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What Is Sudden Alcohol Intolerance?

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Alcohol Allergy vs. Alcohol Intolerance

Alcohol intolerance can result in immediate, uncomfortable reactions after drinking alcohol. The most common symptoms are a stuffy nose and skin flushing.1

Alcohol intolerance is a genetic condition in which the body can’t break down alcohol efficiently. The only way to avoid these uncomfortable reactions is by not drinking.

However, alcohol intolerance isn’t a true allergy. In some cases, what seems to be alcohol intolerance can be a reaction to something in a drink

For example:

  • Chemicals
  • Grains
  • Preservatives

Combining alcohol with certain medications can also cause reactions.

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Signs of Alcohol Intolerance

Common signs and symptoms of alcohol intolerance (or a reaction to ingredients in a drink) include:1

  • Skin flushing or redness
  • Red, itchy bumps on the skin (hives)
  • Worsening of pre-existing asthma
  • Stuffy or runny nose
  • Low blood pressure
  • Nausea
  • Vomiting
  • Diarrhea

Rarer, more severe signs and complications of alcohol intolerance or other reactions to alcohol include:

  • Migraines: consuming alcohol can trigger migraines in some. This is possibly the result of histamines present in some alcoholic drinks. The immune system also releases histamines during an allergic reaction.
  • Severe allergic reaction: in rare cases, an allergic reaction can be life-threatening and requires emergency treatment.

If you or someone else experiences serious signs or complications of alcohol intolerance or another reaction to alcohol, seek medical help.

Why am I Suddenly Sensitive to Alcohol?

Alcohol intolerance occurs when the body doesn’t have the proper enzymes to metabolize the toxins in alcohol. This is caused by genetic traits most commonly found in Asian people.

Other ingredients typically found in alcoholic drinks can cause intolerance reactions, especially those in beer or wine.

These ingredients include:

  • Sulfites or other preservatives
  • Chemicals, grains, or other ingredients
  • Histamine, a byproduct of fermentation or brewing
  • Gluten

Some reactions can be triggered by a true allergy to grain, like corn, wheat, rye, or another substance in alcoholic drinks. In rare cases, severe pain following alcohol use is a sign of a more serious medical problem, like Hodgkin’s lymphoma.2

Risk factors for alcohol intolerance or other reactions to alcoholic drinks include:1

  • Being of Asian descent
  • Having asthma or hay fever
  • Having Hodgkin's lymphoma
  • Having an allergy to grains or other food
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When to See a Healthcare Provider

A mild intolerance to alcohol or a particular ingredient in alcoholic drinks won’t usually require a trip to the doctor.

Most people simply need to:1

  • Avoid alcohol
  • Limit how much they drink
  • Avoid certain types of alcoholic drinks

However, if you experience a serious reaction or severe pain, see your doctor as soon as possible. Additionally, if your symptoms seem to be linked to an allergy or medication you’re using, visit your doctor.

Alcohol Intolerance Diagnosis and Treatment

There are various steps for diagnosing and treating alcohol intolerance: 

1. Diagnosis

If you develop symptoms after drinking alcohol, see your doctor. Depending on your symptoms, they may refer you to an allergist for testing and treatment. An allergist is a type of doctor who focuses on allergic conditions. 

Your allergist will likely ask you questions about your symptoms and medical history, including:

  • What alcoholic drinks trigger your symptoms?
  • What symptoms do you experience?
  • When did you start experiencing symptoms?
  • Do you have relatives with allergies?
  • Do you have any other medical conditions?

2. Allergy Testing

If your doctor suspects you have a true allergy to alcohol or another ingredient typically found in alcoholic drinks, they’ll perform allergy testing. 

The most common form of allergy testing is the skin prick test. During a skin prick test, your allergist will use a lancet to scratch or prick your skin. They’ll add a drop of allergen extract to the pricked or scratched area. Your skin’s reaction can help them determine whether you have an allergy. 

Your allergist may also use an oral challenge test to diagnose an intolerance or allergy. For this test, they’ll ask you to drink a sample of your suspected trigger. They’ll assess any symptoms you develop and might conduct blood tests

Allergy testing should always be conducted in a medical setting, as it can occasionally trigger a severe allergic reaction. It’s essential to have immediate medical treatment available.

3. Treatment

If you have a true alcohol allergy, the only way to prevent symptoms is by avoiding alcohol altogether. Even a small amount of alcohol can lead to a severe reaction.

People with a true alcohol allergy should:

  • Read the ingredients of foods and drinks
  • Ask restaurant staff for information about items on the menu
  • Avoid food, drink, and products containing alcohol
  • Carry antihistamine medication to use if a mild allergic reaction occurs
  • Carry an epinephrine auto-injectors or an EpiPen

Some foods include alcohol as an added ingredient. If you’re allergic to another ingredient in certain alcoholic drinks, switching to a different beverage might be an option. For example, barley is often found in beer but not wine.

If you have a non-allergic intolerance to alcohol, histamine, sulfites, or other ingredients of alcoholic drinks, your doctor may encourage you to reduce or avoid certain types of alcohol. 

Over-the-counter (OTC) or prescribed medications might help reduce symptoms. If you’re unsure about treatment, speak to your doctor for more information about your diagnosis and treatment options.

Can Alcohol Intolerance Go Away?

Alcohol intolerance is a permanent, lifelong condition. However, you can avoid the symptoms and enjoy a healthy, active life by taking some precautions.

The best way to live with alcohol intolerance is by avoiding alcohol as much as possible. Try nonalcoholic drinks as substitutes for your favorite alcoholic beverages.

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Summary

  • Alcohol intolerance can lead to immediate, uncomfortable reactions after drinking alcohol. If you experience a serious reaction or severe pain after drinking alcohol, see your doctor immediately.
  • Alcohol intolerance isn’t a true allergy. Sometimes, what seems to be alcohol intolerance can be a reaction to something in a drink.
  • If your doctor suspects you have a true allergy or alcohol or another ingredient typically found in alcoholic drinks, they’ll perform allergy testing. For example, using the skin prick test.
  • Alcohol intolerance is a permanent condition that won’t go away. However, you can avoid the symptoms by taking some precautions.
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Updated on October 3, 2022
6 sources cited
  1. Alcohol intolerance, Mayo Clinic, 2022.
  2. Bryant, Andrew J, and John H Newman. “Alcohol intolerance associated with Hodgkin lymphoma.” CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2013.
  3. Morozova, Tatiana V, et al. “Genetics and genomics of alcohol sensitivity.” Molecular genetics and genomics, 2014.
  4. Martinez, Julia A, et al. “Deliberate induction of alcohol tolerance: empirical introduction to a novel health risk.” Addiction (Abingdon, England), 2010.
  5. Davis, Christal N, et al. “Effects of alcohol sensitivity on alcohol-induced blackouts and passing out: An examination of the alcohol sensitivity questionnaire among underage drinkers.” Alcoholism, clinical and experimental research, 2021.
  6. Sarkar, Dipak, et al. “Alcohol and the Immune System.” Alcohol Research : Current Reviews, 2015.

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