Alpha-Gal and Lyme- What You Need to Know By Christie Korth, MS, CHC, AADP

If you haven’t already heard it of it, you may be wondering what in the world the term Alpha Gal is.  Is it a new co-infection that you haven’t come across or your LLMD hasn’t explained?  Is it a new supplement available for Lyme?  Great guesses wise reader!

Alpha-gal is a term dubbed for food intolerance; more specifically, an IgG or an IgE reaction to the sugars found in red meat and pork. (Horowitz, 2017)  In late 2017 and to present, this was a very hot topic in the Lyme community.  Alpha Gal has seemingly flourished into its probability in co-occurring with other health concerns, like auto immune issues.  Alpha-gal is seen in many Lyme patients to date.  No one really knows why this intolerance develops completely, though there are some theories. First things first, its crucial to understand what food intolerance vs food allergy actually is.

Food Allergies vs Food Intolerance

We are not talking about a typical food allergy here, which is known as an IgE reaction- thereby causing the body to produce histamines and with a prospective end result of potentially life threatening anaphylaxis.  But more specifically, an IgG food sensitivity in which causes the body to produce cytokines; AKA inflammatory chemicals in the body.  The vast difference between an IgE true allergy vs an IgG food intolerance is that said IgG reaction can take up to 72 hours to occur, whereas a food allergy is almost always immediate and again, can be life threatening.  IgG reactions can be life threatening, but over time as it causes the body to product massive amounts of inflammation.  (Korth, 2012)

IgG vs IgE Chart

Foods to Eat and Foods to Avoid

As daunting as it can sound, a diet sans alpha-gal is not as challenging as it seems.  I always air on the side of “focus on what you CAN eat” vs what you can not eat.   I have found in my two decade tenure as a nutritionist, this policy works best.  Focusing on positivity is most important for success.

With an alpha-gal intolerance/allergy, you should NOT consume red meat, venison or pork.  But you CAN eat chicken, fish as well as any other poultry you’d like to enjoy, so eating for an alpha gal intolerance is definitely not the end of the world!  If you are already avoiding other foods such as gluten, dairy and/or eggs or histamine producing foods, this can get a bit tricky and I definitely recommend to consult with a trusted nutrition professional to ensure you are getting the right amount of caloric intake and overall nutrient density to support your body. 

A seasoned nutritionist, naturopath, and/or LLMD can run the proper testing to help you get diagnosed, as this MAY NOT show up on a traditional allergy test (i.e; an IgE test) so many doctors whom only test for this type of reaction to food will possibly let this go undetected.

For some patients, I have also seen many occurrences that when overall inflammation is reduced and Lyme is in remission, that you CAN attempt to do an what is called a reintroduction diet.  The entails embarking on an alpha gal binge day of sorts, and then removing it back out of the diet to watch and wait for a reaction for up to 72 hours. If no reaction,  see how your body does with small amounts of alpha gal consumption for a few weeks.  If you start going downhill again, remove back out immediately, if not, its possible the intolerance was eradicated, as this IS possible.  If it is an true “IgE allergy”, Id recommend to avoid completely.

For reference- here is a complete table of foods which should be avoided for Alpha Gal along with some substitutions:

Alpha Gal Food List

Complete List of Foods to Avoid	Potential Substitutions
Gelatin (jelly beans, marshmallows)	Home made marshmallows, dark chocolate chips, Lara bars
Red Meat (beef, pork, lamb, deer)	Bacon: Turkey Bacon, Bison Bacon Hotdogs: Chicken Based or plant based Hamburgers: Soy, Chickpea, Portobello mushrooms burger, Bison, Turkey, Chicken Meatloaf: Use Turkey or Bison Sausages:  Chicken Sausages
Dairy	Vegan Cheese Cashew Based “Cheese” Coconut base yogurt or soy Coconut Oil or Olive oil to replace butter Almond milk, cashew milk, macadamia nut milk,  soy milk, rice milk…
Collagen (beef collagen casings, supplements)	Bone broth collagen from turkey, chicken or cornish game hen
Lard	Chicken lard or “Schmaltz”
Carrageenan	Nothing- its bad just don’t eat it LOL

How to Test for Alpha Gal Allergy	A blood test for galactose-alpha-1,3-galactose (alpha-gal) specific IgE (sIgE) is the main test that healthcare providers use to help them diagnose alpha-gal syndrome

Figure 1. The risk and also severity of reactions in the α-Gal syndrome relate to the amount of the oligosaccharide that is present in food, drugs, or other therapeutics. The route of administration is relevant to the speed at which reactions occur; that is, intravenous administration is associated with rapid reactions, whereas oral ingestion has delayed onset. Cofactors such as NSAIDs, exercise, and alcohol can be additional risk modifiers. This schematic reflects clinical experience, as well as challenge studies and laboratory investigations. CroFab, Crotalidae polyvalent immune Fab; MMR, measles, mumps, and rubella; NSAID, Nonsteroidal anti-inflammatory drug.

Work Cited:

1.     Horowitz, Richard “How Can I get Better”? 2017, St. Martin’s Griffin, New York, New York, page 317

2.     Korth, Christie “The IBD Healing Plan and Recipe Book” Hunter House, Alameda, CA 2012 page 42

3.     Reproduced from: Platts-Mills TA, Li RC, Keshavarz B, Smith AR, Wilson JM. Diagnosis and management of patients with the α-Gal syndrome. The Journal of Allergy and Clinical Immunology: In Practice. 2020 Jan 1;8(1):15-23, with permission from Elsevier.

4.     https://www.sciencedirect.com/science/article/abs/pii/S2213219819307950