It was a crisp and snowy morning as I walked into Lolli’s Dinner Bell Café to meet farmer Sharon Pennington in early December.
We're there to sit down to a breakfast of black coffee, hashbrowns and eggs at the small café inside Lolli’s Livestock Market in Macon, Missouri, and to speak about Pennington’s experiences with alpha-gal syndrome, the tickborne allergy to mammalian products, including red meat and dairy.
But within minutes — and before she even finds her seat — Pennington calls me over to introduce me to another cattle farmer who has the condition.
She sits down and nurses her hot cup of coffee, and before we can order, the owner of the livestock market walks in to tell her “Hi” and to share that her young son also has alpha-gal.
As our food arrives, Pennington shares that she knows many folks, most of whom are cattle farmers, who have alpha-gal. Most of them, she added, have had severe, potentially life-threatening allergic responses. Just like her.
“I was having all these nuclear bombs going off in my body,” Pennington said. “[I was] thinking, ‘I need to make sure my will is lined out.’"
Earlier this year, Pennington began experiencing anaphylaxis, a severe full-body allergic reaction that can lead to difficulties breathing, a sudden drop in blood pressure and heart problems.
She said she began noticing these symptoms when working with the orphan calves and nurse cows she raised on Love Lake Iris Farm, the farm she owns with her husband.
“One cow calved, and she had too much milk, so I was milking her and around all that fluid and just wondering, ‘Why in the world am I going to pass out or die? I don't know what's going on with me.’”
She said she was having frequent reactions, but she couldn’t identity was what causing them. She had a “cardiac incident” after helping one of the cows birth a calf. One night she slept in her car because her husband cooked bacon and it became difficult to breath. There was another incident where she couldn’t figure out why she was panting and unable to catch her breath for days — later, she discovered a cattle brush that had made it inside the house.
It got to the point that she wasn’t able to work with her cattle anymore, which she said was heartbreaking as she, her mother and her grandmother had all raised orphan calves on their respective farms.
So, Pennington and her husband made the decision to halt the orphan calf operation and sell off their nurse cows and weaned calves.
“[We] sold the last nurse cow in July,” Pennington said. “I said, ‘Let's go get one of those meat lovers pizzas,' and so, after eating that, with all the meat varieties on it, I could not breathe at all. I was on the couch huffing and puffing and holding my heart.”
Days later, she went to the doctor and finally got an antibody blood test, which came back positive for alpha-gal.
Are severe reactions due to alpha-gal? Doctors say that’s “something we're still trying to discover.”
For most with alpha-gal syndrome, their allergic reactions come from the physical ingestion of red meats, such as beef, pork, rabbit, venison, etc. Some people are more sensitive to alpha-gal and have reactions to mammalian-based products, such as dairy, gelatin and substances filtered through bone char.
Some, like Pennington, seem to have severe anaphylactic reactions when they come into physical contact with irritants, such as amniotic fluid, blood or animal dander in fumes — substances that may have higher concentrations of the alpha-gal sugar that causes the allergic reactions.
But experts aren’t sure whether these reactions are truly due to alpha-gal syndrome.
“I don't think that those are responsible for alpha-gal reactions. What I will say is that a fairly significant fraction of my alpha-gal patients also have non-specific reactivity of their allergy cells where they appear to be reacting, kind of all the time… and it's not to anything. They're just reacting — period,” Dr. Maya Jerath said.
Jerath is an immunologist at Barnes-Jewish hospital and Washington University in St. Louis who has been treating alpha-gal patients for nearly 20 years.
She said, in these cases where patients are reacting to fumes or contact with mammalian bodily fluids, it’s possible that alpha-gal is kickstarting the immune system into overdrive — leading to unpredictable and near-constant allergic reactions.
“Obviously, if you have alpha-gal and you are a beef farmer, that really is an unfortunate thing," Jerath said. "I think now we're straying into that realm of people who are just hyperreactive. I don't think the standard alpha-gal patient will have those issues.”
"Whether alpha-gal is causing this reactivity or the reactivity is somehow amping up alpha-gal, I don't know. That's something we're still trying to discover."Dr. Maya Jerath, immunologist
She said it’s important to understand that this non-specific hyperreactivity is a likely a different, separate condition from alpha-gal, and while there’s no treatment options for alpha-gal except excluding the allergen from your diet, there are treatment options for overactive immune systems.
“I don't think we should attribute all of that to alpha-gal because, when we do that, we run the risk of not treating what's really wrong with them, and they just end up following a more and more restrictive diet, giving up their profession and their livelihood for no reason,” Jerath said. “I think that's criminal to let patients do that.”
Jerath said she hopes that doctors understand that there’s still a lot to learn about alpha-gal syndrome, how it’s caused and other issues it could be causing in humans.
