Living With Airborne Reactions 2.o

A Guide for People With Alpha-gal Syndrome Who React to Airborne Alpha-gal

Reactions to Airborne Alpha-gal

Patients do report symptoms with exposure to fumes from mammalian meats/fats being cooked; however, no blinded challenges have been published to definitively document the airborne (droplet) route of exposure. Interestingly, experience suggests fumes may pose a more potent risk to reactive patients than moderate levels of pet dander exposure. 

Scott Commins, MD, PhD

University of North Carolina

There is no published data on the percentage of people with alpha-gal syndrome who react after airborne exposures to alpha-gal, but the informal estimates of experts range from 10-30%. For those who do, reactions often start within minutes of exposure, progress quickly, and can be severe.

  • Until you know whether you react to airborne alpha-gal, exercise caution around possible sources exposure, especially barbecues and other cooking meat.
  • If you experience ANY airborne reactions, remove yourself immediately from the source of exposure!
  • Some people with AGS report that fume reactions are the most dangerous reactions that they experience, leading rapidly to anaphylaxis, airway issues, and/or unconsciousness.

Sources of Airborne Alpha-gal

Fumes (airborne droplets) from cooking meat

Suspended fat droplets in smoke or fumes from cooking meat, especially from grills, barbeques, and sometimes frying meat is by far the most commonly reported airborne trigger of reactions.

Other possible sources of airborne exposure

People with AGS have also reported reactions to the following:

  • Fumes from cooking milk or dairy products
  • Powdered dairy products
  • Pet dander
  • Emissions from mammalian waste, especially from large quantities of waste on farms
  • Dryer exhaust when dryer sheets that contain lanolin are used
  • Candles which can contain tallow or stearic acid from mammals

There are also reports of reactions to plug-in air fresheners, perfumes, scents, and other products. Because many people with AGS go on to develop mast cell disorders, it isn’t always clear if these reactions are related to AGS or mast cell issues. More research is needed.

Symptoms

People with AGS have reported all of the following symptoms to meat fumes and other airborne exposures:

  • Itching
  • Runny nose
  • Hives, rash or flushing
  • Angioedema (swelling)
  • Nausea or other GI issues
  • Tingling throat
  • Breathing issues like coughing, wheezing, shortness of breath
  • Dizziness
  • Changes in blood pressure or heart rate
  • Brain fog or confusion
  • A sense of impending doom
  • Lightheadedness
  • Loss of Consciousness
  • Other symptoms of anaphylaxis

    Managing Reactions to Airborne Alpha-gal

    If you have airborne reactions to alpha-gal, the following approaches to managing them may help.

    • Remove yourself immediately from the source of exposure!
    • Wash your hands and face as soon as possible.
    • Seek the advice of your doctor about how to cope with future exposures, including the use of drugs like inhaled beta-agonists and omalizumab.
    • Work with your doctor to develop a Food Allergy and Anaphylaxis Emergency Care Plan.
    • Avoid situations where you might be exposed to airborne alpha-gal particles, such as barbecues and restaurants that grill meat.
    • Buy some well-fitting N95 or similar masks.

    Masks

    Patient who react to airborne alpha-gal report that high quality, well-fitting N95 or similar masks can help in situations exposure to airborne particles of alpha-gal cannot be avoided.

    One situation in which many people with alpha-gal syndrome wear, or at least bring, a mask is airplane travel. On a plane you may not be able to move away from the source of fumes.

    Patient-recommended Masks

    Note that not all these masks will necessarily provide protection from airborne viruses and other pathogens

    Cambridge Masks

    Cloth masks

    Vogmasks

    Cloth masks

    Project N95

    A reliable source of N95 masks

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