Alcohol Intolerance & Allergies | Symptoms, Causes, & Treatment

While the majority of American adults report drinking some amount of alcohol over the past year, there are those who are not able to consume even small amounts of alcohol without experiencing uncomfortable physical reactions.

These reactions typically result from either alcohol intolerance or allergies.

Alcohol Intolerance

If drinking causes you to feel uncomfortable, with warm skin, nausea, and a fast or unsteady heartbeat, you may have alcohol intolerance.

Alcohol intolerance is a metabolic disorder, meaning that it relates to the way the body breaks down fuel and uses or stores chemical energy. 

In the case of alcohol intolerance, a defect in a specific gene interferes with your body’s ability to make the enzyme aldehyde dehydrogenase 2 (ALDH2), which is used to process alcohol.

Is Alcohol Intolerance Problematic?

As long as you aren’t drinking, this isn’t a problem. But if you do consume alcohol your liver will process the ethanol you are drinking into a chemical called acetaldehyde, which would normally be converted into nontoxic acetic acid by ALDH2. 

Without this last step, however, acetaldehyde will build up in your body, irritating it and causing the various symptoms of alcohol intolerance.

Symptoms Of Alcohol Intolerance

Symptoms of alcohol intolerance range from mild to severe, and generally include:

• skin flushing (redness and warmth in your face, neck, and/or chest)
• itching or hives
• nausea and vomiting
• tachycardia (fast heartbeat) or palpitations (noticeably strong or irregular heartbeats)
• hypotension (low blood pressure)
• headache
• fatigue
• diarrhea
• nasal congestion (stuffy nose or runny nose)
• worsening symptoms of asthma

 Alcohol Intolerance Causes & Risk Factors

Alcohol intolerance is an inherited genetic condition, meaning that it comes from your parents, and you are either born with it or not. Those of east Asian descent are most likely to have alcohol intolerance, but it can affect people from any ethic background.

Treatment For Alcohol Intolerance

There is no treatment for alcohol intolerance.

Accordingly, those with this condition should avoid drinking alcohol as well as tobacco use or exposure to second-hand tobacco smoke. 

They should also not use antacids and antihistamines to mask the symptoms of alcohol intolerance while drinking, as it can lead to higher and potentially harmful levels of acetaldehyde building up in the body.

Alcohol Allergies

Most people who react to alcohol are intolerant, not allergic. However, it is possible for alcoholic drinks to trigger an over-active and harmful immune system response in certain individuals, just as with food allergies.

These responses are generally targeted to specific allergens found in alcoholic beverages, as allergies to ethanol itself are extremely rare. 

Specific allergens that may cause reactions include gluten, egg protein, sulfites, preservatives, and others. Red wine is often cited as one of the worst drinks for triggering allergic reactions following alcohol use. 

Alcohol Allergy Symptoms

Symptoms of an alcohol allergy are generally more painful and serious than those of alcohol intolerance, and may include:

• rashes
• itchy skin
• swelling
• stomach cramps
• anaphylaxis 

Anaphylaxis, or anaphylactic shock, is a potentially life-threatening severe allergic reaction identified by rapid or weak pulse, nausea, vomiting, and shortness of breath. 

Fortunately, it can be rapidly treated with epinephrine, which is carried by emergency medical personnel and sometimes by individuals with severe allergies in the form of auto-injectors or EpiPens.

Alcohol Allergy Causes & Risk Factors

Allergies develop as a result of the immune system mistaking a harmless substance as a dangerous threat, resulting in an overly severe reaction. 

While unpredictable, allergies are more likely to develop if you:

• have a family history of allergies, hay fever, hives, or eczema
• have asthma or allergies to other substances already
• are a child (though allergies can develop rapidly at any age)

Treatment For Alcohol Allergies

There is no treatment for alcohol allergies. Instead, avoid the types of alcohol that cause reactions or avoid alcohol entirely.

Heavy alcohol consumption, in particular, should be avoided, due to the risk of anaphylaxis.

Alcohol Sensitivity, Intolerance, Or Allergies?

An individual’s normal ability to tolerate drinking may change over time and as their use of alcohol waxes and wanes.

If you have changing or bad reactions to alcohol and aren’t sure why talk to your healthcare provider. They can likely perform tests to identify the issue and advise you further. 

If you are continuing to use alcohol despite it causing harmful physical, mental, or relational effects, you may have an alcohol use disorder, also known as alcohol addiction or alcoholism. 

To learn about our treatment options, please contact us today.