And she hopes that people, and cattle farmers in particular, reach out to an allergist if they’re experiencing these severe reactions because there are medications that could be used to reduce hyperreactivity.
“People are struggling”: The cattle industry’s response to alpha-gal
Sharon Forsyth is the founder of the Alpha-Gal Information website, the Alpha-Gal Alliance and the Alpha-Gal Alliance Action Fund. She was diagnosed with the allergy in 2019 and, since then, has done a lot of education about the condition.
In April, she co-hosted an event specifically for farmers through the AgriSafe Network, a non-profit working to address health disparities in the agricultural community.
“In certain professions, you're way more likely to be bitten by a tick,” Forsyth said.
One 2023 survey of livestock producers in Ohio found that more than 50% of respondents had found 1–5 ticks on themselves within the past year and more than 60% had found 1–10 ticks on their livestock.
Due to this risk of exposure, she said it's important that farmers who have alpha-gal carry an EpiPen with them at all times.
"We may not have hurricanes, but we do have alpha-gal that can be disruptive to a lot of community and a lot of the way that we get together."Ashley McCarty, Missouri Farmers Care
Forsyth said she’s spoken with farmers who are “barely hanging in there” and “have lost the will to live” since being diagnosed with alpha-gal because it has fundamentally changed the way they interact —or, in many cases, can’t interact — with their livestock.
“It's such a cultural value for farmers — caring for their animals, and to feel like you can't care for your animal is very emotionally devastating.” Forsyth said. "If they are driving through their farm and they see a leg sticking out of a cow, [they] got to get right over there and assist with the birth. So, they kind of have to make this choice… ‘Do I go and deliver this calf and risk a life-threatening reaction?’”
Ashley McCarty is the executive director of Missouri Farmers Care, a coalition of statewide agriculture groups in Missouri. She’s also the co-owner of the McCarty Cattle Company in north Missouri and has had alpha-gal herself since the mid-90s.
She said alpha-gal seems to be becoming more and more common among Missouri cattleman and women. She said she can’t attend a meeting anywhere in the state without hearing from farmers about their new alpha-gal diagnoses and the burden of the allergy.
“The need here for awareness is growing because I believe the incidence is growing,” McCarty said. “As a cattleman, I'm concerned for our beef markets. I'm concerned for people's lifestyles.”
McCarty said that many farmers are already taking precautions when it comes to ticks, such as wearing long-sleeved shirts. But there’s no way for cattleman to avoid tick bites all together, which is important after being diagnosed with alpha-gal syndrome because subsequent bites can lead to more severe reactions.
McCarty considers her alpha-gal to be “not severe,” but noted that she has broken out in rashes when handling her cattle and coming into contact with bovine amniotic fluid.
“Our cattle's welfare is paramount,” she said. “We face some danger in ensuring that those animals that we have stewardship over are cared for first and foremost… you can't leave a calf with its nose in a mud hole to go get personal protective equipment, so there are choices to be made.”
McCarty says cattleman are finding ways to adapt. Most now carry EpiPens in case of severe anaphylactic reactions, some are choosing to retire early and others, like herself, are moving into more hands-off roles with the cattle, such as bookkeeping or secretarial work.
She added that some with alpha-gal have begun to outsource tasks, such as vaccinations, to veterinarians. But that’s yet another financial burden for farmers.
“[This is] far more than just a paycheck. It's our lifestyle, it's our lives, our homes, everything,” McCarty said. “This century family farm that we've got is a heritage and a legacy. There's the weight of generations behind it, [so] there's a lot there to unpack when something suddenly pops up and changes the way that you interact with all of that.”
McCarty said she also worries about farmers who are getting desperate for relief and turning to alternative treatments that have yet to be studied thoroughly and whose effectiveness and safety are relatively unknown.
That’s what farmer Sharon Pennington in Macon decided to do. She made the decision to pursue alternative treatment and, currently, she’s able to eat red meat without experiencing anaphylactic reactions.
"My husband told me to do it because he said, 'I hate to see you this way, and your reactions are so severe that whatever they do to you can't be as dangerous as what you're living with.'"Farmer Sharon Pennington
But she said she doesn’t know how long the results might last, especially because it’s nearly impossible to fully avoid ticks working and living on a farm.
“I'm not going to live my life in fear. I'm not going to not enjoy the beautiful outdoors because of this disease,” Pennington said. “It didn't kill me. It came close, but it's also made me look at every day of my life as a gift.”
For now, Pennington’s husband takes care of their remaining beef herd, she still uses many mammal-free products and has lots of chicken stored in the freezer in case her alpha-gal — and all of the complications that come with it — returns.
Pennington and McCarty both agree that farmers shouldn’t look at an alpha-gal diagnosis as a death sentence. But they also hope that the medical community will look more closely at the impacts of the allergy on farmers.
For the full audio transcript, click here.
