What is an Alcohol Allergy?

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An alcohol allergy causes a person to have a severe reaction when they consume alcohol. It can be so severe that it results in anaphylactic shock, which is potentially fatal. Other symptoms of an alcohol allergy include:

  • Difficulty breathing
  • Eye, nose, or mouth itching
  • Swelling of the face and neck
  • Skin irritation
  • Nasal congestion
  • Abdominal pain, vomiting, or diarrhea
  • Dizziness
  • Loss of consciousness

In most cases, what appears to be an allergy is intolerance. Alcohol intolerance causes discomfort but isn’t as serious as a true allergy. True alcohol allergies are rare. It is possible to be allergic to a component in certain types of alcohol, such as wheat or barley or grapes.

Alcohol Allergy vs. Alcohol Intolerance

The primary difference between an alcohol allergy and alcohol intolerance is that someone with an allergy should avoid alcohol entirely.

As far as what occurs within the body in response to alcohol, an allergy causes the immune system to overreact. An intolerance, on the other hand, means the digestive system doesn’t process alcohol as it should.

In very rare instances, Hodgkin’s lymphoma can cause symptoms similar to an alcohol allergy or intolerance.

There is a genetic component to alcohol intolerance. People who do not have a problem digesting alcohol produce enough of an enzyme that turns alcohol into acetic acid in the liver. If someone has a variant of the gene responsible for producing the enzyme, their body does not produce enough to ensure that the alcohol they consume is digested properly. This condition is known as an ALDH2 deficiency and it’s the most common cause of alcohol intolerance. 

People with ALDH2 deficiency tend to experience the following symptoms when they drink alcohol:

  • Reddening and/or warming of the face
  • Nausea
  • Vomiting
  • Headache
  • Rapid heartbeat

People of Asian descent tend to struggle with ALDH2 deficiency more than others. One 2010 study linked the domestication of rice in China to the gene change.

In some cases, alcohol intolerance is caused by histamine intolerance or sulfite intolerance. Added preservatives tend to worsen the effects of wine and other types of alcohol.

If someone has a histamine intolerance, their body does not produce enough of an enzyme called diamine oxidase (DAO). Their body cannot break down histamine, which triggers a reaction to alcohol and foods including smoked meats, aged cheeses, and sauerkraut. 

Histamine intolerance produces many of the same symptoms as an allergic reaction, including red, itchy skin, abdominal pain, nasal congestion, shortness of breath or asthmatic symptoms, and diarrhea.

A sulfite intolerance causes a reaction to the sulfites in certain types of alcoholic drinks. Sulfites are a compound added to beer and wine to prevent the overgrowth of yeast. Some people with sulfite intolerance have had success switching to “no sulfites added” wines.

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Alcohol Allergy Symptoms

Symptoms of an alcohol allergy include:

  • Difficulty breathing
  • Eye, nose, or mouth itching
  • Swelling of the face and neck
  • Skin irritation, including hives, eczema, or itching
  • Nasal congestion and sneezing
  • Abdominal pain, vomiting, or diarrhea
  • Dizziness
  • Loss of consciousness

In some instances, someone with a true alcohol allergy can go into anaphylactic shock, which is a potentially life-threatening condition.

Although they might not seem serious, you should never ignore the symptoms of an allergic reaction to alcohol. An alcohol intolerance or allergy can develop at any time in a person’s life.

Causes of Alcohol Allergy

The cause of an alcohol allergy is the same as any other type of allergy – exposure to the allergen triggers the body’s immune system to overreact. When you have an allergy, the body views the trigger, in this case alcohol, as a threat. It produces antibodies to protect the body, which triggers the allergic reaction.

Can You Suddenly Develop Alcohol Intolerance? 

Yes. Alcohol intolerance can develop suddenly and at any point in your life. Even after years of drinking alcohol without experiencing any problems, you could develop an intolerance. 

If the body determines alcohol is a threat to its healthy functioning, it will launch an immune system response that triggers symptoms. Symptoms will worsen over time if the intolerance is ignored. It’s best to eliminate alcohol or cut back as much as possible, anticipate the reaction your body has if you do drink, and treat the symptoms on a case-by-case basis.

Alcohol intolerance is not as bad as an allergic reaction and will not cause any severe reactions such as anaphylaxis, but it can be very unpleasant and cause secondary complications if ignored.

Alcohol Allergy Diagnosis and Treatment Options

Diagnosis of an alcohol allergy or intolerance requires an assessment from a medical professional. In addition to determining what type of alcohol triggers the allergic reaction, a doctor might also refer you to an allergist.

The most common type of test administered by an allergist is the skin prick test which exposes the body to the suspected allergen. Whether or not an allergy is present is based on how the skin reacts to exposure.

Keep in mind, allergy testing must be performed by a medical professional because exposure can trigger a potentially dangerous allergic reaction.

The only treatment available for a true alcohol allergy is avoiding alcohol. Even a small amount can trigger a reaction. This means that not only should someone with a true allergy avoid drinking alcoholic beverages, they must also avoid foods and beverages that contain trace amounts of alcohol.

If the allergy is associated with a component in a particular type of alcohol, treatment could be as simple as switching to a different drink. For example, someone with a gluten or wheat allergy who reacts to beer could drink wine or vodka instead. Someone who reacts poorly to red wine could switch to white wine.

For mild symptoms, an over-the-counter oral antihistamine could be enough to prevent symptoms. If drinking triggers digestive distress, over-the-counter medications are also helpful. The best treatment for mild to moderate alcohol intolerance is to avoid over-drinking and take medication to ease any symptoms that arise.

Can You Reverse an Alcohol Allergy?

No, like most food allergies, you cannot reverse an alcohol allergy. However, if you have a mild allergy or intolerance, it is possible to control the symptoms. The best way to deal with the issue is to limit alcohol exposure. If you do choose to drink, you’ll want to plan and do what you can to prevent symptoms from becoming severe.

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Resources +

“Alcohol Allergies: Do They Exist? - Alcohol & Other Drug Prevention (AOD) || Ramapo College of New Jersey.” Alcohol & Other Drug Prevention (AOD), www.ramapo.edu/aod/alcohol-allergies-exist/. 

“Alcohol Intolerance.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/17659-alcohol-intolerance.

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