Have you ever gone out for drinks with friends and suddenly experienced uncomfortable symptoms of alcohol intolerance? Perhaps you've wondered whether it is an alcohol allergy.
The purpose of this article is to take an in-depth look at the symptoms, causes and risks associated with alcohol intolerance. It also aims to dispel the common confusion between a mere intolerance to alcohol and the much more severe symptoms of alcohol allergy.
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Jump to: Alcohol intolerance treatments
Alcohol intolerance is not an allergy to alcohol.
Can you be allergic to alcohol? Yes, but intolerance and an allergy to alcohol are two very different things and it's important to understand their differences.
This distinction is essential and one that needs clarification before we talk about ways to help your intolerance to alcohol. The reason for this is that the consumption of alcohol can sometimes lead to fatal consequences for people with a real ethanol allergy, as opposed to a mere intolerance.
Furthermore, some people may have a specific alcohol allergy, like a vodka allergy or wine allergy. The only way to reliably know whether you have an intolerance or allergy is to see your doctor and undergo the proper testing discussed below.
What is an alcohol allergy?
Luckily for most, a real allergy to alcohol is rare but comes with some very severe symptoms.
If you have an alcohol allergy, even a sip of alcohol can cause symptoms. In some cases, it can result in anaphylactic shock and death. Other symptoms can vary from difficulty breathing to unconsciousness. The surest way to know if you are allergic to alcohol or are merely intolerant is to visit an allergy specialist and have yourself tested.
According to the Australasian Society of Clinical Immunology and Allergy's article, alcohol allergy symptoms can include:
- itchiness of the eyes, nose or inside the mouth
- eczema, hives or general itchiness of the skin
- swelling of the face, neck and other body parts
- blocked nose, congestion
- wheezy, restricted or laboured breathing
- abdominal pain, vomiting or diarrhoea
- dizziness or loss of consciousness
Alcohol allergy test - How to get tested for alcohol allergies
If you think that you are allergic to alcohol, a doctor can arrange a test for you. Getting an allergy test done is the only way to know the allergy relates to ethanol itself, or certain ingredients in beverages, like rye, grapes or gluten.
A skin-prick test is also highly effective in testing for allergies. Your doctor will prick your skin with various allergens. If that section of skin reacts to the substance, then you’ll know that you’re allergic to that particular ingredient.
Keeping a food diary for a few weeks can also be helpful. Recording what you consume and when, along with any accompanying symptoms, is vitally important. The doctor will be then able to see what could be causing the reaction.
How do alcohol allergies start?
It begins with exposure to an allergen. In this case, alcohol. This reaction can happen suddenly after a lifetime of drinking alcohol without any trouble.
If the body identifies the alcohol as a threat, the immune system makes a record of it and produces antibodies to prepare for the next time it encounters the danger.
When you come across this allergen again, the antibodies recognise it and activate what is known as mast cells.
These mast cells then release histamines that bind to receptors around the body and cause the symptoms of alcohol allergy listed above.
An allergy to alcohol should never be ignored and pushed aside. If left untreated, it can quickly become worse.
Luckily, according to the Australasian Society of Clinical Immunology and Allergy, most people who think they have an alcohol allergy have an intolerance instead. As mentioned earlier, a real alcohol allergy is very rare.
Alcohol intolerance symptoms
If you’re thinking “alcohol makes me sick all of a sudden” and are trying to figure out if you have an intolerance or allergy, we will help you answer that question.
But, there are actually a myriad of other symptoms you may develop from an allergy to alcohol aside from feeling sick or getting flushed.
These symptoms may appear with even the slightest amount of alcohol consumption, or after a few drinks. While sudden alcohol intolerance 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.
One of the most common alcohol intolerance symptoms is getting red facial flushing, often referred to as the alcohol flush reaction. It is sometimes incorrectly referred to as an Asian alcohol allergy. Unfortunately, this one is difficult to hide.
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 experience 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.
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.
Dizziness or Lightheadedness
Alcohol intolerance can make you 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 crucial 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.
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.
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.
Labored or Restricted Breathing
Labored 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 sulfites, 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 breathe 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.
Progression Of Alcohol Intolerance Symptoms
The onset of symptoms is usually noticed by slightly more laboured breathing after consuming alcohol. Most sufferers will first report minor breathing difficulties, traditionally accompanied by a noticeable increase in heart rate.
Approximately 20 to 30 minutes after alcohol consumption, sufferers will feel a hot or tingling sensation around the eyes, cheeks, forehead and ears.
Following these symptoms is commonly a red flushing skin reaction lasting anywhere between 30 minutes to a few hours. The duration depends on the amount of alcohol consumed and a person's tolerance to alcohol.
