Foods That Contain Alpha-gal

A Guide for People with Alpha-gal Syndrome

Determining Your Tolerance for Alpha-gal

Seek your healthcare provider’s advice about which foods you should and should not eliminate from your diet. If your physician approves,  the following steps may help you:

Step #1: Remove the riskiest foods (meats, organs, etc.) and any other foods that you know you react to from your diet.

Step #2: Learn about the relative risks of other foods that contain alpha-gal (see below).

Step #3: With the advice of your doctor, cautiously work to determine your personal tolerance for different foods that contain alpha-gal. See Determining Your Tolerance for Alpha-gal for more information (coming soon).

The Spectrum of Risk

Many foods contain alpha-gal. Some need to be avoided by everyone with alpha-gal syndrome (AGS); others are tolerated by most of us (57). At one end of the spectrum are the internal organs of mammals, like intestines and pork kidneys. Organs can be so high in alpha-gal content that they can even trigger anaphylaxis in people who do not have reactions after eating mammalian meat (24,59). In other words, some people sensitized to alpha-gal never have a reaction until they eat an organ like a pork kidney. At the other end of the spectrum are hundreds of mammalian byproducts. The alpha-gal content of most of these byproducts is unknown (57), and most people with AGS tolerate most of them.

The Variability of Risk

One of the hallmarks of alpha-gal syndrome is the variability of alpha-gal allergic reactions (57). This variability needs to be taken into account when assessing the risks that different foods and other exposures to alpha-gal may pose.

 

Reactions vary from person to person (57)

  • Some people tolerate all foods except for mammalian meat and organs.
  • Other people react to milk and dairy products, gelatin, and/or carrageenan.
  • A minority of people with AGS react to trace amounts of alpha-gal.

With each individual, reactions can vary dramatically from exposure to exposure (57)

  • A distinctive feature of AGS is that for many people, reactions don’t occur after every exposure, but when they do occur, they are often severe.
  • For example, some people with AGS can eat a hamburger every day for months without reacting; then one day, they eat one and have a life-threatening allergic reaction.
  • This variability is due in part to co-factors, like alcohol consumption, exercise, the use of NSAIDs (like Advil), illness, infection, stress, lack of sleep, and menses (your period) (57).

Reactions change over time (57).

  • Variability over the long-term can be influenced by your exposure to ticks (57).
    • If you avoid ticks, your alpha-gal IgE may decrease over time (91), and you may become less reactive (57).
    • If you are bitten by ticks again, your alpha-gal IgE will likely increase (20), and you may find you cannot eat foods you previously tolerated. In addition, your reactions may become more severe (57). Some people develop a sensitivity to airborne alpha-gal, like fumes from cooking meat, after new tick bites.

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.

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.

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.

Mammalian organs

(kidney, liver, lung, intestines, heart, etc.)

Mammalian sausage casings

(gut or collagen casings, even on poultry sausages)

Flounder roe (eggs)

(Not all fish roe contains alpha-gal).

Dairy products

(milk, cheese, yogurt, butter, etc.)

Gelatin

(Jello, gummy bears, marshmallows, gummy supplements, etc.)

Cross-contamination

(from splattering fat, grills, pans, food prep surfaces, etc.)

Mammalian meat

(skeletal muscle, such as beef, pork, lamb, etc.)

Lard

(in refried beans, vegetables, baked goods, tortillas, chips, foods fried in lard, etc.)

Mammalian broth and gravy

(often added to flavor dishes, injected into poultry, etc.)

Airborne alpha-gal

(e.g. fumes from cooking meat)

Carrageenan

(in dairy products, dairy-free dairy substitutes, poultry products, and many other products)

Mammalian Byproducts

(whey, mono- and di- glycerides, lanolin, vitamin D3, etc.)

Highest  risk: avoidance recommended for all people with AGS 

→ → → → →

Lower  risk: caution advised*

*Highest risk foods trigger reactions in the most people and tend to trigger the most severe reactions. Lower risk foods trigger reactions in the fewest people and are less likely to trigger severe reactions. Keep in mind that some people who are highly reactive to alpha-gal have severe reactions even to the least risky foods. 

x2

Twice as many people react to pork kidneys as react to mammalian meat (24).

