What is the treatment for Alpha-gal syndrome?

From the Guidelines

The primary treatment for Alpha-gal syndrome is strict avoidance of mammalian meat and products containing mammalian ingredients. Patients must eliminate beef, pork, lamb, venison, rabbit, and other mammalian meats from their diet, as well as products made with mammalian ingredients such as gelatin, certain medications with gelatin capsules, and some dairy products 1.

Key Components of Treatment

• Avoidance of mammalian meat and products
• Elimination of gelatin and gelatin-containing products
• Caution with dairy products, especially those with high fat content
• Avoidance of cross-contamination with alpha-gal in restaurants and processed foods

Symptom Management

For symptom management during allergic reactions, antihistamines like diphenhydramine (25-50mg every 4-6 hours) or cetirizine (10mg daily) can provide relief for mild symptoms 1.

Severe Reactions

For severe reactions, an epinephrine auto-injector (such as EpiPen 0.3mg or EpiPen Jr 0.15mg for children) should be used immediately, followed by emergency medical care 1.

Long-term Management

Patients should carry emergency medication at all times and wear a medical alert bracelet. Reading food labels carefully is essential, as alpha-gal can be hidden in processed foods under terms like "natural flavors" 1.

Tick Prevention

The condition may resolve over time (typically 2-5 years) if further tick bites are prevented, so tick prevention measures including using repellents containing DEET, wearing protective clothing, and checking for ticks after outdoor activities are important components of long-term management.

From the Research

Treatment for Alpha-gal Syndrome

The treatment for Alpha-gal syndrome primarily involves avoidance of mammalian meats and products that contain the alpha-gal sugar moiety. Key aspects of treatment include:

• Avoidance of mammalian meats, dairy, and other products that may contain alpha-gal 2, 3
• Acute management of allergic symptoms, which may include:
  • Intramuscular epinephrine for anaphylaxis 4, 5
  • Oral antihistamines and corticosteroids for urticaria and other allergic reactions 4
• Counseling on tick avoidance measures, as the syndrome is often associated with tick bites 2, 6
• Diet modification with elimination of meat, and potentially resuming meat consumption under specialist direction if symptoms improve and IgE levels decrease 4

Management and Prevention

Long-term management of Alpha-gal syndrome involves:

• Avoiding medications and products that contain mammalian-derived materials, such as certain monoclonal antibodies and pancreatic enzymes 4
• Being aware of the potential for delayed allergic reactions to alpha-gal, which can occur 2-6 hours after ingestion 2, 3, 4
• Carrying auto-injectable adrenaline in case of emergency 5
• Regular follow-up with a healthcare provider or allergist to monitor symptoms and adjust treatment as needed 5