Alpha-Gal Blues

Taking a break from writing-related stuff this post to talk about a nasty new(ish) disease/allergy I was diagnosed with a couple of years ago. It's still uncommon, but its effects are profound. And its impact on western diets is only beginning.

The lone star tick - primary transmission vector for alpha-gal syndrome.

Don't Have a Cow, Man. It Could Kill You

Back in February of 2023, the COVID-19 pandemic was beginning to ease. Vaccines had provided some relief from the stress of the disease and obviated some of the control measures imposed to thwart its spread. And companies that had sent workers home two years earlier were starting to get antsy about getting employees to return to on-site work. Problem was, people didn't really want to go back, finding themselves more efficient, productive and happy working remotely. This prompted a broad array of enticements to get asses back in Aerons. My office was no different, offering free lunches as one such perk in the early days of its return to office (RTO) mandate. I worked in Crystal City (now part of the greater National Landing area), home to many of the restaurants that provided those free lunches. On February 9, 2023, I had my last (beef) burger (probably ever) courtesy of a free lunch from Good Stuff Eatery. The burger itself was fine. About two hours later, though, back at home, I bailed on a 4:30 p.m. Teams meeting: "Can't make it," I Slacked. "Got some kind of allergy thing going on."

The "allergy thing" wasn't as much of a surprise to me as it might have been for some people. My wife had been diagnosed with alpha-gal syndrome several months earlier. She'd already omitted mammal products from her diet. Even before that, we'd both already given up pork years earlier after a chance encounter with a stray pig (another story).

Actual photo of the pig that randomly showed up at our house, so charming us that it made us give up pork permanently in 2014.

Regardless, when I started to get that itchy burn, I knew something was happening and my thoughts went immediately to mammal meat. I texted my wife...

It was then I suspected the 'gal.

This progressed to tunnel vision, shortness of breath and generally a bunch of shit that would lead any sane person to call an ambulance or, if I'd trusted myself to drive, to head to an emergency room of my own volition. However, me being me—not sane (little Shirley Jackson Easter egg there for the discerning reader)—I took Benadryl and waited it out. Eventually it did pass, and I fell asleep.

Bloodborne

I'm fortunate to have a really good relationship with my doc. When I woke up from my Benadryl nap, I texted him. He, I and his office manager continued talking for the rest of the afternoon. I got blood work done the next day:

My alpha-gal test results.

And there it was. At some point, probably at the tail end of the previous summer, a tick had sunk its mouthparts into me, spitting in a particular sugar known as galactose-alpha-1,3-galactose: alpha gal. This sugar stimulates an allergic reaction that generally stays with the infected for life. The problem? That sugar occurs naturally in the meat of mammals (and dairy), leading to a severe allergic reaction should the infected consume those products. A fun related fact: primate meat does not contain galactose-alpha-1,3-galactose, meaning both chimp roasts and cannibalism are free game. Meat's back on the menu, boys!

Side note: many doctors are still unfamiliar with the blood test for alpha gal. There is another, similarly-named test called "alpha galactosidase, s." If you believe you may have alpha-gal syndrome and are planning to get tested, check your blood work orders. Let your doctor know this test is not right. For Quest Diagnostics (my provider) the test you want is called "galactose alpha 1,3 galactose ige."

My Options Have Narrowed

The blood test confirmation necessitated a major shift in how I ate. As an active foodie, this hit me hard. I've been fortunate enough to have eaten some amazing restaurant and street food around the world. Now, whole swaths of the culinary universe were off-limits. Not only that, but I have to be extremely circumspect when I do eat out, and have to be that guy: "I'm allergic to mammal products. Can you make sure this doesn't include any pork?" This is a big one: some cuisines use pork more as a flavoring agent than as a protein. It's on me to make sure I eat safely. And mammals infiltrate foods we wouldn't expect. Popeyes, my go-to- for chain fried chicken, is no longer an option because they use beef extensively in their chicken preparations. Super disappointing. That shit is good. Because alpha-gal is uncommon and not yet widely-known, you also get the "Mmm hmm. Mmm hmm. Well this is some bullshit you're saying now" reaction sometimes, though this has become less frequent as time has gone by. You still get the nasty askance when you get a vegan meal "with a side of chicken," though.

