Do you get a bright red face when you drink alcohol? Do you experience laboured breathing, rapid heart rate or immediate headaches after a few drinks? It could be that you have alcohol intolerance.
Most common alcohol intolerance symptoms:
- Red flushing
- Stuffy nose or nasal congestion
- Headaches or migraines
- Rapid heartbeat
- Restricted or laboured breathing
The first thing to consider is what are alcohol intolerance symptoms and do they match what you experience. These symptoms may appear with even the slightest amount of alcohol consumption, or after a few drinks. While this condition is fairly common, it can manifest in everyone slightly differently.
It’s important to note that alcohol intolerance is not a true allergy to alcohol or a real allergic reaction. While some of the symptoms of alcohol intolerance are similar to allergy symptoms, both conditions are different. If you are truly allergic to alcohol, it’s important to avoid alcohol and speak to your doctor before drinking again. You may also need to undergo an allergy test with a professional.
Here are some of the most common alcohol intolerance symptoms. However, not everyone experiences them all, or in equal severity. For example, you might deal with severe facial flushing and headaches, but none of the other symptoms.
For an in-depth explanation of alcohol intolerance and what causes it, learn more at Sudden Alcohol Intolerance.
1. Red flushing
Unfortunately for those with alcohol intolerance, skin flushing is the most common symptom (and the hardest to hide from others). This reaction can make your skin feel hot and individuals usually report feeling sweaty as well.
Red flushing can appear on the face (most commonly) but can also show up on your neck, cheeks, shoulders, chest and arms. For those with severe flushing, they may experience it all over their body.
In a 2019 study, 98% of responders who experience alcohol intolerance deal with this flushing symptom. It's extremely common and immensely uncomfortable. For many who deal with this symptom, it can become very embarrassing, especially drinking around those who do not understand this condition.
Another concern is that it can make the individual look more drunk than they really are, or even make them appear ill. This causes more attention and focus on the flushing, which in turn makes it even more embarrassing.
How an allergy is different: If you have a true allergy to alcohol, you'll likely experiencing flushing as well but it will be to a much more severe degree. The flushing may also accompany (or turn) into hives, which may be painful and itchy.
The main distinction between the two conditions is the severity of the symptoms: intolerance will be uncomfortable, but an allergy could be life-threatening.
2. Stuffy nose or nasal congestion
Another common alcohol intolerance symptom is a stuffy nose or nasal congestion. This symptom can be similar to symptoms of Hay fever or seasonal allergies. If the nasal congestion is quite severe, it can also make headaches (another symptom) more uncomfortable.
On the other hand, some individuals experience a runny nose instead of congestion. Either way, it's uncomfortable and hard to ignore.
Some people with alcohol intolerance find that certain types of drinks make this symptom worse compared to having other drinks. Many report that red wine in particular can make a stuffy nose much more likely than compared to other drinks like vodka or rum. Typically, wine and beer cause more prominent reactions in more people.
How an allergy is different: During an allergic reaction, you may feel your nose, throat and/or mouth swell. Rather than simply getting a stuffy nose, your nose could begin to swell up and make it much more difficult to breathe. This allergy symptom is much more intense than simply getting a stuffy nose or a runny nose.
Dangerously, alcohol intolerance can make individuals feel dizzy or unsteady. As you can imagine, this can turn quite dangerous if the dizziness is severe. If you experience this particular symptom, it’s important to seek medical advice before drinking alcohol again.
Even though alcohol intolerance is not an alcohol allergy, it doesn’t mean that any intolerance symptoms aren’t serious. It’s vital to keep an eye on your reactions to alcoholic drinks since everyone is different and some symptoms may be more severe than others.
How an allergy is different: An allergy can also bring about dizziness, but to a more serious degree.
When you experience an allergy, it is your immune system’s response to am unknown substance that is not usually harmful or toxic to your body. A symptom of this reaction may be nasal congestion, which itself can lead to dizziness. A more severe form of dizziness called vertigo has also been reported.
Dizziness or feeling unsteady should never be ignored, no matter what level of severity it is.
4. Headaches or migraines
Another common symptom of alcohol intolerance is experiencing headaches or migraines (in more severe cases). Like mentioned earlier, experiencing nasal congestion can make this symptom even more noticeable and painful.
Headaches caused from alcohol intolerance may remind you of headaches felt during a hangover. However, these are usually brought on immediately after drinking alcohol rather than the next day. For some, headaches and other alcohol intolerance symptoms can be brought on very quickly.
It's not hard to imagine that experiencing a pounding headache after a pint of beer can really detract from enjoying your night out with friends.
How an allergy is different: Histamine experienced during an allergic reaction can decrease blood pressure which can cause headaches in some people. However, this symptom can be seen in both alcohol intolerance and in allergies, so it may be hard to differentiate.
5. Rapid heartbeat
Many people with alcohol intolerance report feeling a rapid heartbeat, or experience a more pronounced and increased heart rate. If you have an intolerance to alcohol but decide to drink anyway and experience this symptom, it can be very difficult to ignore.
Those with existing heart conditions will also need to be careful before drinking alcohol in case alcohol intolerance could exacerbate their pre-existing conditions.
