Can You Be Allergic to Alcohol? Understanding Alcohol Intolerance and Its Causes

Have you ever had a strange reaction to alcohol? You might have an alcohol intolerance. Find out what an alcohol intolerance is, its causes, symptoms to look for, and how to manage it.

By Jake Parks
Nov 25, 2023 2:00 PMDec 1, 2023 8:03 PM
woman holding her nose in one hand a beer in the other hand, having a bad reaction to alcohol


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When it comes to enjoying a glass of wine or a pint of beer, not everyone can partake without consequence. After consuming alcohol, some individuals find themselves facing sudden and often uncomfortable reactions, such as facial flushing and stuffy noses. This leads to the question: Can you be allergic to alcohol?

In this article, we’ll briefly dive into the basics of alcohol intolerance, its symptoms, the diseases that may cause it, and how to test for this condition.

What Is Alcohol Intolerance?

Alcohol intolerance is an adverse bodily reaction to the consumption of alcohol. It is caused by a genetic condition that makes a person’s body less efficient at breaking down alcohol.

The most common symptoms of alcohol intolerance include skin flushing and a stuffy nose. However, more severe reactions can include red, itchy skin bumps (hives), worsening of asthma, low blood pressure, nausea, vomiting, and diarrhea.

Alcohol intolerance is not a true allergy. So it's important to distinguish between alcohol intolerance and a real allergy that is being triggered by specific ingredients found in alcoholic beverages, like chemicals, grains, or preservatives. And always remember that combining alcohol with certain medications can also cause severe adverse reactions.

Read More: Do Humans Truly Like the Taste of Alcohol

Understanding the Symptoms of Alcohol Intolerance

The symptoms of alcohol intolerance can be quite varied and can manifest differently in individuals.

Common symptoms of alcohol intolerance include:

  • Facial flushing and warmth, especially in the face, neck, and chest

  • Nausea and vomiting

  • Rapid heartbeat or heart palpitations

  • Low blood pressure

  • Headaches, fatigue, and other hangover-like symptoms

  • Stuffy nose

  • Diarrhea

  • Worsening asthma

In rare cases, experiencing severe pain after drinking alcohol can be a sign of a more serious condition, such as Hodgkin’s lymphoma. If you experience severe pain while drinking alcohol, it’s important to speak with a qualified medical professional.

Read More: What Is Alcohol Poisoning? Here Are the Causes, Symptoms, and Management

What Causes Alcohol Intolerance?

As mentioned above, alcohol intolerance is primarily a genetic issue linked to how our bodies process and break down the toxins in alcohol. Alcohol intolerance is an inherited metabolic disorder that is passed down from parents to children through genes.

Specifically, alcohol intolerance is related to problems with the enzymes that our bodies use to metabolize alcohol. When these enzymes are deficient, consuming even small amounts of alcohol can lead to symptoms like facial flushing and warmth.

The Science of Alcohol Intolerance

The aldehyde dehydrogenase (ALDH) enzyme is central to metabolizing alcohol. The liver first uses alcohol dehydrogenase (ADH) to break down ethanol into acetaldehyde, which is then converted into acetate by ALDH. That acetate, which is much less toxic than acetaldehyde, is then further broken down into water and carbon dioxide and eliminated from the body.

In some individuals, variations in the ALDH enzyme can lead to a higher or lower tolerance to alcohol. For example, an inherited lack of an ALDH variant called ALDH2, common in people of Asian descent, often results in alcohol intolerance.

Read More: Even Moderate Drinking Is Not Good for Your Health

Risk Factors of Alcohol Intolerance

Certain risk factors increase the likelihood of alcohol intolerance. Having asthma or hay fever, allergies to grains or other foods, and conditions like Hodgkin's lymphoma.

Complications of Alcohol Intolerance

Complications of alcohol intolerance can lead to migraines or, in rare cases, severe allergic reactions (anaphylactic reactions) that require emergency treatment. And continued alcohol consumption despite intolerance may also elevate the risk for several serious health conditions, such as cancer of the mouth and throat, liver disease (including cirrhosis), and late-onset Alzheimer’s disease.

Remember, alcohol intolerance is typically a lifelong condition. But by taking precautions, individuals with alcohol intolerance can largely avoid symptoms and maintain a healthy, active lifestyle.

Can You Develop Sudden Alcohol Intolerance?

It's possible to develop a sudden intolerance to alcohol due to various factors, such as changes in your alcohol consumption habits, changes in your body’s metabolism, or the onset of allergies to certain ingredients found in alcoholic beverages. Factors like exercise and overall health, which affect body mass and metabolism, can also play a role.

Read More: Uncovering the Truth About Alcohol: Is It Really That Bad For You?

What Are Diseases That Cause Alcohol Intolerance?

In addition to genetic factors, certain health conditions can impact alcohol tolerance. These include:

  • Asthma or hay fever

  • Common allergies (grain, sulfites, histamines, etc.)

  • Severe conditions like Hodgkin's lymphoma

Is There an Alcohol Intolerance Test?

Diagnosing alcohol intolerance usually involves a physical exam and specific tests given by your doctor.

A skin test can determine if you have an allergy to ingredients found in alcoholic beverages, like grains, while a blood test measures the immune system's response to certain substances, checking for allergy-type antibodies in your blood.

However, these tests aren't always accurate, so it’s important to thoroughly discuss your symptoms and test results with a qualified medical professional.

Read More: How Booze Can Make You Sick---and Not Just While You're Drunk

Managing Alcohol Intolerance

Unfortunately, there's no way to entirely prevent the symptoms of alcohol intolerance other than by avoiding alcohol or the substances that cause your reaction. However, there are several management strategies that can help you reduce the negative effects of alcohol intolerance, including:

Avoid Alcohol

This is the most straightforward way to prevent symptoms.

Avoid Tobacco

Smoking can increase levels of acetaldehyde in your body (which also may raise your cancer risk).

Avoid Certain Medications

Some drugs can exacerbate the symptoms of alcohol intolerance.

Limit Antacids and Antihistamines

These can mask symptoms, leading to increased alcohol consumption and worsening the condition.

While not a true allergy in the traditional sense, alcohol intolerance is a real – and often challenging – condition for those who experience it. But by understanding its causes, symptoms, and management strategies, you can reduce or eliminate the negative effects of alcohol intolerance.

But remember, consulting with a healthcare provider for proper diagnosis and advice is a key first step for anyone who suspects they may suffer from alcohol intolerance.

Read More: What Is Alcoholics Anonymous, and How Effective Is It?

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