100%

By definition, all people with AGS react after ingesting mammalian meat and/or organs (6,57).*

75%

75% of people who reacted to red meat also reacted to flounder roe, in one Japanese study (26).

10-33%

10-33% of people with AGS react after ingesting dairy products (57,85) in foods.

10%

≤ 10% of people with AGS react after ingesting gelatin in foods (57). **

1-2%

At least 1-2% of people with AGS report reacting after ingesting carrageenan in foods (57).***

Unknown

An unknown percentage of people with AGS react to alpha-gal in natural flavors and flavorings (6,57).

Unknown

An unknown number but likely ≤1% of people with AGS react to trace amounts of alpha-gal in mammalian byproducts in foods (6,57).

*Some people who are sensitized to alpha-gal but do not react after eating meat or organs may react after exposure to some medical products that contain alpha-gal.

**Many people who tolerate gelatin in foods without experiencing any reactions may have severe reactions after other types of exposure to gelatin, such as the intravenous administration of gelatin-based plasma volume expanders or gelatin-containing vaccines administered via intramuscular injections (6,57).

***There is a lack of data on the risks of medical products that contain carrageenan to people sensitized to alpha-gal. 

†There is a lack of data on the alpha-gal content of many mammalian byproducts and the risks of medical products that contain them (6,57).

To learn more about the relative risks of foods that contain alpha-gal and how to figure out your own, personal tolerance for different foods, see Determining Your Tolerance to Alpha-gal (coming soon).

The Riskiest Foods: Mammalian Meat, Organs, Tissues, and Fluids

Don’t play Russian roulette!

 

Stop eating mammalian meat, organs, and other high risk foods!

Alpha-gal is found in the meat, organs, tissues, cells, and fluids of all mammals except for humans, great apes, and Old World monkeys (1). It is also found in products made from them. Some of the riskiest sources of alpha-gal in food include, but are not limited to:

  • Mammalian meats (1), such as beef, pork, lamb, bison, venison, goat, horse, rabbit, squirrel, kangaroo, antelope, buffalo, camel, guinea pig, bats, whales, etc.
    • If you are not sure which animals are mammals, there is a guide here.
  • The internal organs of mammals, like liver (21), lung, heart, intestines (tripe), sweetbreads, and kidneys (6,57)
    • Internal organs can contain even more alpha-gal than meat  (22,23,24,25,26,27).
    • Some people who do not react to meat react after eating organs, like pork kidneys (24,59).
  • Mammalian gut sausage casings
    • Even turkey and chicken sausages often have these (6,57).
    • Removing the casing from chicken or turkey sausages and then eating the sausage without the casing is not advised, as this can lead to severe reactions. 
  • Mammalian fat, like lard, tallow, and suet
    • Mammalian fat is often in cooked foods, such as sauces, pastries, pie crusts, tortillas, tortilla chips, refried beans, baked beans, vegetable dishes, mashed potatoes, and desserts.
    • Some baking mixes (like Jiffy Corn Muffin Mix) contain lard.
    • Beef fat is often added to fry oil to enhance flavor (6,57).
  • Bones and bone marrow
  • Testicles (Rocky Mountain or prairie oysters)
  • Mammalian collagen (e.g. beef collagen sausage casings) (6,57)
  • Meat broth, bouillon, and stock (6,57)
  • Gravy (6,57)
  • Mammalian blood, found in soups, black pudding, blood sausage, blodplättar, and other foods
  • Meat extracts, like Bonox and Bovril
  • All other mammalian body parts, organs, tissues, cells, and fluids, such as tendons, brain, lungs, heart, nerves, skin, mammalian bile (Papait seasoning), and the products that contain them.

Most of the foods on this list should be avoided by everyone with alpha-gal syndrome. Many of us need to avoid all of them. Refer to the above figure and table for more information.

Kidneys

Kidneys are one of the most dangerous foods for people with AGS!

Tripe (mondongo)

Tripe is made from the stomach of mammals.

Sweetbreads

Sweetbreads are the thymus and pancreas of mammals.

Examples of mammalian meats, organs, and tissues

Chitterlings (tripas)

Chitterlings are made from pork intestines.

