Alpha-gal Syndrome and Impact on Patient Safety

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 
BJC Health

 

Kyna Henrici, RN 
Medical Evidence Director - Cardiovascular 
Vizient, Inc.

Host:   
Stacy Lauderdale, Pharm.D., BCPS 
AVP, Evidence-Based Medicine 
Vizient, Inc.

 

00:05 – Introduction 

• 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 

00:48 – Meet the Guests 

•  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  

01:32 – How It Develops 

• 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 

11:11 – Gaps in Care 

• 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 

12:53 – Closing Remarks 

 

Links and Resources: Alpha-gal Syndrome | Alpha-gal Syndrome | CDC 

 

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