This graphic we all lived by since we were children is no longer valuable for alpha-gal sufferers.

It's easy to think that living with alpha-gal syndrome is a first world problem. "Oh no, he has to be careful to select the right tasting menu. Wahhh wahhh." But it can be more insidious than that. There's a lot that remains unknown about this illness. And, as most dedicated vegetarians/vegans are already well aware, gelatins are very frequently mammal-derived and are ubiquitous in consumer products and medicines. Alpha-gal sufferers may or may not be sensitive to it and, similarly to dairy, there are inflammation issues that may make it wise to avoid gelatins even in the absence of reactions. I shifted over to vegan alternatives to most of my dietary supplements, and just go on optimistic hope for the ones I couldn't (like two prescriptions I have to take).

It's Not All Bad

So is alpha-gal good for anything? Well. In my opinion, yes. My health has gotten significantly better since cutting mammal products from my diet. Those two prescriptions I mentioned earlier? One of them was for a genetic condition that probably can't be addressed with diet or exercise. The other one probably has been ameliorated by dietary changes, and I hope I'll be able to stop taking it soon. Less medication is always a win in my mind.

It's no secret that the production of mammal meat isn't particularly sustainable. It's an entirely different topic, but removing myself from any sort of ranching/feedlot/slaughtering process is a win in my book. I probably wouldn't have made the choice willingly were it not for alpha-gal. That food chain graphic above from The Simpsons? It's funny, but also kind of gross. I live on a farm in Southern Maryland. We keep goats (among other animals), and I've come to enjoy them as sensitive, funny creatures who—odd, I know!—enjoy being alive. I'm so accustomed to thinking of them as living creatures that it takes a couple seconds when I see packaged goat in the supermarket and I have to go, "Oh... goat. Like, goat. Like my goats!" It doesn't sit well with me to conceptualize these animals as food anymore. But I'm a pretty big hypocrite here, because I keep chickens as well, and still enjoy both chicken (though not Popeyes) and fish in my diet. But it's a step forward, I believe.

Shortly after my diagnosis, I listened to the Radiolab NPR show about alpha-gal; the original piece and its follow-up track Amy Pearl's experience with alpha-gal syndrome, and her reaction to a line of genetically-modified pigs bred for organ transplants that do not have alpha-gal present. I highly recommend it whether you have alpha-gal syndrome or not. Her increasing sensitivity to animal welfare is, I believe, an inevitable step for many people with alpha-gal syndrome.

Living with It

Since my diagnosis, I've managed to be symptom- and reaction-free. I carry an alpha-gal kit with me wherever I go (though thanks to the delayed-onset nature of the disease, there's not much chance I'll need to break out an Epipen while I'm still in a restaurant. But still.). I haven't had to use it yet, though I did take some preemptive Benadryl once after a suspicious crumbled topping that I thought at the time—but found refuting evidence later—might have been pork. Regardless, caution and luck have helped me stay reaction-free for over two years as of this writing.

At this point, living with alpha-gal syndrome has become such a second-nature thing that I don't really even notice the avoidance anymore. I will always miss beef, but emu is a reasonable stand-in for special occasions. Life goes on. In some ways, I feel privileged to have had this reflection forced on me. Despite the presence of animals in my diet still, I am far more aware of the composition of my food and the issues involved in its production from the earliest stages of farming to the packaged products in the grocery store.

A warming climate will undoubtedly bring more odd diseases and other biological threats to our health as parasites and predators find more welcoming climes farther afield from their home bases. Including ticks and the animals upon which they feed (and then feed on humans, bringing whatever nastiness they've picked up along the way). Alpha-gal is probably here to stay, and indeed to thrive. So wear socks or boots when you hike the mid-Atlantic, and check yourself over when you're done. The cows are getting their revenge, and they're coming for all of us.