Liver

Sausages

Even turkey and chicken sausages often have casings made from mammalian intestines.

Beef

Lamb

Lamb and mutton are from sheep.

Hamburgers

Beef, lamb, pork, and other mammalian burgers

Pork 

Pork might be called “the other white meat,” but pigs are mammals.

Blood

Foods from many cuisines contain blood, such as this blood sausage from Portugal.

Venison

Jerky

Beef jerky, buffalo jerky, biltong, and other kinds of dried mammalian meat

Pork rinds

Pork rinds are made from pig skin.

Pork lard

Pork bacon

Mammalian bones and bone marrow

All other mammalian meat

Learn about other mammals that people eat, such as goats, rabbits, squirrels, and kangaroos here.

Other meat products

Beef Broth

Mammalian broths are added as a flavoring to many foods.

Bouillon

Mammalian bouillon is also used to flavor many dishes.

Soups

Soups are often made from mammalian meat and bones.

Collagen powder

Meat extracts

Some unexpected sources of lard

Gravy and sauces

Gravy and sauces are often made with lard, as are biscuits.

Refried beans

Refried beans are often made with pork lard, as are many other Mexican dishes.

Tortillas

Tortillas are often made with pork lard, and tortilla chips are often fried in it.

Pies and other pastries

Pies and pastries often have lard added to their doughs.

Corn muffin mixes

Corn muffin mixes, like Jiffy, can contain lard.

Vegetables

Vegetables may be flavored with lard, especially in the southern U.S. 

Baked beans

Baked beans are often made with lard or pork belly.

Fried chicken

Beef tallow or lard may be added to fry oil used to fry chicken and other foods.

French fries

As with chicken, beef tallow can be added to the fry oil used to make French fries.

Mashed potatoes

Mashed potatoes often have lard added to them, especially in the southern U.S.

Tips for Adjusting to a Diet without Red Meat

Explore Substitutes

  • Don’t despair! There a great substitutes for almost all the foods you love.
  • Steak:
    • Many people can’t tell emu from beef.
    • Some people think ostrich is even better, although it’s more expensive.
    • Amaroo Hills Farm, which is owned by a person with AGS, is a great source for both.
    • You can order directly from the Amaroo Hills Farm website or look for a store near you that sells their products.
    • Amaroo Hills Farms also sells other cuts of emu that are good substitutes for other cuts of beef.
  • Burgers:
  • Sausages:
    • Amaroo Hills Farm also sells delicious breakfast, Italian, and other sausage made from duck.
    • Turkey hotdogs are hard to tell apart from pork and beef ones.
    • There are good chicken and turkey sausages.
    • Do not make the mistake of eating poultry sausages with mammalian gut or collagen casings!
  • Bacon:
    • You may discover you like duck bacon better than pork bacon. D’artagnan Uncured Smoked Duck Bacon is a favorite.
    • There are also good brands of turkey and chicken bacon, and they are more readily available and cheaper.

Read Labels

  • Now that you have AGS, you need to become a label detective.  On the bright side, once you start checking labels, you will become more aware of what you eat and can adopt a healthier diet.

Learn How to Eat Out Safely

  • Create a restaurant card explaining your allergy or print one of the existing ones. There are printable restaurant cards in the Additional Resources section below.
  • Learn how to talk to restaurant staff about AGS.
  • Beware of lard! It is hidden in many foods.

Watch Your Nutrients

  • Make sure your diet contains enough protein, calcium, vitamin D, vitamin B12, and iron, especially if you have to give up dairy and don’t like fish or poultry.
    • Keep in mind that most vitamin D3 is produced from mammals, so if you take vitamin D supplements look for vegan products.
  • Consider asking your healthcare provider for a referral to a dietician if you can’t figure out what foods you can eat or have concerns about nutrition.

Use Available Resources

Try New Foods, Recipes, and Cuisines

Exploring new foods and ethnic cuisines can be fun.

  • Try guinea hens, pheasant, or quail in addition to emu and ostrich. They are delicious!
  • You can buy alligator from Fossil Farms.
  • How many kinds of beans have you tried? Check out all the varieties available from Camellia.
  • Buy an Indian Cookbook like Fresh India, which has a lot of vegetarian recipes
  • Middle Eastern cuisine also has a lot of great vegetarian dishes. Feasts has great recipes and meal ideas.
  • Cook more eggs. The Good Egg cookbook has a lot of ideas and won a James Beard award.
  • Sign-up for the New York Times Cooking site and learn how to cook lots of delicious fish, seafood, and bean dishes.

