Navigating Alpha-Gal Syndrome: What Can I Eat?

Newly diagnosed alpha-gal syndrome patients frequently ask, “What should I eat?” This is understandable, given that many are only told they must eliminate mammal meat from their diet after receiving their diagnosis along with a prescription for two Epipens. People wrongly think avoiding red meat is enough, but it’s actually mammal meat of all kinds that should be avoided.

What is alpha gal?

Alpha gal syndrome is both a food allergy and a tick-borne disease. The allergy is complicated because alpha-gal (galactose-alpha-1,3-galactose) is a sugar found in most mammals, but not humans, old-world monkeys or apes. Because it is a sugar instead of a protein, allergic reactions can take hours to emerge.

However, if you react to airborne scents like cooking meat, severe reactions can be rapid. So, fill those Epipen prescriptions and carry two of them with you everywhere, along with your other rescue medications. I also keep two Epipens in my nightstand just in case of cross contamination. Note: there is now a nasal epinephrine called Neffy that works for me, too.

What should I eat?

The first time I went to the grocery store after diagnosis, I wandered around and eventually left the store in tears. All of my gluten-free prepared and packaged foods had long ingredient lists, and I didn’t yet know how to wade through them.

Try the Fig app if you plan to eat foods with multiple ingredients. It’s not perfect, but it filters out the worst offenders. Since I eat very little processed food anymore, I know that protein (other than mammal meat), vegetables, raw nuts, grains, and fruits are AGS friendly.

When you’re newly diagnosed, stick with simple foods.

Remember the old four basic food groups? You divided up your plate with protein, vegetables, dairy, and grains. This is the best place to start. For some of us, dairy’s a no-go, but there are straightforward substitutes. Here is an updated version of the four basic food groups located at myplate.gov.

AGS Safe protein

• Chicken. Since I’m extremely sensitive, I choose organic chicken that is vegetarian fed. I find it is less processed and therefore has less opportunity for cross contamination or processing agents. Although I buy chicken breasts for homemade chicken salad, thighs are my favorite and have more flavor.

• Eggs. Eggs are a wonderful source of protein and vitamins. I personally like eggs that are vegetarian fed. I also buy pastured eggs because I don’t like how animals raised for food are treated in our country.

• Turkey. I love Kroger’s Simple Truth turkey breast for sandwiches. Some turkey and other processed foods—especially some vegan ones—can contain carrageenan which has the alpha-gal epitope. I also react to red algae and carrageenan with GI distress that goes on for days. I like Mary’s turkey lunchmeats too. You can find them at Natural Grocers. I also enjoy Diestel ground turkey, which doesn’t have rosemary extract as a preservative. I find frozen Diestel ground turkey at Natural Grocers. I had an adverse reaction to some fresh ground turkey with rosemary extract. However, I don’t react to organic rosemary extract used as a preservative in crackers from Simple Mills or in organic chicken broth from Pacific Foods. Not everyone may react to this preservative, but I do. It’s also possible I reacted to cross contamination from the meat grinder if it wasn’t well cleaned. You can grind your own boneless chicken thighs with a food processor, and I did until I found the Diestel brand. They also have some Diestel products at Whole Foods.

• Bacon. Don’t expect bacon from other animals to taste like pork bacon. It doesn’t, but it doesn’t send you into anaphylaxis either. I like Godshall’s turkey bacon (simple and safe ingredients) and Kroger’s Simple Truth turkey bacon. I think turkey bacon tastes like Canadian bacon, and we love it at our house. Many people also like duck bacon from Amaroo Hills. I had some, and I didn’t think it was that great, but everyone is different.

• Sausages. Choose chicken or turkey sausages that are casing free. I like Bilinski’s and the casing-free ones from Thrive Market. I buy Bilinski’s from Sprout’s Farmers Market. You can also find chicken breakfast sausages from Thrive Market, and Diestel has turkey breakfast sausage.

• Fish and seafood. Many alpha-gal people can eat canned fish, but I also have Mast Cell Activation Syndrome (MCAS), so I had GI issues with canned tuna. I buy my fish from Wild Alaskan Company and keep it in the freezer until I’m ready to use it. It is frozen on the boat, cut into single serve portions later, and is very good. I don’t eat a lot of seafood because of histamine and processing issues, but it’s fine for most AGS patients. Just make sure you buy seafood from a reputable company. You might even check with your preferred company for processing agents like carrageenan. I write a lot of emails to food companies.

• Emu and Ostrich. At first, I couldn’t make myself eat these two birds, but now I wonder why. They are excellent low-fat beef substitutes. Ground ostrich especially tastes like grass fed beef to me. They offer vitamins and variety I can’t get elsewhere in my diet. I buy my ostrich from Salger’s Ostrich Products, and my emu from Amaroo Farms. I eat more ostrich than emu because I like the taste better. There are also more farms popping up every day, probably because AGS is becoming more common. If you want to try another farm, ask them how their birds are processed. You want to determine whether they are done on shared equipment with mammal and what the cleaning process is.