More severe cases of intolerance can also involve headaches that occur approximately one to two hours after alcohol consumption and last up to several hours.
Even though these symptoms are not as severe as an alcohol allergy, they are still unpleasant and uncomfortable.
Alcohol intolerance causes
Alcohol intolerance can be caused either by a genetic trait or a damaged liver, the former being the primary reason.
Here's a short video summarizing some key points:
The following are the most common causes of alcohol intolerance:
In this case, a person suffering from alcohol intolerance has problems breaking down alcohol in their body.
The cause of this is a genetic deficiency in the ALDH2 enzyme, which affects the way the liver metabolises alcohol. This deficiency results in an accumulation of a toxic metabolic byproduct called acetaldehyde.
Unfortunately, this doesn't happen to someone dealing with alcohol intolerance. The toxic acetaldehyde continues to build-up in their system while they drink alcohol and brings about the uncomfortable and sometimes painful symptoms mentioned above.
According to Dr Benjamin Voight, PhD and associate professor in the Perelman School of Medicine at the University of Pennsylvania:
"Acetaldehyde itself is toxic, and when accumulated causes flushing and is associated with the feelings we associate with hangovers."
"Carriers of the inactive enzyme are extremely slow to metabolise acetaldehyde, as a result, they experience higher internal levels of acetaldehyde and have much higher risks of oesophageal cancer and cancers of the head and neck compared with individuals with the active enzyme."
Therefore, uncomfortable symptoms like red facial flushing, congestion and increased heartbeat are not the only concern. It can also cause serious long-term harm like an increased risk of cancer.
Our bodies naturally created histamines which are chemicals also found in certain foods and alcoholic drinks like beer, champagne and wine. When histamine is not adequately broken down, it accumulates. This build-up causes symptoms with an accent on nasal congestion and skin flushing.
According to researchers in the Department of Dermatology at the University of Bonn, the build-up develops because of a dysfunction in one or two of the following enzymes: Diamine Oxidase (DAO) and histamine-N-methyltransferase (HNMT).
By not processing the histamine correctly, one may experience symptoms similar to those of an allergic reaction.
Sulfites have been very useful to us from Roman times as additives for preserving foods and beverages while preventing bacterial growth. However, sulfates can be found naturally in many alcoholic drinks like wines (mainly white), beer, vermouth, sake and some others.
If you have a sensitivity or intolerance to sulfites, the reaction may increase when consuming sulfites-rich alcohol. The symptoms are similar to those caused by histamine intolerance and can easily be confused with allergy-like symptoms. Doing a test can confirm or deny the actual cause of the alcohol intolerance.
Some people may experience uncomfortable symptoms when drinking alcohol because they are intolerant to an ingredient in the drink.
Grapes, wheat, hops and gluten may be present in the alcoholic beverage, which is causing the problems, instead of the reasons mentioned above.
By knowing what ingredients cause you issues, you can avoid those drinks and make an informed decision about what to drink.
Non-alcohol related allergies
Sometimes the consumption of alcohol itself can increase sensitivity to pre-existing allergies.
In a 2005 Swedish Study of several thousand individuals, researchers found that people with asthma and hay-fever had a higher chance of experiencing breathing difficulties after consuming alcohol.
The study founds that grape-based wine was the most frequent trigger, with women being approximately twice as likely to be affected as men. Regular alcohol consumption has also been shown to aggravate other allergy symptoms.
In a 2008 study of thousands of women, researchers found that exceeding more than two glasses of wine a day nearly doubled the risk of participants experiencing non-alcohol allergy symptoms.
These finding also included women who did not have seasonal and perennial allergies when they started the study.
Alcohol intolerance health risks
The body is smart. When it reacts negatively to external stimuli, it could be a sign to stop consuming whatever it was that caused it (at the very least in the short term).
In the case of alcohol and the various negative symptoms discussed above, the body is very much giving us a warning sign that something is not right.
This logic is consistent with warnings from governmental bodies such as the United States Department of Health Services and the International Agency For Research On Cancer. Both agencies have issued media releases specifically warning people with alcohol intolerance of their heightened cancer risks from alcohol consumption.
If you want to find out more about these risks, please have a read of our article titled: Debunking the Asian Flush Cancer Myth.
Alcohol Intolerance Remedies
There are no permanent treatments for intolerance to alcohol. However, there are various things one can do to minimize the severity of the reaction. This article looks at the most common methods people use to deal with their alcohol intolerance symptoms.
Stop drinking, or at least drink less
The first alcohol intolerance remedy we are going to cover is the most obvious.
If you can’t be bothered to try anything to help your alcohol intolerance, stop drinking. It’s not the first choice for many of us, but still a choice nonetheless and will end your unpleasant reaction to alcohol.