Consider a Plant-Based Diet

  •  In addition to avoiding alpha-gal, other advantages of this diet include zero cholesterol and high fiber. Plant-based diets are associated with many positive health benefits including decreased risk of heart disease, stroke, high blood pressure, obesity, high cholesterol, type 2 diabetes, and many cancers.
  • Forks over Knives is a great source of information about plant-based diets.
  • Even if you have no interest in becoming a vegan, the Forks over Knives cookbook has great ideas for substitutions for baking, etc.
  • Take the Forks over Knives cooking course and become a plant-based home chef in 90 days.
  • Even if you adopt a strictly vegan diet, you may need to avoid carrageenan.

Try These Substitutions

⚠ Beef steak

←Instead of this

Try this→

Many people can’t tell emu from beef. Some people like ostrich steaks even better, although they tend to be pricier. Both can be purchased from Amaroo Hills Farm. Pan-roasted duck breast also makes a meaty maincourse. 

✅ Emu steak

Photo courtesy of TJ Bruce

⚠ Hamburger

←Instead of this

Try this→

Ground ostrich or emu with duck fat added both make great burgers. Ground turkey and chicken are other options.  Vegan options include the Impossible Burger and the Better Burger. If you order any of the above at a restaurant, make sure they are not cooked on a grill used to cook mammalian meats. 

✅ Ostrich burger

⚠ Beef stew with vegetables

←Instead of this

Try this→

There are many cuts of emu. Emu rump roast makes a great stew.

✅ Emu rump roast with vegetables

Photo courtesy of Heather Hibbs

⚠ Pork bacon

←Instead of this

Try this→

Many people discover they like duck bacon more than pork bacon. The most popular brand of duck bacon is D’artagnan’s. Popular brands of turkey bacon include Wellshire Organic Turkey Bacon and the less expensive Sam’s Choice Uncured Turkey Bacon. Some people prefer chicken bacon, including Wellshire Fully-Cooked Chicken Bacon and Al Fresco Uncured Chicken Bacon.

You can also make your own duck bacon.

✅ Duck bacon

⚠ Pork breakfast sausage

←Instead of this

Try this→

People rave about Applegate Chicken and Sage Breakfast Sausages. If you try a different poultry sausage, remember to make sure that it doesn’t have a mammalian gut or collagen casing.

✅ Chicken breakfast sausage

⚠ Pork breakfast sausage patties

←Instead of this

Try this→

The Amaroo Hills Farm duck breakfast sausages are delicious. Amaroo Hills Farm also sells great duck chorizo and Italian sausage.

✅ Duck breakfast sausage patties

Photo courtesty of Tami McGraw

⚠ Pork chop

←Instead of this

Try this→

Revivicor has developed an alpha-gal-free pig, called the GalSafe™ pig. GalSafe™ pork products aren’t available to the public yet, but the FDA process for approving them in underway, and Revivicor is already conducting taste-tests.

✅ GalSafe™ Pork Chop

⚠ Pork lard

←Instead of this

Try this→

Duck fat makes a great substitute for lard. Other good substitutes include vegetable shortening and dairy-free butter. Remember to check labels and make sure the brand you buy doesn’t contain mammalian byproducts or carrageenan.

More advice below in Cooking Tips from People with Alpha-gal Syndrome.

✅ Duck fat

⚠ Beef Bouillon

←Instead of this

Try this→

✅ Vegan Beef Better Than Bouillon

⚠ Pork Franks

←Instead of this

Try this→

Jennie-O Turkey Franks are a popular alpha-gal-free brand of hotdog. Some people like Applegate Naturals Turkey Hotdogs better because of their simple ingredients.

 

⚠ Spaghetti Bolognese Made with Ground Beef

←Instead of this

Try this→

Italian duck sausage from Amaroo Hills farm is delicious in Italian dishes.

