What is alcohol intolerance, and what are its symptoms?

When you drink alcohol, your liver first breaks down alcohol into a toxic chemical called acetaldehyde. Your body uses an enzyme called aldehyde dehydrogenase, or ALDH2, to break down acetaldehyde. However, in some people, ALDH2 does not work correctly, resulting in alcohol intolerance. However, alcohol allergy occurs when someone’s immune system reacts to alcohol, causing the body to attack it.

If you experience a mild allergic reaction, over-the-counter oral antihistamines may be enough to treat it. If you develop any signs of a severe reaction, you should receive one or more doses of epinephrine. It’s available in preloaded syringes, known as epinephrine auto-injectors (e.g., EpiPen). If your doctor prescribes an epinephrine auto-injector, you should carry it with you at all times. Then go to your nearest emergency department for follow-up care. People often call alcohol intolerance an alcohol allergy, and vice versa.

How to test for alcohol intolerance

There are genetic tests that can tell you if you have an ALDH deficiency. Your healthcare provider can order this test or you can purchase one through private vendors. Sulfites, tyramines, and histamines are substances that are naturally found in many forms of alcohol. They’re present in what causes alcohol intolerance higher amounts in certain types of alcohol, like red wine, than others. Alcohol allergy is an immune system response — your immune system overreacts to an ingredient in alcohol. You may be allergic to one of the substances in alcohol (a chemical, grain or preservative, such as sulfite).

Aldehyde is toxic, and buildup is one of the key reasons people develop symptoms of a hangover. ALDH turns aldehyde into acetic acid, a nontoxic substance that doesn’t cause any harm. In 2017, researchers explored how if a person consumes alcohol chronically and in larger quantities, it may promote inflammation throughout the body, resulting in widespread symptoms.

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While there is no evidence to suggest that the after-effects of COVID are likely to cause alcohol intolerance, new evidence may emerge as research continues. In addition to this, studies have identified a link between alcohol consumption and an increased risk of certain cancers. Dr Fox recommends avoiding alcohol to treat alcohol intolerance.

However, if they want to have tests to check their alcohol intolerance, they can contact a doctor to ensure they are drinking safely. People often confuse alcohol intolerance and alcohol allergy, but they aren’t the same condition. With a serious illness, it’s better to abstain from alcohol to avoid further taxing the body.

Treatment

Even if you only have mild symptoms of alcohol intolerance, you should avoid alcohol. Research has shown that some people with mild symptoms of intolerance can get used to the symptoms of excess acetaldehyde in their bodies. However, acetaldehyde is still highly toxic and can significantly increase the risk of cancer. For mild intolerances, you should either avoid alcohol, limit how much you drink or avoid certain types of alcohol with ingredients that may cause a reaction.

People who find they become intoxicated off a few drinks should limit their consumption accordingly, and not try to “keep up” with others. The most common cause of alcohol intolerance is an aldehyde dehydrogenase (ALDH2) deficiency. ALDH2 is used to break alcohol down in the liver, turning it into acetic acid. If you drink a beverage that causes a mild reaction, over-the-counter antihistamines might help relieve symptoms.

The difference between alcohol allergy and alcohol intolerance can be difficult to tell. While there is no cure for this condition, avoiding alcohol can help you stay symptom-free and avoid an uncomfortable reaction. In contrast, an alcohol allergy tends to be more serious, and if left untreated, can be life-threatening. Symptoms include a rash, itchy skin, swelling and crippling stomach cramps. If these drinkers stop or reduce their alcohol consumption, this tolerance could be lost.

Some people can tolerate cocktails easily, but get drunk off just a couple of glasses of wine. One bad night doesn’t necessarily mean you are intolerant to alcohol. If you usually handle alcohol fine, remember that many factors can influence your tolerance on a day-by-day basis! Factors such as when you last ate, the type and amount of food you had, when you last exercised, and the medications you’re currently taking can all alter alcohol’s effects. Once upon a time, when I caught up with friends they regaled me with stories of their big nights. Eating a pie, he was anxious and jittery, said he had a persistent low-level headache and malaise.

Equally, increased alcohol consumption during lockdown could lead to increased metabolic tolerance, where a greater amount of alcohol is needed to feel intoxicated. Some medications can stop your ALDH enzymes from working as well as they normally do. If you drink alcohol while taking these medications, you can experience alcohol intolerance. If you’ve ever had an alcoholic drink only to find your nose running and your stomach roiling, you may have an alcohol intolerance. Or you may have an alcohol allergy, a stronger reaction that involves the immune system.

Sue Quinn explores the telltale signs of intolerances and allergies, the difference between them and what to do if you think you’re affected. This is typically more than just feeling queasy, but severe abdominal cramping and retching that occurs very soon after drinking alcohol. This nausea and vomiting will differ from vomiting that can happen when drinking in that it will be very soon after drinking, occurring suddenly and intensely.