Alpha-Gal Diet: Eating Tolerated Foods

The core of management of symptomatic AGS involves avoidance of mammalian meat (and visceral organs).

Key Dietary And Medication Considerations

1. Some patients also need to avoid dairy products.
2. Avoid mammalian-derived gelatin.
3. High-fat dairy may be more problematic than light milk.
4. Whey proteins such as lactoferrin, gamma-globulin and lactoperoxidase have been shown to carry alpha-gal.139
5. The monoclonal antibody cetuximab has significant amounts of alpha-gal and should be avoided by all patients unless under the care of an allergist.
6. Colloidal fluids can have gelatin and so high risk in AGS patients, though fluids of this kind are no longer used in most countries.
7. Other medications such as pancreatic enzyme replacement (which is typically porcine derived).
8. Anti-venom also often contains alpha-gal,140–144 but these can generally be tolerated or at least, lack good data linking them with severe allergic reactions.71,142
9. Heparin does not intrinsically have alpha-gal linkages, but because heparin is sourced from swine intestines contamination with alpha-gal is possible.
10. Patients who have received high-dose intravenous heparin have experienced excess anaphylaxis.146

Reference

Wilson JM, Erickson L, Levin M, Ailsworth SM, Commins SP, Platts-Mills TAE. Tick bites, IgE to galactose-alpha-1,3-galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha-gal syndrome. Allergy. 2024 Jun;79(6):1440-1454. doi: 10.1111/all.16003. Epub 2024 Jan 9. PMID: 38193233; PMCID: PMC11142869.