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Alcohol intolerance: symptoms and causes

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Alcohol intolerance: symptoms and causes

Alcohol intolerance is a genetic disorder in which the body does not have the right enzymes it needs to efficiently process alcohol. People who have the condition may experience sudden, unpleasant reactions after consuming an alcoholic beverage.

The symptoms of alcohol intolerance include facial flushing, red bumps or hives, stuffy nose, low blood pressure, and worsening of pre-existing asthma. It is not exactly known what causes alcohol intolerance, but research suggests a number of factors.

The causes of alcohol intolerance include ALDH2 (aldehyde dehydrogenase) deficiency, which is mainly due to genetics. Other risk factors for the condition also exist, such as being of Asian descent, having asthma, and having a form of cancer called Hodgkin’s lymphoma.

What is alcohol intolerance?

Alcohol intolerance is a metabolic disorder that involves being unable to break down ingested alcohol the normal way. Also called alcohol sensitivity, someone with the condition may see reactions almost immediately after drinking and is different from a person who is allergic to alcohol. 

Although the disorder is often genetic and can be passed down in the family, it can still affect people who do not have blood relatives with alcohol intolerance.

alcohol intolerance symptoms

What are the symptoms of alcohol intolerance?

The symptoms of alcohol intolerance may indicate alcohol sensitivity, and are triggered by consuming alcohol. The symptoms of alcohol intolerance are listed below.

1. Redness on the face (flushing)

People with alcohol sensitivity experience an unpleasant symptom called the alcohol flush reaction, according to an article on alcohol’s effects on health from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). An alcohol flush reaction is when the face turns red and may also affect your chest and your back. It happens as the blood vessels in the face dilate because of the body’s inability to manage all the toxins in an alcoholic beverage. 

2. Lumps of red, itching skin (hives)

One of the most common alcohol intolerance symptoms is red bumps or hives. They may appear in just one body part, or may also pop up all over. The skin condition could also result from an allergic reaction to alcohol, particularly one of its ingredients. An alcohol allergy test may help determine if the alcohol is indeed causing your hives. 

3. Pre-existing asthma worsens

Alcoholic drinks may trigger asthma symptoms or exacerbate pre-existing asthma. This is especially true if the beverage contains high levels of sulfites or histamine, such as wine, cider, and beer, as stated by a 2003 study on allergic and asthmatic reactions to alcoholic drinks published in Addiction Biology

4. Runny or stuffy nose

Having a runny or stuffy nose after a drink may easily be mistaken for alcohol allergy symptoms, but it is actually a sign of alcohol intolerance. The chemicals present in alcoholic beverages may contribute to nasal congestion or a runny nose.

5. Low blood pressure

Suffering from alcohol intolerance may change the effects of alcohol on your blood pressure, making it drop at significant levels during an alcohol session, according to a 2000 study by Narkiewicz et al., published in the journal Circulation. Signs of low blood pressure after drinking include dizziness, fatigue, and rapid shallow breathing.  

6. Vomiting and nausea

Feeling nauseous and vomiting, especially right after a few drinks, are signs of alcohol intolerance. These symptoms are attributed to increased stomach acid, which irritates the intestines, esophagus, and stomach. 

7. Diarrhea

One of the most common symptoms of alcohol intolerance is diarrhea. Although this may also occur in people who are not alcohol intolerant, it comes on more severe and much quicker for those who suffer from the disorder. Diarrhea happens as a result of alcohol consumption because it inhibits the absorption of water in the large intestine, leading to quicker stool passage. 

Other alcohol intolerance symptoms include: 

  1. Fast heartbeat
  2. Migraines
  3. Increased tiredness
  4. Stomach pain
  5. Heartburn

alcohol intolerance causes

What are the causes of alcohol intolerance?

The causes of alcohol intolerance involve different contributing factors that influence the development of the disorder. The causes of alcohol intolerance are listed below. 

1. Sulfites or other preservatives

Sulfites are additives often found in beer and wine. They are added by manufacturers to keep the beverages fresh for a longer period of time. While most people process sulfites without any issue, they may not sit right with others and can cause symptoms such as coughing and difficulty breathing. 

2. Chemicals, grains, or other components

Wheat, barley, and rye are three grains used to make beer and other alcoholic beverages. A 2013 case control study by Currie et al., published in PLOS ONE states that these grains can also trigger symptoms among those who have celiac disease, which is an autoimmune disease that causes inflammation in the small intestine. Other components found in alcoholic drinks, such as yeast and corn can also trigger symptoms such as alcohol allergy rash, stomach discomfort, and diarrhea, for those who suffer from intolerance to these ingredients. 

