Complete Mammalian Foods List for Alpha-Gal Syndrome

Complete Mammalian Foods List for Alpha-Gal Syndrome — scientific infographic poster
Mammalian foods avoidance grid for alpha-gal syndrome

Alpha-Gal Syndrome (AGS) is an allergy to a sugar made by most mammals, and the published food and product lists for it come from a handful of sources: the U.S. Centers for Disease Control and Prevention (CDC), clinical reviews from allergy research groups, and published case series and patient surveys. CDC states that most healthcare providers recommend patients with AGS stop eating meat from mammals, and that some patients also need to eliminate other sources such as dairy and certain medications. This page gathers what those sources report about mammalian foods, hidden mammalian ingredients and mammal-derived medical products, with each finding attributed.

Table of Contents

  1. The Underlying Rule: Which Animals Make Alpha-Gal
  2. Mammalian Meats
  3. Animal Foods CDC Lists Without Alpha-Gal
  4. Gelatin — A Hidden Source
  5. Dairy — Reactions Vary
  6. Lard, Tallow, Suet, Schmaltz
  7. Broth, Stock, Bouillon and Gravy
  8. Organ Meats
  9. Processed Foods With Mammalian Ingredients
  10. Medicines, Vaccines and Medical Products
  11. Carrageenan — What Is and Is Not Known
  12. Magnesium Stearate and Other Excipients
  13. Sausage Casings
  14. Insects and Novel Foods
  15. Foods CDC Lists as Not Containing Alpha-Gal
  16. Label Terms That Point to Mammalian Sources
  17. Where This Information Comes From
  18. Key Research Papers
  19. Connections
  20. Featured Videos

1. The Underlying Rule: Which Animals Make Alpha-Gal

Alpha-Gal Syndrome is an IgE-mediated allergy to galactose-alpha-1,3-galactose (alpha-gal). The enzyme that makes it, alpha-1,3-galactosyltransferase, is active in marsupials, non-primate placental mammals, lemurs and New World monkeys, and the gene is absent in other vertebrates. It was inactivated in the ancestors of Old World monkeys and apes, so humans, apes and Old World monkeys do not make alpha-gal (Galili 2015). CDC describes alpha-gal as a molecule naturally produced in the bodies of most mammals but not in people, and also found in the saliva of some ticks.

In the United States, CDC states that AGS is primarily associated with the bite of the lone star tick (Amblyomma americanum), and less commonly with blacklegged and western blacklegged ticks; other tick species have been linked to AGS in other countries. CDC reports that most U.S. cases occur in South, East and Central states, where most lone star ticks are found. A 2011 University of Virginia study found that IgE to alpha-gal rose 20-fold or more in 3 people followed after tick bites, and that alpha-gal IgE correlated with tick-bite histories and with IgE to lone star tick proteins (Commins 2011).

CDC reports that more than 110,000 suspected cases were identified in the United States between 2010 and 2022, that AGS is not nationally notifiable, and that as many as 450,000 people may be affected. The 2023 MMWR laboratory analysis found that 90,018 people received a positive alpha-gal IgE test from January 2017 through December 2022 (Thompson 2023). A companion 2023 MMWR survey of 1,500 U.S. health care providers found that 42% had never heard of AGS (Carpenter 2023).

The source lists below follow from that biology:

2. Mammalian Meats

CDC lists beef, pork, lamb, venison, rabbit "or other meat from mammals" as foods that may contain alpha-gal, and states that a person with AGS is more likely to react to mammalian meat than to other alpha-gal-containing products such as dairy. The term "red meat" is loose: pork is a mammalian meat regardless of the colour of the cooked flesh. The original University of Virginia case series described reactions 3 to 6 hours after eating beef, pork or lamb (Commins 2009). Common examples of each group:

Beef and Cattle

Pork

Lamb, Mutton, Goat

Game and Other Mammals

3. Animal Foods CDC Lists Without Alpha-Gal

CDC's list of foods that do not contain alpha-gal names poultry (such as chicken, turkey, duck or quail), fish and seafood (such as shrimp), and eggs. In the 2009 University of Virginia series, patients' IgE bound beef, pork, lamb and cow's milk but not turkey, chicken or fish (Commins 2009), consistent with the gene being absent outside mammals. Prepared dishes made from these foods can still carry mammalian ingredients such as butter, cream, lard or beef stock.

