] vaccination, anti-gelatin IgE production, and risk of anaphylaxis following subsequent immunization with live viral vaccines which contain a larger amount of gelatin.”32 Finally, well before alpha-gal came along, studies had linked bovine serum albumin (BSA) to meat allergies,33,34 and BSA is widely used in the cell cultures that produce vaccines.35 (Recall that the cetuximab drug that prompts alpha-gal-type anaphylaxis is likewise made in a non-primate mammalian culture, although murine rather than bovine or porcine.)
Both the measles-mumps-rubella (MMR) vaccine and the MMR-plus-varicella (MMRV) vaccine contain significant amounts of gelatin. Discussing the allergy potential of the MMR, a review article points out that “the vast majority of allergic reactions to MMR is observed in patients without egg allergy” and deduces that “it is probable that the real triggers are other vaccine’s [sic] components, such as gelatin.”30 A blog about “living with alpha-gal” confirms this scenario, describing what happened to the alpha-gal-diagnosed writer following an MMR booster shot for college:
I was given a leaflet prior to the vaccine that said “if you’ve ever had an allergic reaction to any product containing gelatin, do not take this vaccine.”. . . I knew about alpha gal and gelatin and began the (absurd-sounding) explanation to the nurse that wanted to administer it. I refused the vaccine and checked with my doctor and allergist. Both agreed that there [was] too little gelatin in the shot to cause a reaction. Perhaps because of direct injection into tissue, I had my fastest reaction ever—1 hour after receiving the vaccine the stomach cramping began, followed by the itching, then full-blown hives. Because the reaction was so fast, I went to the ER because I was concerned about how it would progress. Perhaps the most frustrating part of this was that my Dr. insisted I wait for 30 minutes after getting the vaccine to be sure I wouldn’t react. I tried to explain that if I was going to have a reaction, it wouldn’t be in 30 minutes. The misunderstanding of this allergy, even in the medical community, can be very frustrating.36
Around 2012, alpha-gal experts belatedly started connecting some of these dots, exploring the relationship between red meat allergy, sensitization to gelatin, alpha-gal and vaccines.37 In studies published in 2012 and 2017, researchers acknowledged the ubiquitous presence of gelatin and mammalian-derived products such as BSA in vaccines and proposed that “alpha-gal allergic patients might react to these vaccines,” particularly because of their parenteral (injected or intravenous) mode of delivery.38 Reinforcing this point, they stated, “Most reports of serious allergic reactions to gelatin implicate parenteral exposure, either to gelatin colloids used as plasma expanders [a form of intravenous therapy] or to gelatin-containing vaccines.”37
In the 2017 study, the researchers described a patient who developed anaphylaxis after receiving a zoster (shingles) vaccine containing both porcine gelatin and BSA, and they also identified fourteen cases “of adverse reaction to zoster vaccine consistent with anaphylaxis” in the Vaccine Adverse Event Reporting System (VAERS), five of which had a “known associated beef, pork, gelatin, or alpha-gal allergy.”38 Unfortunately, as some vaccine researchers have noted, “The true rate of allergic reactions [to vaccines] is unknown because most reactions are not reported.”39
It is interesting to find that in the comments section of a 2015 People’s Pharmacy show about alpha-gal allergy, vaccines come up repeatedly in the online discussion:
- “My doctor says I wasn’t bit by a tick. About 2 months before my first severe [alpha-gal] reaction I’d received a vaccine which I had a bad reaction from.”
- “I have had the alpha gal syndrome for almost two years. I was undiagnosed for 8 months and almost died from a flu shot.”
- “My husband has a reaction to the flu vaccine. His arm sweats and gets hot for about 4 days and he can hardly lift it. Also we have found out that he does have the alpha gal problem as well.”
- “My biggest fear with this allergy is the lack of knowledge by care providers that any medication with mammalian meat products should not be used to treat alpha gals. For example, gelatin is used in many medicines as a heat stabilizer. I wonder what other mammalian meat products lurk in our pharmaceuticals. I have a severe reaction to the flu vaccine and have had no acknowledgement by any medical practitioner or pharmacist that my symptoms could be related to this allergy.”40
COMING FULL CIRCLE
In the modern era, allergies are a boon for the pharmaceutical industry—the “engine of a multinational, multimillion pound [or dollar] business in pharmacotherapy.”41 On the other side of the health care aisle, however, they are a major cause of workplace absenteeism41 and have significant quality-of-life implications, as well as sometimes fatal consequences.