3. Histamine

Some alcohols, including red wine, contain high levels of histamine. However, some people do not have an enzyme called diamine oxidase, which is supposed to break down histamine. This results in symptoms such as red eyes, runny nose, facial swelling, and nasal congestion after drinking alcohol, according to a 2018 study on allergic and intolerance reactions to wine published in Allergologie Select

Other alcohol intolerance causes include:

  1. Aldehyde dehydrogenase (ALDH2) deficiency
  2. Having asthma or allergic rhinitis
  3. Having food allergies
  4. Suffering from Hodgkin’s lymphoma
  5. Being of Asian descent

What are the risk factors for alcohol intolerance?

The risk factors for alcohol intolerance include being of Asian descent, having asthma or allergic rhinitis, and having Hodgkin’s lymphoma. An inherited deficiency in the enzyme called aldehyde dehydrogenase (ALDH2), which is involved in the breakdown of the toxins in alcohol, is more common among people of Asian descent. 

In particular, a 1995 study on the genetic influences affecting alcohol use among Asians published in Alcohol Health and Research World states that ALDH2 deficiency most commonly affects those with East Asian heritage.

In a way, however, East Asian populations may still have some benefit from being more likely to have this enzyme deficiency. Because of this condition, alcohol-related cancers are less common in the group. This is due to the unpleasant sensations after drinking alcohol that make them drink very little or none at all. 

Having asthma or allergic rhinitis can also put someone at risk for alcohol intolerance. Evidence exists that sulfites and histamines are two components of alcoholic drinks that could contribute to an asthma attack. Allergic rhinitis is also linked to alcohol intolerance, as alcoholic drinks are capable of causing symptoms that resemble allergies and even worsen them, according to a 2008 research news titled, “Alcohol is associated with risk of perennial allergic rhinitis” from the journal Clinical & Experimental Allergy.

Lastly, some people with Hodgkin’s lymphoma report experiencing pain in their lymph nodes following alcohol consumption. Although the condition causes people to develop enlarged lymph nodes, these swollen lymph nodes are usually not painful. But in rare cases, certain individuals have pain in these areas after drinking.

time alcohol intolerance symptoms last

How common is alcohol intolerance?

Alcohol intolerance is more common than a genuine alcohol allergy. In fact, a 2012 study on the prevalence of wine intolerance published in Deutsches Ärzteblatt International which involved 948 participants found that 7.2 percent of the individuals reported having symptoms that resemble allergies after drinking wine.

Of the 68 people who reported intolerance to wine, only two have a medically diagnosed allergy. However, this allergy is triggered by the ingredients of the wine and its production process and not an allergy to alcohol itself. 

How long do the symptoms of alcohol intolerance last?

Symptoms of alcohol intolerance may last anywhere between 30 minutes to several hours. While facial flushing may carry on for a few minutes, severe alcohol intolerance with symptoms such as major headaches may last for one to two hours or more after alcohol consumption. 

It is worth noting, however, that each person experiences alcohol intolerance differently. The duration in which symptoms are felt can depend on a number of factors, including the amount of alcohol consumed and the severity of one’s intolerance to the substance. 

What is the best alcohol for alcohol intolerance?

The best alcohol for alcohol intolerance is gin. Gin has low levels of histamine and is free from sulfites – both are chemicals that may set off allergies and cause alcohol intolerance in some people.

Although gin is not a cure for asthma and allergies, it will not make them worse. Furthermore, compared to beer, wine, and dark liquors, gin can keep your intolerance symptoms such as flushing, stuffy nose, and alcohol rash to a minimum.

How can you get rid of alcohol intolerance symptoms?

Getting rid of alcohol intolerance symptoms can be done more effectively with the help of a doctor for alcohol intolerance diagnosis and treatment. Some tips that can help you get rid of alcohol intolerance symptoms are listed below. 

  • Cut down or completely cut out alcohol: Curbing or quitting alcohol is the only surefire way to avoid experiencing the unpleasant sensations related to alcohol intolerance. Once the doctor finds, through a physical exam or other lab tests, that a certain component in alcoholic beverages is what triggers your reaction, avoid drinks that contain the substance by reading product labels and seeing the list of ingredients.
  • Taking over-the-counter or prescription medications: Over-the-counter or prescription medications such as oral antihistamines may help reduce symptoms of alcohol intolerance.
  • Avoid mixing alcohol and medications: Drinking alcohol while taking medications can be dangerous, especially if you have alcohol intolerance. The danger goes both ways, as certain medicines may make your symptoms worse, and alcohol could make your medication less effective. 

Other ways on how to get rid of alcohol intolerance symptoms include: 

  1. Quit smoking.
  2. Avoid exposure to secondhand smoke
  3. Avoid foods that contain alcohol as an ingredient