What is Alcohol Allergy?
Whether you like to only prefer drinking on special occasions, or like selecting wine pairings for dinner, you can’t ignore how alcohol plays an important role in different cultures.
But despite the fact that a fourth of the world population drinks alcohol, and that humans have been drinking it for thousands of years, our bodies still respond with an allergic reaction at times.
You’ve probably heard of allergic reactions due to peanuts, milk, and even shellfish, but unlike its more popular counterparts, alcohol allergy is less common. Nevertheless, some people have reported adverse reactions when they consume alcohol. In this piece, let’s discuss its symptoms, causes, and potential treatment.
Symptoms of Alcohol Allergy
Now that you know that alcohol allergy is a real thing, you’re probably wondering if you’ve ever had it. You may have experienced an adverse reaction after drinking alcoholic beverages, but you should still narrow down the symptoms to determine if you really have an alcohol allergy.
- itchy rash or hives
- stomach cramps
- difficulty breathing
- stuffy nose
- nausea
- labored breathing
If you experience the above-mentioned symptoms when you drink alcohol or use a product like mouthwash, you could have an allergy.
Reasons for Allergic Reaction to Alcohol
When you suffer from alcohol allergies, you can feel a reaction after having as little as two sips of wine or beer. Researchers have yet to learn why the body experiences a severe allergic reaction to mild alcoholic drinks. This is despite the fact that our bodies naturally produce small amounts of alcohol.
In addition, people with Hodgkin’s lymphoma, which is a cancer of the lymph nodes, may experience severe allergic reactions upon consuming alcohol as well. In many cases, it’s mistaken for a severe alcohol allergy, but the underlying cause is much more serious.
And it’s not just an alcoholic drink that leads to symptoms, but dishes and foods that contain it as well. Hence, you may experience symptoms when you eat or consume the following:
- cough syrup
- tomato puree
- mouthwash
- marinades and sauces
- overripe fruit
It’s why people with a diagnosed allergy tend to avoid alcohol in products.
Acute Alcohol Sensitivity
An interesting thing about alcohol allergies is that you may not have it while consuming alcohol for the first time. In fact, people have reported that they developed an allergy suddenly.
Diagnosing an Alcohol Allergy
Our body is always producing small quantities of alcohol on its own. The average levels in the blood are 0.01 to 0.03 mg per 100 ml. Allergy tests for alcohol are often negative, but come out positive when they detect byproducts of breaking down alcohol, like acetaldehyde.
To test if you have an alcohol allergy, your doctor will assess how many antibodies your body is producing. These are proteins that protect the body from dangerous substances, but can sometimes target harmless ones.
These antibodies are called immunoglobulin E, which can lead to an allergic response. This typically includes common symptoms like a stuffy nose, flushing, and an itchy rash. Similarly, they can use a skin prick test or a blood test to see how your immune system responds to alcohol.
Blood Test
For a blood test, you’ll have to submit a blood sample at a laboratory for testing and get the results later. The lab will measure your body’s immune response to a particular substance by assessing how many immunoglobulin E antibodies are in your blood sample. But keep in mind that this test isn’t always accurate.
Skin Prick Test
With this test, you can find out if you’re allergic to ingredients in alcoholic beverages, like grain-based substances. The lab technician will prick your skin with a small amount of the particular substance you get tested for. This is usually recommended by your doctor, who deduces what possible allergens could be causing the reaction. If you’re allergic to, say, grains, your skin will react and develop a bump or redness.
Alcohol Intolerance
Unlike an allergy that causes your body’s antibodies to target alcohol, an intolerance is attributed to your body’s lack of enzymes to break down the toxins in alcoholic drinks. But it’s not just alcohol that causes the intolerance, but other common ingredients in drinks like wine and beer as well.
For example, you may have an intolerance to grains, a common ingredient in beer, or sulfites, which are often used as preservatives. Similarly, your body may show adverse reactions because of exposure to histamine, which is a byproduct of the brewing or fermentation process.
