Alpha-gal syndrome is an emerging and often underrecognized allergy triggered by a tick bite that can cause delayed reactions to red meat and mammalian-derived products. In this episode, host Stacy Lauderdale is joined by clinical experts Zack Stacy and Kyna Henrici to unpack the science behind alpha-gal, its implications in healthcare settings, and the operational challenges providers face in managing this complex condition.
Guest Speakers:
Zachary Stacy, Pharm.D., MS, FCCP, BCPS
Clinical Pharmacy Specialist, Surgery
Medical Evidence Director - Cardiovascular
Host:
Stacy Lauderdale, Pharm.D., BCPS
AVP, Evidence-Based Medicine
Podcast introduction and welcome to VerifiedRx 00:14 – What is alpha-gal syndrome
Overview of alpha-gal syndrome Delayed allergic reactions after eating red meat Often linked to tick bites Zack Stacy, clinical pharmacy specialist Kyna Henrici, medical evidence director 01:10 – Understanding the Allergy
Alpha-gal is a carbohydrate in nonprimate mammals that can trigger an allergy in humans Key difference is delayed reaction timing Symptoms are not always easy to trace Triggered by tick bites Immune system produces IgE antibodies Oral exposure to alpha-gal leads to delayed reactions IV exposure to alpha-gal can cause immediate reactions 02:17 – Prevalence and Diagnosis Challenges
More common in Midwest and southern United States Likely underdiagnosed Often mistaken for general food allergies Allergy may fade over time 03:07 – Risks in Healthcare Settings
Patient safety concerns beyond food Mammalian components in medications and devices Examples include heparin and surgical materials 03:44 – Hidden Medication Risks
Inactive ingredients can be animal derived Examples include glycerin, lactose, amino acids, stearates Difficult to identify and track 04:42 – Lack of Transparency
No centralized ingredient database Sourcing can change frequently Variability across manufacturers and batches 05:33 – Screening in Surgical Settings
Medication review at NDC level Identification of active and inactive ingredients May require contacting manufacturers 06:45 – Timing Challenges
Urgent procedures limit investigation time Manufacturer responses may take days Alternative medications often needed 07:14 – Identifying At Risk Patients
Many patients are unaware they have alpha-gal syndrome Screening includes questions about dairy tolerance Three patient categories used for evaluation 08:32 – Using Dairy as a Screening Tool
Dairy tolerance helps guide risk level Food exposure typically higher than medication exposure Determines need for deeper review 09:12 – Managing Emergencies
Focus shifts from avoidance to risk mitigation Use of team communication and clear documentation Preparation for unavoidable exposure 10:03 – Prevention and Preparedness
Stock alpha-gal safe medications when possible Prepare for allergic reactions with standard treatments 10:47 – Team Based Care Approach
Collaboration across care teams is essential Premedication strategies may be used Close monitoring for reactions Limited visibility into product ingredients Need for better labeling and transparency 11:33 – Need for Standardization
Call for clearer guidance and clinician education Desire for centralized resource for medication ingredients 12:24 – Monitoring Challenges
CDC tracking decreased after privatization of testing Cases likely still increasing Links and Resources: Alpha-gal Syndrome | Alpha-gal Syndrome | CDC