You'll probably need to recite a speech on why you're not drinking every time you're out with friends. However, at least you'll know that you definitely won't experience any of the negative symptoms of alcohol intolerance.
"...try to meet friends, dates, or business associates at a coffee bar, not a tavern."
According to Dr Dan Valentine, PhD, VP of clinical services at Laguna Treatment Hospital:
“Avoid triggers or areas and events where there is a tendency to drink more – like sporting events,”
Green tinted makeup
If you’re not interested in limiting your alcohol intake, using slightly green-tinted makeup might be something worth trying out.
You can learn more about using green-tinted makeup for red facial flushing by checking out this video from Susan Yara.
Choose your drinks wisely
Many people with alcohol intolerance choose drinks with lower alcohol content, like spritzers. Another method is to alternate drinks with water or soda. This method ensures that alcohol intake is more moderate and also gives the body a break between drinks.
Becoming knowledgeable about the specifics of one's intolerance allows more informed choices about what to drink and what to avoid. For example, if one has a particular sensitivity to sulfites, avoiding alcoholic beverages high in sulfites might help reduce alcohol intolerance symptoms.
According to an article in Verywell Health, ingredients that cause intolerance in some people include:
- Gluten in wheat, barley and rye
A person with sensitivity to any of these might avoid drinks containing that particular ingredient. Choosing beverages wisely like this can reduce the histamine load on the body and alleviate alcohol intolerance symptoms.
You should pay attention to how you feel when having different drinks. If you feel as if you have an intolerance or are allergic to vodka, but feel fine when drinking beer, just stick to what you can handle!
An obvious solution to feeling bad after alcohol is by staying hydrated. Drinking water and non-alcoholic drinks throughout your night at the bar will help soften the effects of alcohol and minimize hangovers.
Of course, if you binge-drink throughout the night, no amount of water will really stop your impending hangover.
Drinking alcohol slowly can help give the body time to metabolize it. The body may struggle breaking down alcohol effectively, so giving it more time to do so will help with negative symptoms. If you flood your body with alcohol and it cannot be broken down properly, you’ll be overwhelmed with negative symptoms.
Certain supplements can help the body metabolize alcohol quickly, such as Sunset Alcohol Flush Support. By assisting the body with breaking down alcohol effectively, the individual won’t experience as many negative symptoms.
Of course, no supplement is 100% effective against negative symptoms from alcohol, but at least some supplements can help you drink a bit more comfortably.
While supplements like Sunset are designed for Asian Flush, or alcohol flush reaction, their main basic function is to break down alcohol as quickly as possible.
This means that it can also be effective for those who cannot break down alcohol as effectively anymore. In both cases, the individual needs help getting rid of alcohol from their system, as the body cannot do so properly.
Warning about the dangers of using Antacids with alcohol
Many dealing with alcohol intolerance symptoms may know of the off-label use of antacids such as ranitidine.
Zantac is the most well-known antacid containing ranitidine. Its intended use is for indigestion, acid reflux and heartburn.
On September 13, 2019, the FDA announced that preliminary tests found low levels of N-nitrosodimethylamine (NDMA) in ranitidine, often sold as Zantac.
"As of now, the FDA has allowed ranitidine to remain on the market. Still, some manufacturers have issued voluntary recalls and some pharmacies have pulled it off the shelves."
There are also other dangers of using antihistamines like Pepcid and Zantac for alcohol flushing. Using antihistamines in this way increases the rate at which your blood alcohol levels rise, which means you can reach your drinking limit much more quickly.
For experienced drinkers, this may not be an issue. But for those who are new to drinking or don't fully understand their alcohol limit, this can be a severe issue.
How alcohol intolerance impacts your life.
Living with the symptoms of alcohol intolerance is difficult. In many cultures, alcohol is the unequivocal drink of choice when it comes to celebration, dating and even doing business. It underpins our general enjoyment of life, relationships and even professional networking.
That's not to say you can't have a great social or professional life if you have alcohol intolerance. However, it's sometimes easy to feel left out. You may decide to drink less, or even nothing at all, in fear of suffering embarrassing symptoms in public like Asian flush, hives and alcohol-related headaches.
It's natural to care about how we look. Most of us take pride in the clothes we wear, our hairstyle, skin complexion and general appearance, especially before going out to socialise or preparing for a special occasion.
Understandably, it is frustrating for people who are intolerant to alcohol when their symptoms come in the way of looking their best. Because let's face it, a red face from alcohol is not the ideal 'look' you'd choose for a hot date or business meeting. That's why you should consider taking Asian flush pills to mask the redness.
The good news is, a basic understanding of alcohol intolerance is the first step towards enjoying a more vibrant social and professional life.