This article first appeared on Health.
Celebrity personal trainer Tracy Anderson is the picture of health; just check out our recent cover story on the 43-year-old fitness guru and you’ll see what we mean. Not only is she incredibly fit, but she’s also a huge proponent of giving your body what it needs—whether that’s good food, a hard sweat session, or plenty of self care.
So when Anderson broke out in hives at the end of one of her trademark Vitality Weeks last July, she knew that something was seriously wrong. What she would learn later is that she’d developed alpha-gal syndrome—an allergy triggered by a Lone Star–tick bite, which can cause potentially fatal reactions to red meat.
Almost a year after that scary incident, Health spoke with Anderson and with Erin McGintee, MD, the Long Island–based allergist who diagnosed her. Here’s what they both want people to know about alpha-gal syndrome, a condition that’s becoming more prevalent as the tick population around the country explodes.
“I was in Charleston, South Carolina, last July, and I ate ice cream,” Anderson recalls. “I was about to get on my flight home three hours later, and I started breaking out in this horrible rash all over my stomach and back. I didn’t have any allergies that I knew of, but it felt really bad. I decided not to get on the plane and go to the hospital instead.”
At the hospital, Anderson received Benadryl and steroids, and doctors advised her to see her allergist as soon as she returned to New York. Once she was home on Long Island, she called Dr. McGintee of ENT and Allergy Associates in Southampton.
A routine allergy test offered no answers, but Dr. McGintee had another idea: She wondered if Anderson might have alpha-gal syndrome, a condition triggered by a tick bite. Alpha-gal syndrome causes an allergic reaction to red meat, and in rare cases, also to dairy products.
Anderson knew she’d been bitten by a tick a few weeks earlier. “I’d been in the Hamptons and was shaving my legs in the shower,” she says. “I remember seeing a little black dot behind my knee, but I saw it too late and I shaved it off—slicing it in half, basically—before I had a chance to remove it the right way.”
After finding the tick, Anderson knew she should be on the lookout for symptoms of Lyme disease, which has reached epidemic levels on Long Island. (She’d developed Lyme disease once before, but had caught it early and recovered after a course of antibiotics.) It hadn’t occurred to her, however, to watch for signs of a strange new allergy.
She agreed to a blood test—the only way to definitively diagnose alpha-gal syndrome—which came back positive. “The really scary thing is, if I were to have eaten bacon or a hamburger, I could have gone into anaphylactic shock,” Anderson says. “Now I carry an EpiPen with me all the time.”
What is alpha-gal syndrome?
lpha-gal is short for galactose-alpha-1,3-galactose, a carbohydrate found in the blood and meat of mammals—think beef, lamb, pork, and venison. When ticks feed off deer and then bite a human, they can expose that human to alpha-gal molecules.
For some people, that exposure trigger their immune system to produce antibodiesto fight alpha-gal. Those antibodies build over the following weeks and months, eventually resulting in allergic reactions every time that person eats red meat. Some people also react to dairy products or medications containing gelatin as well.
Doctors aren’t sure why only some people develop alpha-gal antibodies, or what the exact window for developing a reaction is. “Most people who do get the allergy develop it within several weeks to a month,” Dr. McGintee tells Health. “If you’ve been bitten and you’re still eating meat two months later, you probably didn’t get the allergy.”
The prevalence of alpha-gal syndrome has increased on Long Island—and in other pockets of the southern and eastern United States—as tick populations have grown. Dr. McGintee diagnosed her first case in 2010, and since then has identified more than 440 others.
“It’s that time of year—sometimes I may diagnose five or six cases a week,” says Dr. McGintee. Those numbers may not tell the whole story, either. “I believe there are many more patients out there who haven’t recognized what’s causing their symptoms,” she adds, “or who have heard about the allergy and have diagnosed themselves.”
It’s unclear how prevalent alpha-gal syndrome is nationwide, but case estimates are in the thousands. Since it was first identified in 2006, only one type of tick has been shown to spread the allergy: the Lone Star tick, which is common throughout the southeastern and eastern United States.
