Alcohol intolerance can cause immediate, uncomfortable reactions after you drink alcohol. The most common signs and symptoms are stuffy nose and skin flushing.
Alcohol intolerance is caused by a genetic condition in which the body can't break down alcohol efficiently. The only way to prevent these uncomfortable reactions is to avoid alcohol.
Although not a true allergy, in some cases, what seems to be alcohol intolerance might be your reaction to something in an alcoholic beverage — such as chemicals, grains or preservatives. Combining alcohol with certain medications also can cause reactions.
Symptoms of alcohol intolerance
Signs and symptoms of alcohol intolerance — or of a reaction to ingredients in an alcoholic beverage — can include:
- Facial redness (flushing)
- Red, itchy skin bumps (hives)
- Worsening of pre-existing asthma
- Runny or stuffy nose
- Low blood pressure
- Nausea and vomiting
- Diarrhea
Having a mild intolerance to alcohol or something else in alcoholic beverages might not require a trip to a doctor. Simply avoid alcohol, limit how much you drink or avoid certain types of alcoholic beverages.
However, if you have a serious reaction or severe pain, see your doctor. Also, if your symptoms seem to be linked to an allergy or a medication you're taking, see your doctor.
Causes of alcohol intolerance
Alcohol intolerance occurs when your body doesn't have the proper enzymes to break down (metabolize) the toxins in alcohol. This is caused by inherited (genetic) traits most often found in Asians.
Other ingredients commonly found in alcoholic beverages, especially in beer or wine, can cause intolerance reactions. These include:
- Sulfites or other preservatives
- Chemicals, grains or other ingredients
- Histamine, a byproduct of fermentation or brewing
- In some cases, reactions can be triggered by a true allergy to a grain such as corn, wheat or rye or to another substance in alcoholic beverages.
Rarely, severe pain after drinking alcohol is a sign of a more serious disorder, such as Hodgkin's lymphoma.
Risk factors of alcohol intolerance
Risk factors for alcohol intolerance or other reactions to alcoholic beverages include:
- Being of Asian descent
- Having asthma or hay fever (allergic rhinitis)
- Having an allergy to grains or to another food
- Having Hodgkin's lymphoma
Complications of alcohol intolerance
Depending on the cause, complications of alcohol intolerance or other reactions to alcoholic beverages can include:
- Migraines. Drinking alcohol can trigger migraines in some people, possibly as a result of histamines contained in some alcoholic beverages. Your immune system also releases histamines during an allergic reaction.
- A severe allergic reaction. In rare instances, an allergic reaction can be life-threatening (anaphylactic reaction) and require emergency treatment.
Prevention of alcohol intolerance
Unfortunately, nothing can prevent reactions to alcohol or ingredients in alcoholic beverages. To avoid a reaction, avoid alcohol or the particular substance that causes your reaction.
Read beverage labels to see whether they contain ingredients or additives you know cause a reaction, such as sulfites or certain grains. Be aware, however, that labels might not list all ingredients.
Diagnosis of alcohol intolerance
Besides conducting a physical exam, your doctor might request these tests:
- Skin test. A skin test can determine whether you might have an allergy to something in alcoholic beverages — for example, the grains in beer. Your skin is pricked with a tiny amount of a substance that could be causing your reaction. If you're allergic to the substance being tested, you'll develop a raised bump or other skin reaction.
- Blood test. A blood test can measure your immune system's response to a particular substance by checking the amount of allergy-type antibodies in your bloodstream known as immunoglobulin E antibodies. A blood sample is sent to a laboratory to check reactions to certain foods. However, these tests aren't always accurate.
Treatment of alcohol intolerance
There is no way to treat or cure alcohol intolerance that is inherited. You can limit the negative effects of alcohol intolerance by avoiding:
- Drinking or restrict alcohol use. In social situations, consider substituting non-alcoholic beverages for beer, liquor, or wine.
- Smoking or exposure to second-hand smoke. Smoking is associated with an increase in levels of acetaldehyde, a potential carcinogen.
- Alcohol use when taking certain medications.
- Taking antacids or antihistamines to alleviate the symptoms of alcohol intolerance. Drugs will only mask the symptoms and may lead to increased consumption of alcoholic beverages. Misuse of antacids may also increase the risk of stomach ulcers.
Talk to your doctor if you take medications that may increase alcohol sensitivity. If you might have a drinking problem, seek professional help.
