This tick bite can make you allergic to red meat, other animal products

The University of Kentucky Public Relations and Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week’s column is by Arfa Faiz, M.D., an allergist with UK HealthCare as well as Jonathan Larson, Ph.D., and Hannah Tiffin, Ph.D., both assistant extension entomology professors in the Department of Entomology at the UK Martin-Gatton College of Agriculture, Food and Environment.

LEXINGTON, Ky. (May 28, 2025) — Outdoor-loving Kentuckians know that tick bites carry risk.

Many have heard that tick bites can lead to Lyme disease, but did you know they can also cause a little-known allergy to red meat and other mammalian byproducts called Alpha-Gal Syndrome? Kentuckians are more at-risk for Alpha-Gal Syndrome (AGS) because the tick that carries the allergy is prevalent here.

With warm weather and long days beckoning many a Kentuckian outdoors in the spring and summer, it’s best to be aware of AGS, how to avoid it and even how to live with it.

To help better understanding around this unique allergy, UKNow spoke with Arfa Faiz, M.D., an allergist with UK HealthCare as well as Jonathan Larson, Ph.D., and Hannah Tiffin, Ph.D., both assistant extension entomology professors in the Department of Entomology at the UK Martin-Gatton College of Agriculture, Food and Environment. They explain the basics of AGS, how to avoid it and what lifestyle changes you can make if you’ve been diagnosed with the allergy.  

Additionally, tune into a webinar on the allergy presented by UK Martin-Gatton CAFE on Thursday, May 29, at 7:30 p.m. Your local extension office may be hosting a watch party.

UKNow: What is alpha-gal syndrome and what causes it?

Faiz: For most allergic conditions in the world, the immune system attacks protein in a food or medication. In this special kind of allergy, the immune system attacks a carbohydrate or sugar molecule called “galactose-alpha-1,3-galactose.” Alpha-Gal, as we commonly know it, is an allergy or overreaction to this molecule which is found in most mammalian or red meat.

This allergy presents as rashes, swelling of the face/lips/eyelids, trouble breathing, coughing, wheezing, vomiting, abdominal pain, passing out or similar symptoms. In this case, the reaction occurs typically three to eight hours later. Because these symptoms are delayed, you may wake up with them in the middle of the night after an evening meal.

UKNow: What types of ticks can cause it? Are they more prevalent in Kentucky?

Larson: The tick most associated with AGS in the United States is the lone star tick, which is the most common medically relevant tick species in the Commonwealth. States known to deal with more lone star ticks are also the states with the highest reported cases of AGS, according to the Centers for Disease Control and Prevention map. Not every lone star tick is a metaphorical “loaded gun.” You may be bitten by one and experience no issues with Alpha-Gal. The tick may not be carrying the molecule and individuals react differently to exposure.

UKNow: What can people do to avoid tick bites?

Larson: In Kentucky, the high tick season tends to be April-June, though we can be exposed to ticks on any day above freezing. Kentuckians should be conscious of when they are entering tick habitat, which tends to be overgrown areas with lots of vegetation. They don’t thrive in the open sun; therefore, they don’t tend to live in places like the bright center of a yard. They usually prefer the edges of habitats.

Tiffin: You can use this intel to make your property more tick-safe as well — focusing on areas of highest use and keeping those areas mowed, vegetation well-maintained (reducing brushy areas) and removing leaf litter in the fall from these high-use areas. Reducing wildlife visitors on your property, particularly deer and rodents that can bring ticks with them, can also help reduce your tick exposure.

Larson: After being in “ticky” areas, it’s best to do a tick check, first on your clothes and then on susceptible spots on the body (hair, ears, armpits, belly button, groin, knees and ankles). Getting the lone star tick off of you before it bites is essential. You can further prevent tick bites by wearing skin-based repellents such as DEET or treating your clothing with permethrin. Permethrin is an insecticide, once it dries on the clothes, it will kill any ticks that climb aboard. People who work outdoors or who enjoy outdoor activities often turn to it over DEET.

