Tick Bites, Meat Allergies, and Chronic Urticaria

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The rising incidence of tick-bite induced meat allergies may account for cases of previously unexplained (“idiopathic”) persistent hives among children.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Tick-bite induced meat allergies are really unlike any other food allergy we know. “[T]he most interesting feature of the [reaction] may be the first [symptom] can occur [hours] after eating meat.” Normally, if you have an allergic reaction to a bee sting or something, it happens within minutes. But with this, you could eat a piece of bacon for breakfast, and your throat doesn’t start closing off until the afternoon, and so you blame lunch, or doctors just call it “‘spontaneous’ or ‘idiopathic’ anaphylaxis.” Ideopathic is just doctorspeak for we have no idea what the cause is.

The delay is because the alpha-gal is thought to be absorbed along with the fat in the meat, given that “[t]he allergic reaction [occurs] 4 to 5 hours after [meat] ingestion correspond[ing] to the peak absorption time of [the fat] from the [digestive] tract.”

What makes it even more difficult to diagnose is that “the majority of [victims experience] only occasional overt reactions, despite regular meat consumption.” “[F]attier meats [like] pork rinds, [may] provoke episodes more consistently and [severely].” But, still, it’s not like it happens every time.

And, it’s on the rise. Ten years ago, we didn’t even know the thing existed. But, now, in tick-ridden states, as many as “20% of the population…have [these anti-meat allergic] antibodies,” and more and more people are coming in affected—though probably no more than 10% who test positive go on to experience hives, or serious allergic reactions to meat.

We’re also seeing it more and more in kids—researchers in Virginia finding it not uncommonly, though “[i]dentification of these cases may not be straightforward.” “Unlike in [adults] who frequently present with [systemic reactions],…the majority of children with this syndrome present with [just skin manifestations, such as hives].” Doesn’t mean it’s not serious. In fact, nearly half the kids ended up in the ER, and about one in twelve needed to be hospitalized.

Up to a quarter of the population breaks out in hives at some point in their lives, but some children can be affected for weeks or months. And, it can be triggered by infections, foods, drugs, parasites, autoimmune. But, in a large subset of cases, we don’t know what the trigger is, and so, we call it “chronic idiopathic urticaria.” It’s a common thing pediatricians see, and the only cure is avoiding and eliminating whatever is triggering it. But, in three-quarters of the cases, we have no clue.

But, now, we know that “many children who [have] been diagnosed with [mysterious hives or allergic reactions], [and may have] been specifically told that the reactions were not a result of [a] food allergy,” may have actually been suffering from anti-gal meat allergies. Given “the serious nature of the reactions” and “the rising frequency” of allergic swelling and hives across all age groups, this “underscore[s] the importance of identifying” what’s going on. And, “clearly…physicians should keep this [new] diagnosis in mind.”

“[A]llergies to [meat] might be more common than previously thought;” 2% would mean millions of people. But, just to put it in context, Americans are much more likely to suffer an anaphylactic reaction due to seafood—tick bite or not—no matter where they live. A national survey of emergency rooms found shellfish was by far the most frequently implicated food. And, unlike many other allergies, kids don’t tend to outgrow fish and shellfish allergies.

And, many fish allergies are actually allergies not to the fish, but to worms within the fish—like anisakis. Exposure to these parasites, living or dead, in fish is “a widespread problem.” In fact, you can even have an allergic reaction to the parasitic fish worm eating chickens that were fed on fish meal. This is one of the ways someone who’s allergic to fish could get triggered by just eating chicken.

Reminds me of “pork-cat syndrome,” where your mouth can get all itchy eating bacon, in people with cat allergies, because of an “allergic cross-reaction” between cat skin and pig-blood proteins.

Anisakis worms are found particularly in cod, anchovies, and squid, and can also cause chronic hives and intractable chronic itching.

Because of these worms, researchers recommend that people stop eating all seafood sushi altogether, because “besides inducing allergenic reactions,” the worms may cause a leaky gut syndrome, “which often is unrecognized and…can predispose to other, more important pathologies” than just being itchy all over.

Please consider volunteering to help out on the site.

