COLUMBIA, Mo. – As cases of alpha-gal syndrome continue to surface across the Show-Me-State, University of Missouri Extension has released five new publications to help individuals and families understand, prevent and manage the condition.
Alpha-gal syndrome (AGS) is a potentially life-threatening food allergy triggered by the bite of the lone star tick. The tick can transmit a carbohydrate known as alpha-gal (galactose-alpha-1,3-galactose), which is found in meat and products derived from mammals such as beef, pork and venison. Symptoms, which typically occur two to six hours after eating, range from hives and digestive distress to severe anaphylaxis.
Missouri has one of the higher reported rates of AGS, making public awareness especially important. MU Extension’s interdisciplinary alpha-gal syndrome team is led by Eden Stewart, MU Extension nutrition and health specialist. They are available in print and as free downloadable PDFs.
“Together, the guides are designed to provide practical, research-based information that helps reduce confusion and give people clear next steps,” Stewart said.
Alpha-Gal Syndrome Awareness (N1350)
Alpha-Gal Syndrome Awareness, by MU Extension nutrition and health specialist Rachel O’Halloran, explains what AGS is, how it develops and how it is diagnosed. The guide details common symptoms, including hives, nausea, diarrhea, swelling, breathing difficulties and drops in blood pressure.
Because there is no cure, prevention is emphasized. The guide provides step-by-step tick-avoidance strategies, including protective clothing, use of EPA-approved repellents, permethrin-treated gear, post-outdoor tick checks and proper tick removal techniques.
Cooking With Alpha-Gal Syndrome (N1351)
Cooking with Alpha-Gal Syndrome, by former MU assistant extension professor Sarah Wood, outlines common trigger foods, including red meat, organ meats, certain dairy products, gelatin, broths and gravies made from mammalian sources.
It explains that sensitivity varies widely. Some individuals react only to red meat, while others must avoid dairy or even cross-contact from shared cooking surfaces. The publication describes areas where cross-contact may occur, such as grills, fry oil, meat slicers, cast iron pans and shared utensils.
The guide offers lists AGS-friendly options such as poultry, fish, eggs, legumes, nuts, seeds, soy products and plant-based dairy alternatives. A detailed chart helps readers understand how to meet daily protein needs without red meat.
The publication also encourages open communication when dining out and with family members, reinforcing that education and planning can reduce risk and stress.
Shopping for Alpha-Gal Syndrome (N1352)
For many people, the grocery store becomes one of the biggest challenges after diagnosis. Shopping for Alpha-Gal Syndrome, by MU Extension nutrition and health specialist Eden Stewart, focuses on reading labels carefully and identifying hidden ingredients.
The guide explains how ingredients such as gelatin, collagen, glycerin, lard, suet, beef or pork broth and certain “natural flavors” may contain mammal-derived components. It provides examples of where these ingredients may be present unexpectedly, including poultry products, snack foods, baked goods, pantry staples and protein powders.
In addition to food, the publication addresses personal care items and medications. It advises individuals to inform physicians, dentists and pharmacists of their diagnosis, since some capsules, supplements, vaccines or ointments may have mammalian byproducts.
Alpha-Gal Syndrome Food Substitutions (N1353)
For those who enjoy cooking and baking, Alpha-Gal Syndrome Food Substitutions, by former MU Extension community health specialist Shelby Yake, provides practical alternatives for commonly used mammalian ingredients.
It suggests poultry, fish, shellfish and plant-based proteins as substitutes for beef and pork. For baking and sautéing, it lists options such as olive oil, coconut oil, vegan butter and other plant-based fats. It provides alternatives for milk, buttermilk, cheese, cream cheese and meat broths, including plant-based milks, vegetable stocks and creative flavor enhancers like miso, nutritional yeast and vinegars.
The guide encourages readers to try substitutes in small amounts, research proper ratios and explore different grocery stores or ethnic markets for allergy-friendly products. It also reminds readers to check labels every time, since processing methods and ingredients can change.
Alpha-Gal Syndrome Nutrients of Concern (N1354)
When people eliminate red meat or dairy, nutritional gaps can occur. Alpha-Gal Syndrome Nutrients of Concern, by MU Extension community health specialist Emily Poncher, explains which nutrients may be affected, including iron, vitamin B12, zinc, calcium, vitamin D and protein.
The guide describes why each nutrient matters and lists AGS-friendly sources. For example, iron can be found in beans, leafy greens and seafood; vitamin B12 in fortified cereals, eggs and fish; and calcium in fortified plant milks and certain vegetables. Practical tips are included to help incorporate these foods into everyday meals.
A practical path forward
“While an AGS diagnosis can feel overwhelming, informed choices can significantly reduce risk and improve quality of life,” Stewart said. “By combining prevention strategies with practical guidance on shopping, cooking, substitution and nutrition, the new publications aim to give Missourians tools they can use immediately.”
All five guides are available through MU Extension as free downloadable PDFs and as print handouts.