• Vegan. Beans and tofu along with pea protein if you digest it well are great vegan sources of protein. Because I’m gluten-free I cannot eat seitan. I eat a lot of beans, and I like Rancho Gordo beans best. They are so fresh I can set them to cook in the early morning, and then have them for dinner with some type of bread I’ve made. Rancho Gordo has great vegetarian recipes on their website too. If you want to add ground turkey or turkey sausages to your bean soup, just add them after the beans are cooked. They need little cooking. I usually add them for the last hour. I freeze my beans for later use, but canned beans work too.

Here’s where I wrote about beans and greens. If I mentioned pork, it was before I was diagnosed with AGS.

Can I eat dairy?

Many people with alpha-gal syndrome don’t need to eliminate dairy, especially low-fat sources. In fact, it’s advised to keep dairy in your diet if you have no reactions. However, after a month or two of going mammal meat free, I still had terrible GI symptoms, so I removed dairy from my diet.

If you decide to eliminate dairy, here are my favorite dairy-free substitutes.

• Myoko’s plant butter and pourable mozzarella. Many people love her oatmilk spreadable butter, and I love her cashew butter for baking. It has the best consistency for my quick breads, cakes and desserts. I use it one-to one. I enjoy her pourable mozzarella for homemade pizzas and nachos.

• Melt. This is my favorite spreadable plant butter. I use it all the time. I find it at Sprouts and Uptown Grocery Co.

• Violife sliced mature cheddar and smoke provolone along with shredded cheddar. I think these taste pretty close to cheese if you’ve had no mammal cheese in a while. The shredded cheese melts better than the slices, and I wouldn’t use the slices as a grilled cheese sandwich. I use them for turkey sandwiches.
• Babybel plant-based cheese is also good, and it melts. I order it from Kroger, and it’s at Sprouts Market. Bill even likes it on crackers.
• Plant-based milk. Oatley oat milk is very good, but if I’m buying plant-based milk I buy Elmhurst or Malk. They don’t have gums, and are made of a few simple ingredients. I like cashew milk, and I now make my own. I use this Kidisle nut milk maker. This way, my nut milk is very fresh because I make it every four or five days. I can also control the richness of the milk by adding a few more nuts.
• Myoko’s cream cheese alternative. It is of outstanding quality and works well in recipes.
• Coconut milk. I like Native Forest Simple coconut milk because it doesn’t contain gums or other thickeners. Although gums are not an alpha-gal problem in particular, I find some of them hard to digest.

Vegetables are AGS safe.

When I was first diagnosed, I ate a lot of sweet potatoes topped with black beans. It was good and hearty, and it felt good in my stomach. I still eat a lot of vegetables. Of course, all vegetables are alpha-gal free. Just remember to watch out for any sauces in frozen vegetables. Instead of buying those, use your own butter or plant butter.

You may find with the alpha-gal diet you need more fat than you did before. I do. I lost 80 pounds since October 2023, but I’m now at a stable weight. However, I eat more carbs and fat than I did previously. Granted, I make all of my food so it’s as natural as I can make it.

Fruit is AGS safe.

Just like vegetables, fruit is AGS safe. One of my favorite lunches is an apple with almond butter. I eat this all the time. Fruit and vegetables are a great way to get vitamins and minerals into your diet.

Nuts.

Because some nuts are lightly coated in gelatin, I buy all of my nuts raw and then roast them myself. It only takes a few minutes to create whatever type of roasted nuts you want. Myoko’s plant butter is great for pecans, for example. Add a little flaky salt, and you have a delicious snack.

Oils.

I stick with coconut, olive, and avocado oil, using use coconut oil for some bread and cake recipes. Use a combination of avocado and olive oil to fry fish, chicken and vegetables.

Bread.

For those who can eat wheat, I hear Dave’s Killer Bread is great and safe to eat. As a gluten-free eater since 2007, I favor some breads from Natural Grocer. Recently, I’ve also started making my sourdough and regular gluten-free breads. Again, it’s all about quality and since I’m fume reactive, I don’t go out to many places. I’m learning to love my homemaking skills again.

One more thing

Always read labels. I react more strongly to cross-contamination and questionable ingredients than many other alpha-gal patients. However, we should remain cautious about potential issues, including natural flavors and preservatives like rosemary extract. It’s definitely a learning curve, but I wanted to give you somewhere to start.

To learn more about my experiences with alpha-gal syndrome, I have blog posts on both the condition itself and gardening while living with it.

Whew, that was a long post, and I’m sure I’ve missed some things. If you’re aware of any other safe products for those with alpha-gal, share them in the comments.

Until next time, stay warm and eat well.