With the steady increase in the number of vaccines recommended for both children and adults—and the evidence that injection is a particularly potent mode of allergic sensitization— it is vital to pay more attention to the “possible role of these injections in the increase in allergic disease or in food allergy in particular.”9 Heather Fraser, author of The Peanut Allergy Epidemic, describes how Charles Richet came to view anaphylaxis as the result of injection—“a response to proteins that had evaded modification by the digestive system.”42 According to Fraser, Richet saw anaphylaxis as an inevitable outcome of vaccination. The telling origins of “serum sickness”—acknowledged to this day as “a type of delayed allergic response”43 resulting from the injection of foreign proteins in immune-modulating agents, anti-venoms or vaccines44,45—and serum sickness’s contributions to the concept of “allergy” likewise suggest that alpha-gal may simply be a new name for a longstanding problem.
THE CHALLENGING PATH OF AVOIDANCE
Worryingly for those diagnosed with alpha-gal, clear labeling is apparently “not a requirement of the FDA [Food and Drug Administration],” and manufacturers often have “no method of accurately determining whether or not an ingredient [is] sourced from mammalian products.”46 The list of gelatin-containing drugs and supplements is particularly long and includes the clotting drug heparin, pancreatic enzymes, thyroid supplements, intravenous fluids, suppositories and magnesium stearate, among many others.7,30 Other products that alpha-gal sufferers may have to watch out for include toothpaste, lotions, sunscreens, antibiotics and whey protein powders.47,48
In a blog post about farm life, a woman diagnosed with alpha-gal poignantly describes the difficulty of not only having to give up mammalian meat but also dairy products:
Yes, I cried. It’s just that I already have a laundry list of food allergies. And, it was summer. And, it was grilling season. And, I do love a good steak. . . . My favorite food in the world is milk. I drink more milk than anyone I know. I love it. I crave it. My ancestry is Scotch/Irish. A lot of blood type O. Freedom fighters. Meat eaters. Milk drinkers. In particular I love goat milk. I have two angel goats I milk twice a day. . . . So, this was particularly hard for me.49
NATURAL REMEDIES FOR ALPHA-GAL?
Clinicians who see alpha-gal patients generally tell them simply to stay away from the offending foods and cross their fingers that they will become one of the rare individuals who eventually outgrows the condition. If that seems like a dismal prognosis, one can explore natural health websites and discussion boards to find and experiment with other suggestions. For food allergies in general, three natural remedies include fermented foods and acidophilus to balance the gut bacteria; daily apple cider vinegar (diluted in water) to restore pH levels (unless you are prone to histamine reactions); and food-grade hydrogen peroxide diluted in distilled water.50 For alpha-gal specifically, people have shared the following testimonials online:
KOMBUCHA: In a People’s Pharmacy post, someone with alpha-gal wrote: “About two years ago, I started making and drinking my own kombucha tea. About a year into this regimen, I accidentally ate a sausage ball. . . at a reception. Nothing happened. I experimented with small amounts of other meats and was able to eat it with no reaction. On a trip out West last winter, I wasn’t able to continue my kombucha regimen (3x/week), and when I ate beef, I broke out in hives four or five hours later. Back home after resuming the kombucha, I was able to eat meat again. I realize that this is anecdotal evidence, but I wonder if there’s a way that kombucha could acidify my system in a way that would allow easier digestion or affect the tick bite antibodies?”40
AURICULAR ACUPUNCTURE: Some acupuncture clinics offer a form of ear acupunture called Soliman Auricular Allergy Treatment (SAAT), which is said to help “reset” the immune response to the alpha-gal carbohydrate. The process involves the insertion of tiny needles in the ear (one per allergen), which are left for three weeks (covered by medical adhesive tape).
OXYGEN AND OTHER APPROACHES: A health coach and wellness therapist reported tackling her alpha-gal through “herbal therapy, nutritional/mineral medicine, natural cellular therapies, massage therapy, chiropractic, and biofeedback. . . . I began to consider oxygen because of the research into nutritional anemia. . . . [The chiropractor] suggested I try a new therapy, Hyperbaric. I decided that was an answer to prayer and began the therapy the following week. I have gone every day for almost 40 sessions (5 days a week). I have had some amazing, noticeable changes in my body, sleep, energy, and hormones.”51
DOCUMENTING HOPE PROJECT SEEKS PARTICIPATION BY WAPF PARENTS
Epidemic Answers has an important initiative called the Documenting Hope Project (@documentinghope). Part of the project is a study called the Children’s Health Inventory for Resilience and Prevention Study a.k.a. the “CHIRP Study.”