In an NPR article published this week, Scott Commins, MD, an allergist and associate professor of medicine at the University of North Carolina, Chapel Hill, said that the range of the Lone Star tick is expanding and that "we're confident the number is over 5,000 [cases of alpha-gal syndrome], and that's in the U.S. alone."
Adult female Lone Star ticks can be identified by the white dot on their backs, but males and immature nymphs—which can also transmit alpha-gal—do not have this telltale mark. “There’s a misconception that if a tick doesn’t have a white dot, than you’re okay,” says Dr. McGintee. “What you really need is a good tick identification chart, or if you can remove the tick, your doctor can identify it for you.”
What it’s like to have alpha-gal syndrome
Most people with alpha-gal syndrome experience an allergic reaction about three to six hours after eating red meat. Symptoms vary but can include itchy skin, runny nose, and vomiting and diarrhea. Some people can experience a full-blown anaphylactic reaction, which can include a dangerous drop in blood pressure, loss of consciousness, and difficulty breathing.
“Severe reactions are rare, but I’ve had a number of patients who’ve had close calls and needed an ambulance, and had IV lines placed before they got to the hospital,” says Dr. McGintee. Fortunately, she says, there have been no reported cases of fatalities due to alpha-gal syndrome.
RELATED: 15 Things You Must Know About Ticks
Anderson says her experience with alpha-gal syndrome has changed her life, in several ways. “I don’t eat red meat for health reasons, so that part has been easy,” she says. “But now I also have to make sure my salmon or fish isn’t cooked in a pan that steak is being cooked in, or that a food isn’t made with some type of mammal-meat broth.”
And since Anderson is part of the small percentage of people with alpha-gal syndrome who also react to dairy products, those are off-limits as well. “No butter, no cheese, no ice cream, and that’s been really hard because I just love dairy too much,” she says.
Her diagnosis has also made her more vigilant about watching her kids, ages 5 and 19. “If they get bit by a tick but the tick falls off or we don’t find it, and then they eat bacon, they could have a reaction,” she says. “So I make sure I have EpiPens for either one of them at any time.”
The good news is that alpha-gal syndrome doesn’t seem to be permanent. “If you can avoid being bitten by another tick, the allergy will eventually go away for most patients,” advises Dr. McGintee. “It goes away at different rates for everybody,” she adds, but three to five years is a frequently cited estimate. Anderson says that just a year later, her antibody levels are much lower than they were when she first received her diagnosis.
How to protect yourself
Dr. McGintee stresses that most people who are bitten by Lone Star ticks will notdevelop alpha-gal antibodies. She thinks it’s a bit extreme to buy an expensive EpiPen or to stop eating meat completely, just in case you have (or may have) been bitten.
She also doesn’t recommend that everyone who’s been bitten get a blood test for alpha-gal, because false positives do occur and the condition would likely become dramatically over-diagnosed. “As scary as it sounds, I think waiting until you experience some type of reaction is the best way to go,” she says.
But she does recommend taking common-sense precautions if you do find a tick attached to your skin. First, remove it with tweezers and clean the skin around the bite. Then, pay attention for the next month or two for any strange symptoms—and maybe cut back on the burgers, too.
“This isn’t like a peanut allergy, where a tiny little exposure could kill you,” says Dr. McGintee. “The vast majority of people require a decent serving of meat, and they’re more likely to have a reaction if the meat is more fatty.”
“So if you want to play it safe, don’t eat large, fatty portions of meat for the next few weeks,” she continues. “Then gradually add meat back in, starting with leaner cuts.”
To reduce your risk of getting tick bites in the future, wear insect repellant with DEET when you’re spending time outdoors, especially in wooded or grassy areas where ticks are prevalent. Wearing tall, light-colored socks, long pants, and clothing treated with the permethrin can help keep ticks off your skin, as well. (Here are some of our editors' picks.)
It’s also important to conduct skin checks on yourself, your pets, and your family members any time you come indoors from tick-infested areas. Finding them before they bite will protect you not just from a sudden and scary meat allergy, but also from the other diseases ticks can carry.