 

✅ Spaghetti Bolognese Made with Eggplant and Italian Duck Sausage

Photo courtesy of Kim Nellis Bivins

 

⚠ Pork Ham

←Instead of this

Try this→

 

Yes, turkey ham. It’s a thing! Wellshire Seasoned Honey Turkey Ham Nugget comes highly recommended. Smoked turkey legs can also be used in place of ham. Watch out for carrageenan in some other brands.

✅ Turkey Ham

Photo courtesy of Jennifer Burton

 

Cooking Tips from People with Alpha-gal Syndrome

How to Make a Turkey Burger Taste More Like a Hamburger

Rebecca:

I finely chop up some mushrooms and cook them with the ground turkey and it tastes really good. All of my little kids eat it up too. The mushrooms give the meat moisture and a beefy flavor. I also discovered that the cheaper turkey is more tender since it has dark and white meat. If I use ground turkey made from only white meat, it is pretty tough. 

Astrid Smith:

Add mushroom powder and soy sauce… but we just use ground emu

Julie Lyn:

Add Worcestershire sauce, a tablespoon of duck fat, and powdered mushrooms, a teaspoon garlic powder, a teaspoon onion powder. You can’t hardly tell the difference

Crystal J. Norton:

Add Worcestershire sauce and McCormick hamburger seasoning.

Crystal Payne:

Mix half ground chicken and half ground turkey then add a cap of liquid smoke for each lbs. Boom, tastes like burgers!

Annie Katarina:

Dehydrated mushroom powder adds great flavour.

Kim Nellis Bivins:

I like Mushroom & Company Umami from Trader Joe’s.

Liz Palmer: 

I find that adding onions and mushrooms sautéed in margarine or plant-based “butter” to my ground turkey gives it a heartier taste. I also sometimes add a few drops of liquid smoke.

Debbie Jones: 

Blend up onions, carrots and celery and brown it with the ground meat. Helps with the texture and taste.

April McQuate: 

Grinding your own chicken or turkey helps with texture! I buy chicken breasts or boneless chicken thighs usually. Cut them down into strips that will fit into your grinder. Package in freezer quart bags FLAT. They thaw better that way.

Butter Substitutes

Becky Godwin Ball:

I  use plant butter, mainly Miyoko’s Organic Cultured Vegan Butter, for frostings and things of that nature. For cookies that call for butter I use butter flavored vegetable shortening. I also use a product called Nutiva Organic Coconut Oil Butter Flavor to cook my eggs in every morning and to spread on my toast.

Nutiva Organic Coconut Oil Butter Flavor

Miyoko's Organic Cultured Vegan Butter

Substitute Duck Fat for Pork Lard

Montie Webb Vogt:

Duck fat is the best substitute for pork lard. I render my own from duck skins/fat available at Amaroo Hills website. It can also be purchased from D’Artagnan already rendered.

Jennifer Burton:

Best sub for pork lard – duck fat

How to Cook an Emu Steak

From Amaroo Hills Farm:

COOKING TIPS

The USDA recommends emu and ostrich be treated like beef in terms of internal cooking temperatures.  Emu and ostrich are both true red meats and are categorized as such by the USDA. Since emu and ostrich both have little fat, overcooking the meats may cause them to become dry and a bit tough.  You do not need specific emu or ostrich recipes to cook them.  Emu and ostrich are not gamey and do not require any special preparation. You can simply substitute emu and ostrich in place of beef, but just keep in mind that these meats cook quicker than beef.

 

GRILLED STEAKS/FILETS

 Chefs in culinary schools learn that grilled emu and ostrich steaks are best cooked no more than medium rare for optimal taste.  For optimal flavor and consistency, grill (or pan fry) steaks to an internal temperature of 125-130F degrees.   Then wrap in foil and let the steak rest for 5 to 10 mins to allow it to continue to cook and marinate in its own juices.  You can also cook the steaks to medium (130-140 degrees) if you prefer a more cooked steak.  For seasoning you can go simple (olive oil, salt, pepper), use a dry rub, or use a marinade—whatever you prefer.

Bacon Ideas

Stephanie Smith:

I cook turkey bacon on a sheet pan with olive oil, garlic and onion powder to get a nice crisp and savory flavor.
Using a sprinkle of brown sugar/pumpkin pie spice or drizzle maple syrup would work too for those who like sweet bacon.

