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Alcohol Allergies/Intolerance

What is an Alcohol Allergy?

An alcohol allergy occurs when the body overreacts to alcohol. The body creates antibodies to fight off a ‘perceived threat’ caused by compounds found within the substance. This activity causes an allergic reaction, similar to those brought on by common food allergens. 

For those who suffer from this, even a slight amount of alcohol can be enough to trigger a response. Less than a single ounce of wine or beer could be enough to cause serious allergic effects.

Many people have adverse reactions to alcohol. However, typically people experience an alcohol intolerance rather than an alcohol allergy. Alcohol intolerance occurs due to a lack of alcohol dehydrogenase (ADH) or aldehyde dehydrogenase (ALDH2), which are enzymes that process alcohol. People with an alcohol allergy have more severe reactions than those with an intolerance.

What are The Symptoms of Alcohol Allergy?

Common alcohol allergy symptoms include:

  • Nausea or vomiting
  • Hives or rash
  • Difficulty breathing
  • Abdominal cramps
  • Weakness and collapse
  • Anaphylaxis

Anaphylaxis, or anaphylactic shock, is a serious reaction. It can cause a rapid heart rate, weak pulse, nausea, and vomiting. If any of these symptoms occur after ingesting alcohol, it is critical to seek help immediately.

Alcohol Allergy
Alcohol Allergic Reaction

Allergic Reaction to Alcohol Photos

What Causes Alcohol Allergy? 

An alcohol allergy is an immune response. The body’s immune system treats one or more of the compounds found in alcohol as dangerous and creates potent antibodies to fight the ‘infection.’

This reaction is usually caused by a certain type of grain or preservative in alcohol. It is vital to treat true alcohol allergies as you would other severe food allergies, such as an allergy to tree nuts.

Common Allergens Found in Alcoholic Beverages

There are many common food allergens found in alcohol, including:

  • Barley
  • Hops
  • Rye
  • Wheat (gluten)
  • Grapes
  • Seafood proteins
  • Egg protein (found in both red wine and white wine)
  • Sodium metabisulfite
  • Sulfites
  • Yeast

What’s The Difference Between Alcohol Allergy & Intolerance?

Alcohol intolerance is a genetic disorder caused by the lack of key enzymes needed to process alcohol properly. This is an inherited trait, and it is found most often in people of East Asian descent.

An alcohol allergy, on the other hand, is an immune system response. It typically creates a much more serious reaction to the components found in alcohol.

Though symptoms differ, both alcohol intolerance and alcohol allergy can cause nausea, stomach pains, rashes, and trouble breathing. However, the distinguishing symptom found only in alcohol intolerance is facial flushing.

Other symptoms of alcohol intolerance include: 

  • Feeling hot
  • Headache
  • Heartburn
  • Rash or hives
  • Increased heart rate
  • Low blood pressure
  • Nasal congestion or rhinitis
  • Sneezing
  • Stomach pain
  • Diarrhea
  • Nausea
  • Vomiting
  • Trouble breathing or worsening asthmatic reaction

Why Can’t I Drink Alcohol Like I Used To?

It is common to develop alcohol sensitivity with age. Older adults tend to become intoxicated easier than younger adults. This is because alcohol tolerance decreases as you drink less, which usually happens with age. There are also some natural changes in the body that contribute to this, including:

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Higher body fat percentage

Everyone, including those who work out regularly and eat healthy, lose muscle and gain fat easier as they get older. This change in body composition causes a higher blood alcohol level in older adults. 

Changes in liver health

The liver is an incredible organ, but age takes a toll on it, whether or not you have been watching alcohol consumption and drinking sufficient water.

The liver is unable to break down alcohol at a comparable rate to when you were younger. This allows alcohol to stay in your system longer and generally leads to a more heightened feeling of intoxication.

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Lower blood volume

As we age, the body loses water and blood volume. This leads to a higher blood alcohol content than if you were to drink the same amount at a younger age. There is a higher percentage of alcohol in the blood and a more heightened feeling of intoxication. 

Another aspect of alcohol tolerance is psychological. The more time spent intoxicated, such as during college years, the more comfortable you feel being in that state of mind. But when you are no longer accustomed to drinking alcohol on a consistent basis, you may feel more drunk even with the same blood alcohol content.

Alcohol Intolerance Prevention and Treatment Options/Resources

Even if you are experiencing only mild symptoms, you should avoid alcohol consumption to prevent the symptoms from occurring or getting worse.

Some research suggests that people with mild symptoms of alcohol intolerance can get used to excess acetaldehyde in their bodies. But this is not typically recommended as acetaldehyde is highly toxic if the body cannot break it down. 

Unfortunately, there are no drugs or treatments to avoid or lessen the symptoms of alcohol intolerance. Avoiding alcoholic drinks is the only way to do this.

Alcohol Allergy Diagnosis and Treatment 

If you are concerned about how you or a loved one reacts to alcohol, talk to a doctor about an alcohol allergy evaluation. This may help avoid potentially life-threatening symptoms while out drinking. 

A true alcohol allergy requires diagnosis by the same methods that food and environmental allergies are diagnosed. To evaluate for an alcohol allergy, your healthcare provider may:

  • Perform a physical exam
  • Order a skin prick test to show if you are allergic to any specific ingredients found in alcohol
  • Order blood tests

If you have a reaction while out in public, it is important to assess the situation and treat it accordingly. Lie down if possible and contact a healthcare professional as soon as possible, even if it does not seem to be life-threatening.

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Updated on March 16, 2022
3 sources cited
  1. Gonzalez-Quintela A, Vidal C, Gude F. Alcohol, IgE and allergy. Addict Biol. 2004 Sep-Dec;9(3-4):195-204. doi: 10.1080/13556210412331292235. PMID: 15511713.
  2. Australasian Society of Clinical Immunology and Allergy. Alcohol Allergy. ASCIA. https://www.allergy.org.au/patients/other-allergy/alcohol-allergy
  3. Vally H, Thompson PJ. Allergic and asthmatic reactions to alcoholic drinks. Addict Biol. 2003 Mar;8:3-11. doi: 10.1080/1355621031000069828. PMID: 12745410.

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