The study is an IRB-approved private online survey that asks what children in the U.S. are eating, their chemical exposures at home and school, EMF exposures, industrial sites nearby, their medical history, consumption of medical products, preconception and prenatal health of parents, family medical history, etc.
Epidemic Answers is asking U.S. parents of children 1-15 years old to volunteer a few hours of their time (between 3 and 6 hours) to protect the health of current and future generations of children. The survey can be saved and completed at your own pace in the comfort of your home.
The organizers are especially interested in participation by WAPF parents. The survey includes questions about consumption of raw milk, cod liver oil, fermented foods, bone broth, etc.
Parent participants will receive a free comprehensive health report on their child upon completion, as well as discounts to various natural and healthy-living focused companies.
Learn more and volunteer today: DocumentingHope.com/CHIRP-Study
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- Jacquenet S, Moneret-Vautrin DA, Bihain BE. Mammalian meat-induced anaphylaxis: clinical relevance of anti-galactose-alpha-1,3-galactose IgE confirmed by means of skin tests to cetuximab. J Allergy Clin Immunol 2009;124(3):603-5.
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- Valenta R, Hochwallner H, Linhart B, Pahr S. Food allergies: the basics. Gastroenterology 2015;148(6):1120-1131.e4.
- Allergists say alpha-gal red meat allergy better understood, as numbers continue to increase. VUMC Reporter, Dec. 21, 2016.
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- Tick spit protein may trigger allergic reactions. ScienceDaily, Sep. 25, 2015.
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- Fischer J, Huynh HN, Hebsaker J et al. Prevalence and impact of type I sensitization to alpha-gal in patients consulting an allergy unit. Int Arch Allergy Immunol 2020;181(2):119- 27.
- Berg EA, Platts-Mills TAE, Commins SP. Drug allergens and food—the cetuximab and galactose-α-1,3-galactose story. Ann Allergy Asthma Immunol 2014;112(2):97-101.
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- Bircher AJ, Hofmeier KS, Link S et al. Food allergy to the carbohydrate galactose-alpha-1,3-galactose (alpha-gal): four case reports and a review. Eur J Dermatol 2017;27:3-9.
- Kuhlen JL, Virkud YV. Pathogenesis, newly recognized etiologies, and management of idiopathic anaphylaxis. Discov Med 2015;19(103):137-44.
- Wood RA, Camargo CA, Lieberman P et al. Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol 2014;133(2):461-7.
- Franceschini F, Bottau P, Caimmi S et al. Vaccination in children with allergy to non active vaccine components. Clin Transl Med 2015;4:3.
- Sakaguchi M, Nakayama T, Fujita H et al. Minimum estimated incidence in Japan of anaphylaxis to live virus vaccines including gelatin. Vaccine 2000;19(4-5):431-6.
- Sakaguchi M, Inouye S. IgE sensitization to gelatin: the probable role of gelatin-containing diphtheria-tetanus-acellular pertussis (DTaP) vaccines. Vaccine 2000;18(19):2055-8.
- Fiocchi A, Restani P, Riva E et al. Meat allergy: I—Specific IgE to BSA and OSA in atopic, beef sensitive children. J Am Coll Nutr 1995;14(3):239-44.
- Restani P, Ballabio C, Cattaneo A et al. Characterization of bovine serum albumin epitopes and their role in allergic reactions. Allergy 2004;59 Suppl 78:21-4.
- Mullins RJ, James H, Platts-Mills TAE, Commins S. The relationship between red meat allergy and sensitization to gelatin and galactose-alpha-1,3-galactose. J Allergy Clin Immunol 2012;129(5):1334-1342.e1.
38. Stone CA Jr., Hemler JA, Commins SP et al. Anaphylaxis after zoster vaccine: implicating alpha-gal allergy as a possible mechanism. J Allergy Clin Immunol 2017;139(5):1710-1713. e2.
- Dreskin SC, Halsey NA, Kelso JM et al. International Consensus (ICON): allergic reactions to vaccines. World Allergy Organ J 2016;9(1):32.
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- Pelat H. UNC doctor calls alpha-gal meat allergy “tremendously underdiagnosed.” CBS17, May 9, 2016.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Spring 2020