Fish

Shellfish and Other Seafood

Poultry

Eggs

Reptiles

4. Gelatin — A Hidden Source

Gelatin is made from the collagen of animal hides, bones and connective tissue, and CDC lists "gelatin made from beef or pork" among the animal products some people with AGS are sensitive to. In an Australian study of 1,335 adults skin-tested with gelatin, 30 of 40 patients with red-meat allergy tested positive to gelatin and 12 were clinically allergic to it; alpha-gal was measured in bovine gelatin colloids at about 0.44 to 0.52 μg per gram of gelatin (Mullins 2012). In a 2026 survey of 3,437 adults with clinician-diagnosed AGS, 61.3% reported reactions to gelatin (Merritt Meinholz 2026).

Where gelatin commonly appears

Gelatin and collagen terms on labels

Non-mammalian gelling agents

5. Dairy — Reactions Vary

CDC states that food products containing milk and milk products may contain alpha-gal, but that many patients with AGS can tolerate milk products; cow's milk is the only alpha-gal-containing ingredient classified as a major food allergen under U.S. labeling law, so it must be named on food labels. A 2020 clinical review from the University of Virginia group describes the primary treatment as avoiding mammalian meat "and also dairy in some cases" (Platts-Mills 2020).

How many patients react to dairy depends on who is counted. A 2024 laboratory study cites recent studies reporting that 10–20% of AGS patients also react to dairy proteins; it found that three milk-fat-globule proteins (butyrophilin, lactadherin and xanthine oxidase) carry alpha-gal, supporting the possibility that milk, "especially in its whole form," can cause reactions (Aiuto 2024). In the 2026 self-selected patient survey recruited through social media and support organizations, 66.9% reported reactions to dairy (Merritt Meinholz 2026). In a CDC-led chart review of 100 patients at the University of North Carolina, those reporting dairy reactions were less likely to have isolated skin symptoms (3% vs. 24%) than dairy-tolerant patients (Binder 2023).

A bar chart from a 2026 survey of 3,437 adults with clinician-diagnosed alpha-gal syndrome, recruited through social media and support organizations: the share who reported reactions to each product was beef 97.7 percent, pork 87.2 percent, dairy 66.9 percent, gelatin 61.3 percent, personal care products 42.0 percent, prescription medicines 41.3 percent and over-the-counter medicines 36.4 percent. WHAT PATIENTS REPORTED REACTING TO 2026 survey · 3,437 adults with clinician-diagnosed AGS · share reporting a reaction to each product beef 97.7% pork 87.2% dairy 66.9% gelatin 61.3% personal care products 42.0% prescription medicines 41.3% over-the-counter medicines 36.4% self-reported; respondents recruited through social media and support organizations · Merritt Meinholz et al., Healthcare (Basel) 2026

The published sources do not set out a dairy reintroduction schedule, and CDC describes later tolerance of alpha-gal-containing products as an individualized medical decision made with a healthcare provider. Dairy foods that contain cow's milk or milk fat include:

6. Lard, Tallow, Suet, Schmaltz

CDC lists "products made or cooked with mammal fat, like lard, tallow, or suet" among the animal products some people with AGS are sensitive to. Restaurant frying fats are not always stated on menus, so the same dish can differ between kitchens. The fats by source animal:

7. Broth, Stock, Bouillon and Gravy

CDC lists "meat broth, bouillon, stock, and gravy" among the animal products some people with AGS are sensitive to. Bone broth is simmered collagen, fat and tissue from whichever animal is used, so its alpha-gal status follows the animal:

No published data were found on how much alpha-gal skimmed or clarified beef broth carries. Chicken and fish stocks are the poultry and seafood alternatives in CDC's terms.

8. Organ Meats

CDC lists "mammal organ meat, such as liver, kidneys, intestines, or sweetbreads" and Rocky Mountain or prairie oysters (testicles) among foods that may contain alpha-gal. A German clinical review reports that reactions to innards come on more rapidly than reactions to red meat (Fischer 2016), and a Luxembourg–German study describes pork kidney as the most potent known trigger; it identified two alpha-gal-carrying kidney proteins whose IgE epitopes resisted heat denaturation (Hilger 2016).

9. Processed Foods With Mammalian Ingredients

CDC notes that its product list is not complete and that people with AGS might not react to every product containing alpha-gal, or may react differently to the same product at different times. Common places mammalian ingredients appear in processed foods:

Soups and sauces

Candies and sweets

Vitamins and supplements

Baked goods

Beverages

Beans, dressings and condiments

10. Medicines, Vaccines and Medical Products

CDC states that some medications and vaccines may contain alpha-gal-containing additives, stabilizers or coatings, that not all patients with AGS react to them, and that decisions about specific vaccines and medications are individual risk-benefit decisions made with healthcare providers. CDC names animal-derived medical products — heart valves from pigs or cows, monoclonal antibodies, heparin and certain antivenoms — as products that may contain alpha-gal. The 2020 clinical review notes that heart valves, gelatin-based plasma expanders and pancreatic enzymes are relevant to select patient groups, and that a minority of patients may benefit from avoiding a wide range of mammalian-derived products such as gelatin (Platts-Mills 2020). Published findings:

In the 2026 patient survey, 41.3% reported reactions to prescription medications, 36.4% to over-the-counter medications and 42.0% to personal care products (Merritt Meinholz 2026). In a Tennessee anaphylaxis series, alpha-gal was the most common identified cause among cases with a definitive cause, at 28 of 85 (Pattanaik 2018). Decisions about medicines belong with a clinician.