Tiffin: You can use both of these products in tandem, too. By treating your clothes with permethrin, you can still safely perform outdoor activities even if you forgot the DEET at home. It is important to follow all label instructions and treat clothing in ventilated areas away from pets. Permethrin when wet is particularly toxic to cats but is safe around your furry animals after your treated clothes dry.

If you need to be in more “tick risky” areas, for outdoor and agricultural work, you can also wear tall boots or tape the bottoms of your pant legs so that ticks do not find an “alternate route” under your clothing.

UKNow: If a tick does bite me, what should I do?

Faiz: If a tick is found, remove it carefully with tweezers, clean the site, and keep the tick for future identification — you can also take a picture with your phone. You can see your primary care provider to be evaluated and discuss any new symptoms. If there are no new symptoms, you likely don’t need to do be evaluated.

Tiffin: If keeping the tick for future tick identification or testing, you can either put the tick in a plastic bag and freeze it or put it in a small bottle with ethanol -- this can be found at your local drug store, pharmacy and many grocery store first aid sections.

Kentucky residents can have ticks identified by going to their county extension office for more information. 

UKNow: What foods or products might cause a reaction and is there treatment for Alpha-Gal?

Faiz: Alpha-Gal is found in mammalian meats or red meats and their associated byproducts. This includes beef, lamb, goat, pig and even horse products. Think hamburgers, hot dogs, pepperoni, steak, bacon, pork, etc. Rarely, people can react to milk or gelatin made from these animals.

After the diagnosis is confirmed by history taking and testing, the best treatment is avoidance of the meats. If there is accidental ingestion and symptoms develop, the treatment is epinephrine/epipen. Nasal epinephrine is also now available. Antihistamines can help if there is only rash and swelling and no other symptoms. Sometimes in the case of allergic reactions to medications, we need to avoid them long term. It is important to see an allergist to discuss your options.

UKNow: What sorts of lifestyle changes do individuals with Alpha-Gal have to make? Does the allergy ever subside?

Faiz: Living with an allergy can involve changing your lifestyle. A wholly vegetarian or vegan diet is not usually necessary — people can still have fish, chicken and other poultry. Checking ingredients in foods that you eat is important. When eating out at a restaurant, inform the staff about your allergy. For most allergies, there is no cure. For Alpha-Gal allergy, sometimes after avoidance of reaction-causing meats for a period of time — often years — people may be able to resume eating meat in the future.

It is important to note that many medications — cetuximab, for example, a cancer medication — contains molecules that look like Alpha-Gal. We now know that people with this allergy also react to these medications, so they need to be avoided. Common cautionary ingredients include gelatin, animal-sourced magnesium stearate, glycerin and lactose.

UKNow: Are there any resources that UK’s extension offices offer that may be helpful for Alpha-Gal?

Larson: Easily accessible information on AGS can be found on the UK Department of Entomology website or you can check out this publication from the UK Cooperative Extension Service.

We will be offering a statewide webinar on this topic. It is Thursday, May 29, at 7:30 p.m. Interested folks can attend on Zoom or find out if their local extension office is hosting a watch party.

UKNow: Anything else I haven’t asked about that you think is important to add?

Faiz: This allergy was first reported in the U.S. Other countries like Australia, Sweden, Germany, France and South Africa have reported similar cases but due to the bite of different ticks. I find it interesting that we discover these new allergic conditions and get more answers every day through the help of our dedicated researchers and scientists.

Tiffin: Preventing tick bites is your best course of action when protecting yourself and loved ones from AGS and other tick-associated diseases and syndromes. Think like a tick and stay away from places ticks like to hide out. Cover and check places on your body that a tick could get an easy, hidden blood meal. Plus, don’t forget to use preventatives on your four-legged family. While this syndrome is primarily associated with the lone star tick in the U.S., it has recently been linked to other tick species, so being tick aware and bite safe is your best bet for reducing your risk.