Images thanks to andy_carter via flickr

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Tick-bite induced meat allergies are really unlike any other food allergy we know. “[T]he most interesting feature of the [reaction] may be the first [symptom] can occur [hours] after eating meat.” Normally, if you have an allergic reaction to a bee sting or something, it happens within minutes. But with this, you could eat a piece of bacon for breakfast, and your throat doesn’t start closing off until the afternoon, and so you blame lunch, or doctors just call it “‘spontaneous’ or ‘idiopathic’ anaphylaxis.” Ideopathic is just doctorspeak for we have no idea what the cause is.

The delay is because the alpha-gal is thought to be absorbed along with the fat in the meat, given that “[t]he allergic reaction [occurs] 4 to 5 hours after [meat] ingestion correspond[ing] to the peak absorption time of [the fat] from the [digestive] tract.”

What makes it even more difficult to diagnose is that “the majority of [victims experience] only occasional overt reactions, despite regular meat consumption.” “[F]attier meats [like] pork rinds, [may] provoke episodes more consistently and [severely].” But, still, it’s not like it happens every time.

And, it’s on the rise. Ten years ago, we didn’t even know the thing existed. But, now, in tick-ridden states, as many as “20% of the population…have [these anti-meat allergic] antibodies,” and more and more people are coming in affected—though probably no more than 10% who test positive go on to experience hives, or serious allergic reactions to meat.

We’re also seeing it more and more in kids—researchers in Virginia finding it not uncommonly, though “[i]dentification of these cases may not be straightforward.” “Unlike in [adults] who frequently present with [systemic reactions],…the majority of children with this syndrome present with [just skin manifestations, such as hives].” Doesn’t mean it’s not serious. In fact, nearly half the kids ended up in the ER, and about one in twelve needed to be hospitalized.

Up to a quarter of the population breaks out in hives at some point in their lives, but some children can be affected for weeks or months. And, it can be triggered by infections, foods, drugs, parasites, autoimmune. But, in a large subset of cases, we don’t know what the trigger is, and so, we call it “chronic idiopathic urticaria.” It’s a common thing pediatricians see, and the only cure is avoiding and eliminating whatever is triggering it. But, in three-quarters of the cases, we have no clue.

But, now, we know that “many children who [have] been diagnosed with [mysterious hives or allergic reactions], [and may have] been specifically told that the reactions were not a result of [a] food allergy,” may have actually been suffering from anti-gal meat allergies. Given “the serious nature of the reactions” and “the rising frequency” of allergic swelling and hives across all age groups, this “underscore[s] the importance of identifying” what’s going on. And, “clearly…physicians should keep this [new] diagnosis in mind.”

“[A]llergies to [meat] might be more common than previously thought;” 2% would mean millions of people. But, just to put it in context, Americans are much more likely to suffer an anaphylactic reaction due to seafood—tick bite or not—no matter where they live. A national survey of emergency rooms found shellfish was by far the most frequently implicated food. And, unlike many other allergies, kids don’t tend to outgrow fish and shellfish allergies.

And, many fish allergies are actually allergies not to the fish, but to worms within the fish—like anisakis. Exposure to these parasites, living or dead, in fish is “a widespread problem.” In fact, you can even have an allergic reaction to the parasitic fish worm eating chickens that were fed on fish meal. This is one of the ways someone who’s allergic to fish could get triggered by just eating chicken.

Reminds me of “pork-cat syndrome,” where your mouth can get all itchy eating bacon, in people with cat allergies, because of an “allergic cross-reaction” between cat skin and pig-blood proteins.

Anisakis worms are found particularly in cod, anchovies, and squid, and can also cause chronic hives and intractable chronic itching.

Because of these worms, researchers recommend that people stop eating all seafood sushi altogether, because “besides inducing allergenic reactions,” the worms may cause a leaky gut syndrome, “which often is unrecognized and…can predispose to other, more important pathologies” than just being itchy all over.

Please consider volunteering to help out on the site.

Images thanks to andy_carter via flickr

Doctor's Note

What is this alpha gal stuff? Make sure you see my “backgrounder” video, Alpha Gal and the Lone Star Tick.

I previously covered anisakis in Allergenic Fish Worms, and other allergenic parasite reactions in Chronic Headaches and Pork Tapeworms.

Worms might not the only thing increasing allergies in fish. See:

A few weeks ago I did a 4-part series on allergies if anyone’s interested:

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