11. Carrageenan — What Is and Is Not Known

Carrageenan is extracted from red seaweed (Chondrus crispus and relatives), not from mammals, and is used as a thickener and stabilizer in dairy alternatives, deli meats, ice cream, yogurt and infant formula. It is not on CDC's list of products that may contain alpha-gal.

The question raised in the literature is structural. Carrageenan is a chain of galactose units joined by beta-1,4 and alpha-1,3 galactose–galactose bonds (Borsani 2021). A 2015 letter in the Journal of Allergy and Clinical Immunology raised the possibility that carrageenan relates to the alpha-gal epitope (Tobacman 2015), and a 2024 laboratory study found that enzymatically produced carrageenan fragments bound natural human anti-alpha-gal antibodies and a monoclonal anti-alpha-gal antibody (Sokolova 2024). No clinical study was found showing that dietary carrageenan triggers reactions in people with AGS. Separately, a 2021 review describes carrageenan's use as an inflammatory agent in animal and cell experiments and states that no definitive human safety data are available (Borsani 2021).

12. Magnesium Stearate and Other Excipients

Magnesium stearate is a common flow agent in tablets, capsules and powdered supplements. It is a magnesium salt of stearic acid, and stearic acid can come from either vegetable fat or animal fat; labels often do not state which. CDC lists magnesium stearate among medication and vaccine ingredients that may contain alpha-gal, together with gelatin, glycerin and bovine extract, and adds that not all patients with AGS react to these ingredients.

13. Sausage Casings

The filling of a sausage may be poultry while the casing comes from a mammal. CDC lists mammalian intestines among organ meats that may contain alpha-gal.

The label phrase "natural casing" does not name the animal.

14. Insects and Novel Foods

CDC's lists do not address insects, cultivated meat or plant-based meat substitutes, and no clinical studies of these foods in AGS were found.

15. Foods CDC Lists as Not Containing Alpha-Gal

CDC's list of foods that do not contain alpha-gal is short: poultry, fish and seafood, eggs, and fruits and vegetables. Plant foods — grains, legumes, nuts, seeds, fruits and vegetables — come from no animal at all. Examples within those groups:

Proteins

Fats and pantry items

Grains, legumes and vegetables

Snacks

16. Label Terms That Point to Mammalian Sources

CDC's managing-symptoms page lists reading food labels as part of identifying products that contain alpha-gal. Ingredient-panel terms that indicate, or can indicate, a mammalian source:

17. Where This Information Comes From

Key Research Papers

  1. Platts-Mills TAE, Li RC, Keshavarz B, Smith AR, Wilson JM. Diagnosis and management of patients with the α-Gal syndrome. J Allergy Clin Immunol Pract. 2020;8(1):15-23.e1. — clinical review of diagnosis and management. — doi:10.1016/j.jaip.2019.09.017
  2. Commins SP, James HR, Kelly LA, et al. The relevance of tick bites to the production of IgE antibodies to the mammalian oligosaccharide galactose-α-1,3-galactose. J Allergy Clin Immunol. 2011;127(5):1286-93.e6. — the tick–alpha-gal IgE connection from the University of Virginia group. — doi:10.1016/j.jaci.2011.02.019
  3. Pattanaik D, Lieberman P, Lieberman J, et al. The changing face of anaphylaxis in adults and adolescents. Ann Allergy Asthma Immunol. 2018;121(5):594-597. — alpha-gal was the most common definitive cause of anaphylaxis in this series. — doi:10.1016/j.anai.2018.07.017
  4. Fischer J, Biedermann T. Delayed immediate-type hypersensitivity to red meat and innards: current insights into a novel disease entity. J Dtsch Dermatol Ges. 2016;14(1):38-44. — reports that reactions to innards come on more rapidly than to red meat. — doi:10.1111/ddg.12821
  5. Commins SP, Satinover SM, Hosen J, et al. Delayed anaphylaxis, angioedema, or urticaria after consumption of red meat in patients with IgE antibodies specific for galactose-alpha-1,3-galactose. J Allergy Clin Immunol. 2009;123(2):426-33. PubMed PMID: 19070355
  6. Chung CH, Mirakhur B, Chan E, et al. Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1,3-galactose. N Engl J Med. 2008;358(11):1109-17. PubMed PMID: 18337601
  7. Thompson JM, Carpenter A, Kersh GJ, et al. Geographic distribution of suspected alpha-gal syndrome cases — United States, January 2017–December 2022. MMWR Morb Mortal Wkly Rep. 2023;72(30):815-820. PubMed PMID: 37498787
  8. Carpenter A, Drexler NA, McCormick DW, et al. Health care provider knowledge regarding alpha-gal syndrome — United States, March–May 2022. MMWR Morb Mortal Wkly Rep. 2023;72(30):809-814. PubMed PMID: 37498792
  9. Galili U. Significance of the evolutionary α1,3-galactosyltransferase (GGTA1) gene inactivation in preventing extinction of apes and old world monkeys. J Mol Evol. 2015;80(1):1-9. PubMed PMID: 25315716
  10. Mullins RJ, James H, Platts-Mills TA, et al. Relationship between red meat allergy and sensitization to gelatin and galactose-α-1,3-galactose. J Allergy Clin Immunol. 2012;129(5):1334-1342.e1. PubMed PMID: 22480538
  11. Hilger C, Fischer J, Swiontek K, et al. Two galactose-α-1,3-galactose carrying peptidases from pork kidney mediate anaphylactogenic responses in delayed meat allergy. Allergy. 2016;71(5):711-9. PubMed PMID: 26728983
  12. Binder AM, Cherry-Brown D, Biggerstaff BJ, et al. Clinical and laboratory features of patients diagnosed with alpha-gal syndrome—2010–2019. Allergy. 2023;78(2):477-487. PubMed PMID: 36178236
  13. Aiuto B, Cirrincione S, Giuffrida MG, et al. Milk fat globule proteins are relevant bovine milk allergens in patients with α-Gal syndrome. Mol Nutr Food Res. 2024;68(10):e2300796. PubMed PMID: 38704747
  14. Merritt Meinholz T, Cleary K, Iweala OI, et al. Alpha-Gal syndrome is more than meats the IgE: a patient survey of symptoms, diagnosis, and burdens. Healthcare (Basel). 2026;14(16):2522. PubMed PMID: 42651291
  15. Stone CA Jr, Hemler JA, Commins SP, et al. Anaphylaxis after zoster vaccine: implicating alpha-gal allergy as a possible mechanism. J Allergy Clin Immunol. 2017;139(5):1710-1713.e2. PubMed PMID: 27986511
  16. Mozzicato SM, Tripathi A, Posthumus JB, et al. Porcine or bovine valve replacement in 3 patients with IgE antibodies to the mammalian oligosaccharide galactose-alpha-1,3-galactose. J Allergy Clin Immunol Pract. 2014;2(5):637-638. PubMed PMID: 25213067
  17. Hawkins RB, Wilson JM, Mehaffey JH, et al. Safety of intravenous heparin for cardiac surgery in patients with alpha-gal syndrome. Ann Thorac Surg. 2021;111(6):1991-1997. PubMed PMID: 33031779
  18. Nwamara U, Kaplan MC, Mason N, et al. A retrospective evaluation of heparin product reactions in patients with alpha-gal allergies. Ticks Tick Borne Dis. 2022;13(1):101869. PubMed PMID: 34798527
  19. Tobacman JK. The common food additive carrageenan and the alpha-gal epitope. J Allergy Clin Immunol. 2015;136(6):1708-1709. (letter) PubMed PMID: 26518095
  20. Borsani B, De Santis R, Perico V, et al. The role of carrageenan in inflammatory bowel diseases and allergic reactions: where do we stand? Nutrients. 2021;13(10):3402. PubMed PMID: 34684400
  21. Sokolova E, Jouanneau D, Chevenier A, et al. Enzymatically-derived oligo-carrageenans interact with α-Gal antibodies and Galectin-3. Carbohydr Polym. 2024;324:121563. PubMed PMID: 37985065

PubMed Topic Searches

Focused PubMed searches for deeper reading on hidden sources, dairy tolerance, gelatin exposure, and the mammalian-food question:

  1. PubMed: Alpha gal gelatin
  2. PubMed: Alpha gal dairy tolerance
  3. PubMed: Alpha gal syndrome diet
  4. PubMed: Alpha gal hidden sources
  5. PubMed: Galactose alpha 1 3 galactose food list
  6. PubMed: Alpha gal magnesium stearate
  7. PubMed: Alpha gal carrageenan
  8. PubMed: Alpha gal organ meat

Back to Table of Contents

Connections

Back to Table of Contents