A Must-Read for Journalists: Alpha-gal Syndrome’s Overlooked Medication Safety Crisis
- Jasmine Uchi, PharmD
- 12 hours ago
- 7 min read
Media coverage often focuses on food. For patients, some of the most difficult questions begin at the pharmacy, hospital, or operating room.
Alpha-gal syndrome (AGS) is often introduced as an unusual tick-associated allergy that forces people to give up foods such as beef, pork, and dairy. That framing makes the condition easy to explain, but it captures only part of the story.
Many people living with AGS already understand that their reactions may extend beyond food. The greater challenge is determining whether medications, vaccines, medical devices, and surgical materials contain ingredients derived from mammals when that information is not readily available.
For these patients, the question is not simply, “What foods should I avoid?” It is also, “How can I make an informed healthcare decision when ingredient sources are not disclosed?”
That is the medication safety story still waiting to be told.
A growing condition with delayed and unpredictable reactions
Alpha-gal syndrome can develop after certain tick bites cause the immune system to become sensitized to alpha-gal, a sugar molecule found in most non-primate mammals. Unlike many food allergies, reactions can occur several hours after exposure, making the trigger difficult to identify.
Symptoms and sensitivity levels also vary considerably. Some people react primarily to mammalian meat, while others report reactions associated with dairy products, gelatin, medications, personal care products, or medical materials. Reactions may include gastrointestinal symptoms, hives, swelling, respiratory distress, or anaphylaxis.
The Centers for Disease Control and Prevention has estimated that as many as 450,000 Americans may have been affected by AGS between 2010 and 2022. HHS Secretary Robert F. Kennedy Jr. has suggested that the true number could be substantially higher, potentially reaching into the millions. [1]
Healthcare awareness has not kept pace. In a CDC survey, 42% of participating healthcare providers had never heard of AGS, while another 35% reported that they were not confident in their ability to diagnose or manage it. [2]
For patients, this knowledge gap can mean delayed diagnoses, unexplained symptoms, and repeated efforts to identify exposures across food, medications, and other products. Patients are not overlooking these risks. They are attempting to navigate a healthcare system that frequently does not provide the information needed to evaluate them.
The label lists the ingredient, but not necessarily its source
Patients with AGS may encounter ingredients such as gelatin, lactose, glycerin, or magnesium stearate in medications. The presence of one of these ingredients does not automatically mean that every patient with AGS will experience a reaction. Individual sensitivity, the route of administration, the amount present, and the ingredient’s source may all affect risk.
The central problem is uncertainty.
Drug manufacturers are not required to disclose the sources of inactive ingredients. A medication label may list gelatin, for example, without indicating whether it was derived from cattle, pigs, fish, or another source. Other inactive ingredients may be produced from either plant or animal materials, yet their origins are rarely identified in the package insert. For a patient with AGS, this omission can mean the difference between confidently taking a routine prescription and facing the possibility of a serious allergic reaction. [3]
Even pharmacists and prescribers may be unable to determine an ingredient’s source without contacting the manufacturer. Manufacturers may then need to consult suppliers or review raw material records before providing an answer, if a definitive answer is available at all.
For a patient deciding whether to take a prescription, undergo a procedure, or receive treatment during an emergency, this is not a theoretical labeling issue. It is a barrier to informed medical decision-making.
A survey of 559 people with AGS found that 91.8% had changed how they used medications because of the condition. Nearly half reported experiencing anaphylaxis after using a medication they believed contained an alpha-gal source. [4] Additional research presented at the 2025 AAAAI/WAO Joint Congress documented an 81.9% increase in animal-free medication inquiries between the first two quarters of 2024. The findings reinforce that inadequate labeling of animal-derived ingredients can create a substantial burden and contribute to worse health outcomes for people with AGS. [7]
These findings do not establish that every medication containing a potentially mammalian-derived ingredient will cause a reaction. They demonstrate the extent to which patients are being forced to make healthcare decisions amid significant uncertainty.
The issue extends beyond prescription bottles
The same transparency gap can follow patients into hospitals and operating rooms.
Researchers have detected alpha-gal in certain commercially available bioprosthetic materials, vascular grafts, and surgical patches. Clinical reports have also described adverse reactions or complications involving bovine-derived and porcine-derived tissues, including biological heart valves, in patients with AGS. [6]
This does not mean that every mammalian-derived medical product is unsafe for every patient with AGS. It means clinicians need reliable information to assess the risks, consider alternatives when appropriate, and engage patients in informed decision-making.
The consequences of missing information become especially important when a product is implanted or administered directly into the body.
A federal proposal could bring alpha-gal into the labeling conversation
Representative Morgan Griffith of Virginia, who has publicly discussed living with AGS, introduced H.R. 1178, the Alpha-Gal Allergen Inclusion Act.
The legislation seeks to include alpha-gal among the major food allergens recognized under federal law and would establish related disclosure requirements. Its introduction reflects a growing recognition that current labeling standards do not adequately address the needs of people with AGS.
Pill Clarity, formerly VeganMed, has also pursued regulatory action. On July 10, 2023, its team filed a Citizen Petition urging the FDA to require manufacturers of drugs and dietary supplements to disclose whether ingredients are animal-derived, encourage the use of suitable plant-based or synthetic alternatives, and permit certification symbols identifying products without animal-derived ingredients. [8]
However, food labeling represents only one part of the transparency problem. Patients and clinicians also need clearer information about medications, inactive ingredients, vaccines, biologics, medical devices, and surgical materials.