Julie Lyn:

I fry turkey bacon in duck fat. It’s so delicious!

Use Smoked Turkey Instead of Ham

PJ Scott:

To season dishes such as beans use smoked turkey legs or wings. Also you can put legs in slow cooker till the meat falls off the bone and make bbq.

Jennifer Burton:

The best turkey ham is Wellshire Farms 1.75 lb Seasoned Honey Turky Ham Nugget. The next best thing to Wellshire Farms is Frick’s Smoked Turkey Drum or wings.  They make great ‘ham & beans’ or pulled pork sammies.

Anna Lee Lightsey Jordan: 

Use smoked turkey necks to season vegetables. Use smoked turkey wings to make gumbo.

Meatballs

PJ Scott:

Italian duck sausage (available from Amaroo Hills Farm) makes great meatballs or pasta sauce.

Avoidance Beyond Mammalian Meat, Organs, and Tissues

When avoiding the riskiest foods isn’t enough to stop your reactions, you may need to eliminate other sources of alpha-gal from your diet. Use the links below to learn more about these sources. 

Cross-contamination→

Milk and Other Dairy Products→
(Coming soon)

Gelatin→

Carrageenan→

Natural Flavors and Flavorings→
(Coming soon)

Mammalian Byproducts→

Not Just Food

Alpha-gal syndrome is not just a food allergy. People with AGS can also have life-threatening, and sometimes fatal, reactions to medications and other medical products. Some react to airborne alpha-gal, especially fumes from cooking meat. Personal care and household products can also cause reactions. For more information, see What is Alpha-gal Syndrome.

Non-Food-Related Risks By the Numbers

Variable

A very high to low percentage of people with AGS react to alpha-gal in medications and other medical products, depending on the product and route of administration (6,57).

Variable

Many vaccines contain alpha-gal. Some of these, notably some vaccines that contain gelatin, have been associated with severe anaphylactic reactions in people with AGS (6,42,43,57). Other vaccines that contain less alpha-gal may also pose risks. More research is needed.

10-30%

Ten to thirty percent of people with AGS report reacting to airborne alpha-gal (e.g. fumes from cooking meat) (57,93). Symptoms range from mild, such as a runny nose, to severe, including loss of consciousness.

Unknown

An unknown percentage of people with AGS react to alpha-gal in personal care and household products (57). These reactions can have a rapid onset.

More Information, Coming Soon

Medications and Other Medical Products→
(Coming soon)

Personal Care and Household Products→
(Coming soon)

Airborne Alpha-gal→
(Coming soon)

Additional Resources

The AlphaGal Kitchen

Check out the AlphaGal Kitchen for more tips on how to adjust to an alpha-gal-free diet, including recipes, emu and ostrich suppliers, restaurant tips, alpha-gal related food blogs, product recommendations and more. There is an AlphaGal Kitchen website, Facebook group, and Youtube channel.

Copeland Casati’s Shopping Tips

Copeland Casati has compiled shopping tips for people with alpha-gal syndrome here.

Restaurant Cards

Bring a card describing you allergy to restaurants and ask the wait staff to share it with the manager and chef preparing your meal. You can make your own or use one created by someone else.

 

Jennifer Burton’s restaurant cards:

Webinars

FARE Alpha-gal Syndrome: from Diagnosis to Ingredient Detective

Tick-Borne Conditions United Co-founders Dr. Jennifer Platt and Beth Carrison team with TBCU Board Chair Dr. Tina Merritt to provide guidance to those with Alpha-gal Syndrome on what ingredients to avoid in food, medicines, and other personal care products. The webinar provides an overview of Alpha Gal Syndrome (AGS) – the tick-borne condition that renders patients allergic to mammalian meats and the myriad by-products that contain mammalian-derived ingredients (e.g. pharmaceuticals and vaccines).

Cookbook Suggestions 

Warning: some recipes in some of these cookbooks include mammalian ingredients. 

Vegan for Everybody

Thug Kitchen

Warning: language may not be appropriate for children.