Testing For Alcohol Intolerance
You can test for an alcohol intolerance using an at-home test, or opting for a medical test. The primary method underlying both methods is genetic testing. With both methods, you take a skin cell sample from the inside of your cheek, which is then tested for ALDH enzymes, the primary marker indicating an alcohol intolerance.
Another method is the alcohol patch test, in which a medical professional puts a drop of ethanol on some gauze and tapes it to your arm. After seven minutes, they remove the gauze to check for signs of redness and inflammation.
Other Explanations: Exposure to Allergens While Drinking Alcohol
Contrary to the name, it’s quite possible to display an allergic reaction to other substances that are in alcoholic beverages, as well. In some cases where people think they’re facing an alcohol allergy, it turns out to be an allergy to foods like rye, wheat, or corn, which are often present in beverages.
- Gluten is present in grains like barley, hops, or wheat. These are commonly used to make alcohols like bourbon, gin, and whiskey.
- Grapes can contain some proteins that lead to a reaction when you drink alcohols like champagne, wine, cognac, Armagnac, and wine coolers.
- Fining agents are often used to remove small particles present in wine. These are made from fish, milk, or egg proteins, which can trigger an unpleasant reaction in people who have an allergy.
- Sodium metabisulfite, now known as additives 221 and 220, is a common preservative in alcohol like wine and beer since the Roman era. They can lead to an asthma flareup in about 10 percent of people suffering from asthma.
- Some distilleries may ferment alcohol in barrels made from oak wood, which can cause a reaction. Because of this, people with a tree nut allergy can end up experiencing symptoms.
Histamine Intolerance
Histamines can lead to symptoms like headaches, an upset stomach, wheezing, or a runny nose. While it’s commonly present in wines, the actual amount will vary depending on the type of wine.
Generally, red wines have a higher concentration of histamine than white ones, and grape varieties like Shiraz will produce more histamine during fermentation than others, such as Cabernet.
Studies have indicated that taking antihistamines can prevent a severe reaction after having a glass of wine. However, since most research looks at the effect of antihistamines after a single glass of wine, you can’t expect it to help you with a hangover.
At the same time, other substances can lead to problems as well, but there’s a lack of data to prove how these interactions can lead to symptoms.
Sulfite Sensitivity
What you may think of as alcohol intolerance could just be a case of sulfite sensitivity. As mentioned above, they’ve been used in alcoholic beverages for centuries, acting as a preservative to reduce the growth of yeast.
Some of the most common variants include potassium metabisulfite and potassium bisulfite, while sulfur dioxide is a closely related compound that can lead to adverse reactions.
People can sometimes display allergy-like reactions to sulfites, especially when they have asthma. In terms of sulfite content, white wines have a higher concentration than red wines and beer.
Symptoms of Alcohol Intolerance
Some people find that their face becomes flushed when they drink even small amounts of alcohol and think of it as an allergic reaction. This isn’t the case, and alcohol flushing syndrome usually affects Asian people.
Other symptoms include low blood pressure, abdominal pain, headaches, and an increased body temperature. These are often linked to a rise in blood acetaldehyde levels.
Plus, flushing isn’t always a result of alcohol consumption, but rather skin conditions like rosacea, hypoglycemia, or menopause. Similarly, it could be an interaction between alcohol and medication, like antibiotics, or drugs used to reduce blood fat levels.
Risk Factors of Alcohol Intolerance
Despite many people confusing an alcohol intolerance with an allergy, they both have different causes and risk factors. While the main cause for an allergy is uncertain, an intolerance is usually attributed to ingredients found in alcoholic beverages.
Common risk factors include conditions like asthma or hay fever since alcohol tends to worsen symptoms of alcohol intolerance. The most common risk factor, however, is being of Asian descent. This occurs due to a genetic variant that developed after China called for domesticating rice many centuries ago.
Aldehyde dehydrogenase, which is an enzyme often found in the body, is required to break down ethanol in the liver. Some Asian people may possess a less active form of aldehyde dehydrogenase, making it more difficult to process alcohol properly. Consequently, low levels of this enzyme are often called alcohol intolerance.
