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 

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