CASE STUDY: Why Ben Can’t Eat Steak!

I’d known the two of them for years. Now in their early fifties, Ben and Frieda were in good health—until Ben started reacting to red meat. What was happening? As it turns out, Ben was developing Alpha-Gal Syndrome, a tick-borne allergy that causes reactions to red meat.

Frieda began, “We think this probably began weeks after we got back from vacation. We went hiking in the Shawnee National Forest in southern Illinois. Been there? Garden of the Gods? Gorgeous! But we did see a lot of ticks and probably weren’t cautious enough. After we got home, everything seemed fine.”

Ben finished… “Then one evening a month ago, I grilled a pair of New York sirloin strips on our Weber and two hours later, I’m covered with hives.”

Frieda continued, “We didn’t panic. Hives, big deal. Gave him some Benadryl and in a few hours, they were gone. But the next day, spaghetti and meatballs, and the hives are worse. The Benadryl takes longer. But broiled chicken? Nothing? Poached salmon? Nada? But two lamb chops, wow! Are you getting my drift?

“Very much,” I replied. And I went on to explain what probably was happening.

THE LONE STAR TICK SOUNDS TEXAN BUT IT’S NOT

While Frieda and Ben were hiking, Ben managed to get bitten by a Lone Star tick which gets its name from a characteristic bright white spot on its back. The Lone Star is quite different from the Deer Tick spreading Lyme Disease across New England and the Upper Midwest but in its own way, the Lone Star is quite vicious.

Imagine being chased by a running dinosaur like a velociraptor or a running zombie out of the movie “28 Days Later”, except you are being chased by something you can’t see because it’s the size of a lentil. As you walk through wooded areas especially with dense undergrowth, the Lone Star lies waiting for you. It “smells” you walk by, and unless you’ve sprayed yourself and your clothes with a DEET repellant, you’re as yummy to that tick as a freshly baked croissant. Unlike other ticks that wait for you to walk by, the Lone Star will go in for the chase, often in packs.

WHAT HAPPENED WITH BEN

When Ben was bitten, the tick injected a substance called alpha gal, a carbohydrate that triggers an immune reaction in Ben’s body, creating antibodies to it so that when he comes in contact with more alpha gal, he’ll have an allergic reaction like the one he experienced. Alpha gal is found in all red meat including pork but not in poultry, seafood or fish. Obviously vegetarians never have alpha gal issues. Dairy is “if-fy.” Some alpha-gal patients can tolerate it, others can’t.

Because we see so many patients with Lyme and other tick borne illnesses here at WholeHealth Chicago, we began seeing alpha-gal patients a few years ago. They were rare and usually came from the southeastern parts of the U.S. Now, because of climate change and global warming, the tick population is literally exploding and tick related diseases, especially Lyme and alpha gal have increased dramatically.

Ben’s reaction is fairly typical of an allergic reaction to food although with alpha gal, the reaction is slower (hours) as opposed to the commoner immediate ones (like ‘peanuts’). Severity is usually, but not always, related to quantity ingested: a 14 ounce T-bone versus a 6 ounce filet mignon. A bad reaction can add respiratory symptoms (wheezing, shortness of breath) and/or digestive symptoms (cramping abdominal pain, diarrhea). 

WHAT WILL HAPPEN TO BEN

Actually, Ben was fortunate in that he and Frieda suspected a new food allergy and traced it to red meat. Of the 500,000 estimated cases of alpha gal, most patients are unaware of their diagnosis and the average “delay” is an astonishing seven years. This is based on surveys taken of physicians: fully 78% of primary care doctors have either never heard of alpha gal or have very limited knowledge of it.

First, he really needs to avoid tick bites. Another Lone Star bite will make everything much worse. Hiking is fine: long pants, tucked into hiking boots, everything sprayed with DEET, permethrin, etc.

Second, he and Frieda need to familiarize themselves with the alpha gal support group. Ben can purchase genetically modified pork totally free from alpha gal from farms in Tennessee and North Carolina. For some patients, after prolonged avoidances, the symptoms actually get milder and eventually disappear.

Third, working with an allergist familiar with alpha gal is always a good idea. We refer many patients to our neighbor Premier Allergy.

Last, unfortunately very few patients who are bitten by a tick, especially here in the Midwest only get a single infection, like alpha gal. Usually, a hike in tall grass or through woods means several bites and several infections (termed “co-infections”). Also transmitted by the Lone Star is Ehrlichiosis, a cousin to Lyme, and often overlooked and untreated. For a thorough evaluation of your status with tick-borne disease, schedule with one of our WholeHealth practitioners.

Be well,

David Edelberg, MD