People’s Pharmacy: Meat allergy extends to pills and vaccines

Q. I have tested positive for alpha-gal syndrome. I recently developed elevated blood pressure and I have had an allergic reaction to every blood pressure medication that my doctor has prescribed. One drug gave me a red rash over my entire body.

The physician who diagnosed alpha-gal, Dr. Commins, suggested having a compounding pharmacy make my blood pressure meds. He thinks, that way, I can avoid the fillers that may be causing the hives and swelling. People should know that alpha-gal may trigger a reaction to chemicals in many medications.

A. Thank you for the warning. You are in good hands for alpha-gal syndrome, since Dr. Scott Commins of the University of North Carolina is one of the world’s experts on this condition. He helped with the discovery of this potentially life-threatening reaction to mammalian meat (beef, pork, lamb, rabbit, goat, etc.).

The reaction begins with the bite of a lone star tick. After that, exposure to red meat can cause a delayed allergic reaction that could range from hives or digestive distress to trouble breathing. The diagnosis can be confirmed with a blood test.

Prevention is the only available treatment: Avoid eating meat. Some people must also avoid milk, cheese and yogurt. Highly sensitive individuals may be vulnerable to smoke from a barbecue.

Your note on medications is important. Few people react to pills, but medicines or vaccines that contain gelatin, glycerin, magnesium stearate or bovine extract can cause trouble for highly sensitive individuals. Heparin, heart valves from pigs or cows and monoclonal antibodies may also trigger an allergic response. You may want to listen to our recent interview with Dr. Commins and his colleague, gastroenterologist Dr. Sarah McGill. It is “Show 1344: Managing Meat Allergy and Other Tick-Borne Diseases” at www.PeoplesPharmacy.com.

Q. I have a friend who came in contact with Agent Orange while serving in Vietnam. As a result, he now has diabetes. At 73, he is active working as a handyman. His doctor put him on Jardiance about four months ago. He is complaining about muscle and joint aches and thinks that Jardiance is causing his pain. Could it be?

A. Jardiance (empagliflozin) helps control blood sugar and reduces the risk of cardiovascular events like heart attacks. According to the prescribing information, nearly as many people on placebo had joint pain as those on Jardiance. Muscle pain is not listed as an adverse reaction.

On the other hand, doctors in Australia have described the case of a 69-year-old man who developed muscle pain, weakness and wasting while on empagliflozin (Endocrinology, Diabetes & Metabolism Case Reports, April 12, 2020). His symptoms disappeared within weeks of stopping the drug, and the doctors could find no other explanation. Although it appears to be rare, this type of reaction is possible.

Your friend can learn about other types of diabetes drugs to discuss with his doctor in our “eGuide to Preventing & Treating Diabetes.” This online resource is available under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. How long does it take after stopping a sulfa antibiotic for sun sensitivity to wear off?

A. Several antibiotics such as tetracyclines and fluoroquinolones as well as co-trimoxazole can cause increased sun sensitivity (phototoxicity). Exaggerated sunburn or skin darkening may occur with modest sun exposure. The case reports we found do not answer your question. Experiment cautiously!

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”