A recent study done in Munich, Berlin, found a link between alcohol consumption and heart rates. “The more alcohol you drink, the higher your heart rate gets,” said Dr Stefan Brunner, a cardiologist at the University Hospital Munich. This particular study was done with relatively healthy young adults, 35 years old on average. We can assume that a similar study done on older patients, or those with existing heart conditions or those with alcohol intolerance, may show even more dramatic results.
How an allergy is different: An allergic reaction can also trigger a rapid heartbeat, so it can be hard to tell these two symptoms apart from an allergy versus an intolerance. However, it's generally agreed that an allergic reaction will cause your heart more stress than an intolerance.
6. Laboured or restricted breathing
Laboured or restricted breathing can be commonly brought on by alcohol intolerance. Some may even experience wheezing instead.
This condition can also make pre-existing asthma worse, so it’s important to keep an eye on your symptoms. Restricted breathing or worsening asthma can start for some with only one alcoholic beverage. Asthma UK reports that red wine, white wine, cider and beer are the most common drinks to trigger asthma symptoms. Clear alcohol like vodka and gin contain less histamine and sulphites, so are less likely to cause a reaction. However, this isn’t the case for everyone.
How an allergy is different: Like mentioned with nasal congestion, an allergy can cause your nose, throat and/or mouth to swell. This can easily disrupt your ability to breath normally and can cause severe restricted breathing. This symptom is very important to keep an eye on, especially if you have asthma.
Unfortunately, diarrhea is also a common symptom of alcohol intolerance. While it doesn’t happen to all individuals with this condition, it’s still fairly common. This can leave you feeling sick and dehydrated, which can also make hangovers the following day even worse. Making sure you drink enough water can help off-set the dehydration.
Wine is reportedly one of the main culprits for this reaction. Wine contains tannins (which are found in the skin of grapes) which many people react negatively to, including experiencing diarrhea.
How an allergy is different: Intense stomach pain, diarrhea and nausea have all been reported during certain allergic reactions. Where an alcohol intolerance may cause some discomfort and diarrhea, an allergy can cause much worse. If you experience extreme stomach cramps, nausea and diarrhea, it's important to speak to a professional before drinking alcohol again.
Alcohol intolerance impact
No matter what type of symptoms you experience, or their severity, alcohol intolerance can negatively impact your daily life - from work dinners with colleagues to getting drinks on a first date. Although we don’t always notice it, alcohol is a huge part of society and socializing.
Some of the main complaints from those with this condition are often:
- Wanting to fit in like everyone else
- Increased social anxiety in situations with alcohol
- Feeling embarrassed when they turn red from alcohol
- Feeling uncomfortable from alcohol intolerance symptoms when they just want to enjoy their night out
- Changing their drinking habits around people they don’t know well to avoid having to explain why they’re experiencing negative symptoms
- Trying to use off-label antihistamines to reduce their reaction, even though it has negative side effects
The recent 2019 survey found that 88% of those that experience negative symptoms from alcohol have either reduced their alcohol consumption or stopped drinking entirely. This means that people with this condition have to actively change their lifestyle, or risk feeling horrible.
How is alcohol intolerance different to an alcohol allergy?
Because alcohol intolerance symptoms and allergy symptoms look and seem similar, it can be difficult to differentiate.
A few points to keep in mind:
- A true alcohol allergy is extremely rare
- Alcohol intolerance symptoms are far less severe than allergy symptoms
- Alcohol intolerance can be caused by various factors
Typically, alcohol intolerance is caused by the body’s inability to break down alcohol properly. Sometimes referred to as an ALDH2 deficiency, this condition means alcohol cannot be metabolized effectively and efficiently in the body. By-products of alcohol can be toxic and will cause these negative symptoms when they're left in the body, such as flushing and headaches.
Alcohol intolerance may also be called Asian Flush, but this can be miss-leading. This condition can happen to anyone with this particular liver enzyme deficiency, not just Asians. However, a large portion of Asians (especially those of East Asian descent) have Asian Flush - hence the name.
However, additives in alcoholic beverages may also cause a reaction in some people, even those without the ineffective liver enzyme.
Common ingredients that can cause negative reactions include sulfites, grains, histamine and wheat. These ingredients can cause a reaction in those that have an intolerance.
To make things more confusing, you may have a true allergy to an ingredient used in alcoholic drinks. If you have an allergy to things like corn, wheat or grapes, drinking a beverage with that ingredient will give you a true allergic reaction. However, it’s very rare to be allergic to alcohol, or ethanol, itself. The allergy is more likely to be directed at an ingredient like rye instead.
All in all, it can be difficult and confusing to understand why you’re getting a negative reaction to drinking alcohol. It could be:
- From alcohol intolerance (also called Asian Flush)
- An intolerance to an ingredient or preservative in alcoholic drinks (sulfites)
- A real allergy to one of the ingredients (wheat, grapes, etc)
If you’re unsure about your condition, speak with your doctor or allergy specialist. While some individuals still continue to drink alcohol even with an intolerance, it’s important to understand the severity of your symptoms.
What should I do next?
Your doctor or healthcare professional will know what is best for your individual case. If your alcohol intolerance, or Asian Flush, is severe, you may need to stop drinking alcohol entirely. Otherwise, you may benefit from changing your drinking habits, or choose alcoholic drinks strategically. This may mean avoiding red wine which gives you the worst reaction and sticking to other types of alcohol instead.