Alcohol Intolerance Vs. Allergy
While we often use the word allergy and intolerance, they both have different meanings. A true alcohol allergy is one that elicits an immune response by activating the antibodies. This can trigger a number of symptoms, which can be quite severe.
On the other hand, an intolerance usually refers to effects on the digestive system, so symptoms are less serious. In many cases, what people think is an alcohol allergy is just alcohol intolerance symptoms.
The main difference between the two is the reaction it induces. This is a metabolic disorder that leads to some pretty uncomfortable side effects. It’s an inherited condition that can cause an inability to process alcohol. These genetic traits are most commonly found in people of Asian descent.
Alcohol Allergy Rash Treatment
Unfortunately, just like food or pollen allergies, there’s no specific treatment for an alcohol allergy. Any existing treatments rely on alleviating your symptoms instead of addressing the root cause. For example, if your reactions to alcohol include an itchy rash, your doctor may prescribe a topical ointment to reduce inflammation.
Aside from that, you may have to consider cutting down on your alcohol consumption, which can include choosing alcohol-free options to avoid serious allergy symptoms.
Speaking to Your Doctor
But even though you won’t run into serious issues as long as you’re not drinking alcohol, you should consider speaking to your doctor about it. Ideally, you should attend your next appointment while keeping in mind the following details.
- The symptoms you’re experiencing. You can even list symptoms that could be unrelated to alcohol consumption. Also mention when you experience these symptoms.
- Personal factors, like stressors that recently occurred. These are often due to big life changes, and end up making a preexisting intolerance or allergy worse.
- Mention any supplements, medications, and vitamins you’re currently taking, as well as the dosage.
To have a better understanding of your allergy, you can also ask your healthcare provider a few questions. For instance, you can ask about potential reasons you experience allergic reactions when you have alcoholic beverages.
You can also ask if any of the medications you currently take are causing an adverse reaction to alcohol. In that case, they’ll refer to specific tests and treatments you’ll have to take, along with instructions on reducing alcohol consumption.
Managing Your Alcohol Allergy
Accidentally consuming alcohol can cause unpleasant symptoms. If you have a severe alcohol allergy, management will be similar to that of anaphylaxis. One of the simplest measures is to read the labels on beverages and foods to see if they contain alcohol or other ingredients can that elicit a reaction. Of course, keep in mind that labels don’t always list all the ingredients, so you’re still at risk of alcohol exposure.
Your doctor may also advise you to wear a medical identification bracelet so that bystanders can recognize symptoms and call an ambulance in time.
Additionally, it’s best to carry epinephrine with you, so you have an emergency plan to address life-threatening symptoms in the event of alcohol exposure. It’s the preferred medication when administering first-aid to people with anaphylaxis.
It acts as a vasoconstrictor, thereby preventing shock and hypotension. It also prevents upper airway mucosal edema, which can otherwise lead to life-threatening asphyxia as a result of obstruction. To put it simply: it relaxes the muscles blocking your airways, which helps restore your breathing to normal levels.
Alcohol Allergy FAQs
Here are some of the most questions that people have about alcohol allergies and intolerance.
Do I have an alcohol allergy or intolerance?
This will depend on how your body responds to alcohol. If your immune system starts producing large numbers of immunoglobulin antibodies to target the alcohol you consumed, then it’s attributed to an allergic response. But if your body is unable to metabolize alcohol, it’s an intolerance.
How can I treat an alcohol allergy?
There’s no treatment for severe alcohol allergy, and your best bet is to use management strategies. These include avoiding alcoholic beverages, checking food labels to see if they contain alcohol, and carrying epinephrine.
How can I test for an alcohol intolerance?
You can order an at-home test or go to a laboratory for genetic testing. For an at-home test, use the sterilized swab that comes with the test to get a skin cell sample from the inside of your cheek. You’ll get the results in a few weeks. Testing at a medical facility will follow a similar process, except that a medical professional will take your sample and store it safely.
How do doctors diagnose alcohol allergy?
To diagnose an alcohol allergy, doctors recommend a blood test to check the levels of immunoglobulin antibodies in your blood. A high concentration indicates that you’re allergic to alcohol.