Until those systems change, patients are left contacting manufacturers, searching package inserts, consulting pharmacists, and comparing information from multiple sources. This is not a failure by patients to consider exposures beyond food. It is the predictable result of an information system that was not designed with AGS in mind.
What happens when even manufacturers cannot provide a clear answer?
Pill Clarity operates a Medical Information Service that investigates medication ingredients and their sources for patients and healthcare professionals.
The service supports questions involving allergies, dietary needs, and religious considerations. Its pharmacists research individual products, contact manufacturers when necessary, and typically provide findings within 24 to 72 hours.
This work can involve reviewing prescribing information, communicating with pharmaceutical medical information departments, and investigating the sourcing of raw materials. In many cases, the answer cannot be found on the medication label alone.
The difficulty of obtaining reliable information is exemplified from the medical information departments of 20 leading pharmaceutical companies. Only 60% ultimately provided an accurate response, and only 45% provided a response without additional prompting. Pharmacists were unable to determine whether 33% of the medications evaluated were free from animal-derived ingredients. [5]
In effect, 40% of the companies evaluated did not provide an accurate answer about the ingredients or ingredient sources in their own products.
The missing infrastructure for medication transparency
Corrie Newman, a compounding director and pharmacy technician who regularly relies on Pill Clarity, described the service’s role this way:
“Pill Clarity is critical to the community, from the patient level, pharmacy level, hospital, doctor level, because without their service, without the resources that Pill Clarity is able to do, for me personally, if someone comes to me, I can’t do my job. I can’t complete that job without Pill Clarity.”
Her experience illustrates the larger story. AGS is not only a food allergy story or a tick story. It is also a medication safety, healthcare infrastructure, and ingredient transparency story.
Patients are already doing the work of asking questions, tracking possible exposures, consulting clinicians, and advocating for themselves. What they lack is a standardized system capable of providing clear, accurate, and timely answers.
For reporters covering the growth of alpha-gal syndrome, the next chapter is not another list of foods patients may need to avoid. It is an investigation into what happens when a patient, pharmacist, physician, or surgeon asks a straightforward question about a medical product and discovers that no one can provide a definitive answer.
The central question is no longer whether patients understand that AGS can extend beyond food.
It is why the healthcare system still makes them investigate their medication risks largely on their own.
For more information on navigating medications in the setting of AGS:
Listen - Questions People Ask (Podcast with Dr. Scott Commins)
Watch: Is your hospital ready for alpha-gal? (Hospital focused webinar)
For media requests, contact - Sachin A Shah, PharmD, FACC, FAHA (info@pillclarity.org)
Co-authored by: Abtin Anvari, Patrick Moreno, and Prince Neequaye
References
U.S. Department of Health and Human Services. (2026, May 29). HHS unveils sweeping plan to combat Lyme disease and advance treatment [Press release]. https://www.hhs.gov/press-room/hhs-unveils-plan-to-combat-lyme-disease.html
Carpenter, A., Drexler, N. A., McCormick, D. W., Thompson, J. M., Kersh, G., Commins, S. P., & Salzer, J. S. (2023). Health care provider knowledge regarding alpha-gal syndrome — United States, March–May 2022. MMWR Morbidity and Mortality Weekly Report, 72(30), 809–814. https://doi.org/10.15585/mmwr.mm7230a1
National Association of Boards of Pharmacy. (2026, April 2). ISMP safety briefs: Alpha-gal syndrome — Evaluate active and inactive ingredients. https://nabp.pharmacy/news/blog/regulatory_news/ismp-safety-briefs-alpha-gal-syndrome-evaluate-active-and-inactive-ingredients/
Uchi H, et al. Patient survey on medication use and reactions in AGS (DIA poster/self-selected sample), 2023. — 559-patient survey on medication avoidance/anaphylaxis rates.
Son M, Wolfe C, Uchi H, et al. "Accuracy of pharmaceutical company responses on animal-derived ingredients." Journal of Contemporary Pharmacy Practice, 2023. — pilot study of top-20-manufacturer response accuracy.
Kuravi KV, Sorrells LT, Nellis JR, Rahman F, Walters AH, Matheny RG, Choudhary SK, Ayares DL, Commins SP, Bianchi JR, Turek JW. Allergic response to medical products in patients with alpha-gal syndrome. J Thorac Cardiovasc Surg. 2022 Dec;164(6):e411-e424. doi: 10.1016/j.jtcvs.2021.03.100. Epub 2021 Apr 9. PMID: 33933257; PMCID: PMC9673037.
American Academy of Allergy, Asthma & Immunology. Labelling of Animal-Free Medications Needed for Patients with Alpha-Gal Syndrome. Published February 10, 2025. Accessed August 25, 2026. https://www.aaaai.org/about/news/news/2025/animal
VeganMed, Inc. Citizen Petition Regarding the Labeling of Animal-Derived Ingredients in Drugs and Dietary Supplements. Submitted to the U.S. Food and Drug Administration July 10, 2023. Docket No. FDA-2023-P-2852. Accessed August 25, 2026. https://www.regulations.gov/document/FDA-2023-P-2852-0001
Disclaimer: The product and/or information provided on Pill Clarity is of a general nature and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. We do not lab test the products to confirm that they are free from animal ingredients, and it is possible that the formulation and ingredients could have changed. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or product. The information provided in this post is accurate and up to date as of the date it was written. However, please note that circumstances and facts may change over time, and new information may become available that could alter the accuracy or relevance of the content. We encourage readers to verify and cross-reference any information provided here with trusted sources or consult relevant professionals for the most current and accurate updates.
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