If you do not experience anaphylaxis or hives/swelling 4-6 hours after consuming mammalian meat or have recurrent episodes of unexplained anaphylaxis, then there is no need for alpha-gal IgE testing. Chronic isolated gastrointestinal symptoms are not a feature of the alpha-gal syndrome. Many of these patients do improve with mammalian meat avoidance, suggesting a possible malabsorption issue, not an allergic issue. A recent tick bite is also not a reason to test for alpha-gal if there are no symptoms as noted above.
Please note that studies have shown that up to 30-40% of residents of Arkansas, Missouri, and Oklahoma have evidence of IgE antibodies to galactose-alpha-1,3- galactose (alpha-gal). However, over 90% of patients with evidence of alpha-gal specific IgE (a “positive” test) tolerate mammalian meat without any allergic symptoms. This means alpha-gal has a high false positive rate, so a positive lab result is not always clinically significant.