Forks Over Knives

The Good Egg

Feasts

Fresh India

Online Stores

Amaroo Hills Farm

Amaroo Hills Farm is owned by a farmer with alpha-gal syndrome and is a popular source of emu, ostrich, guinea fowl, and a variety of duck sausages for the alpha-gal community. 

Fossil Farms

Fossil farms sells ostrich, emu, guinea fowl, pheasants, quail, and squab, in addition to more common poultry species. They also sell alligator. 

D'Artagnan

Many people with alpha-gal syndrome like D’Artagnan duck bacon. Sometimes it is available in supermarkets, but it can also be ordered online.

Thrive Market

Thrive Market is a popular source of vegan foods and other vegan products.

Camellia

Camellia is a great source of beans and other legumes.

References

1. Commins SP, Satinover SM, Hosen J, Mozena J, Borish L, Lewis BD, Woodfolk JA, Platts-Mills TA. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-α-1, 3-galactose. Journal of Allergy and Clinical Immunology. 2009 Feb 1;123(2):426-33.

2. Commins S, Lucas S, Hosen J, Satinover SM, Borish L, Platts-Mills TA. Anaphylaxis and IgE antibodies to galactose-alpha-1, 3-galactose (alphaGal): insight from the identification of novel IgE ab to carbohydrates on mammalian proteins. Journal of Allergy and Clinical Immunology. 2008 Feb 1;121(2):S25.

3. Commins SP, James HR, Kelly LA, Pochan SL, Workman LJ, Perzanowski MS, Kocan KM, Fahy JV, Nganga LW, Ronmark E, Cooper PJ. The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1, 3-galactose. Journal of Allergy and Clinical Immunology. 2011 May 1;127(5):1286-93.

4. Soh JY, Huang CH, Lee BW. Carbohydrates as food allergens. Asia Pacific Allergy. 2015 Jan 1;5(1):17-24.

5. Levin M, Apostolovic D, Biedermann T, Commins SP, Iweala OI, Platts-Mills TA, Savi E, van Hage M, Wilson JM. Galactose α-1, 3-galactose phenotypes: Lessons from various patient populations. Annals of Allergy, Asthma & Immunology. 2019 Jun 1;122(6):598-602.

6. 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.

7. Commins SP. Invited commentary: alpha-gal allergy: tip of the iceberg to a pivotal immune response. Current allergy and asthma reports. 2016 Sep 1;16(9):61.

8. Crispell G, Commins SP, Archer-Hartman SA, Choudhary S, Dharmarajan G, Azadi P, Karim S. Discovery of alpha-gal-containing antigens in North American tick species believed to induce red meat allergy. Frontiers in immunology. 2019 May 17;10:1056.

9. Monzón JD, Atkinson EG, Henn BM, Benach JL. Population and evolutionary genomics of Amblyomma americanum, an expanding arthropod disease vector. Genome biology and evolution. 2016 May 1;8(5):1351-60.

10. Raghavan RK, Peterson AT, Cobos ME, Ganta R, Foley D. Current and future distribution of the lone star tick, Amblyomma americanum (L.)(Acari: Ixodidae) in North America. PLoS One. 2019 Jan 2;14(1):e0209082.

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32. Dunkman WJ, Rycek W, Manning MW. What does a red meat allergy have to do with anesthesia? Perioperative management of alpha-gal syndrome. Anesthesia & Analgesia. 2019 Nov 1;129(5):1242-8.

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43. Stone CA, Hemler JA, Commins SP, Schuyler AJ, Phillips EJ, Peebles RS, Fahrenholz JM. Anaphylaxis after zoster vaccine: Implicating alpha-gal allergy as a possible mechanism. Journal of Allergy and Clinical Immunology. 2017 May 1;139(5):1710-3.

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56. Steinke JW, Platts-Mills TAE, Schuyler A, Commins SP. Reply to “The common food additive carrageenan and the alpha-gal epitope”. Journal of Allergy and Clinical Immunology. 2015 Oct 28;136(6):1709-10

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67. Stein D, Schuyler A, Commins S, Behm B, Chitnavis M. P-002 YI First Dose IgE-Mediated Allergy to Infliximab Due to Galactose-α-1, 3-Galactose Allergy. Inflammatory Bowel Diseases. 2016 Mar 1;22:S9-10.

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