Updated on February 3, 2023
4 min read

Alcohol Allergies/Intolerance

What is an Alcohol Allergy?

An alcohol allergy causes a person to have a severe reaction when they consume alcohol. The allergy can be so severe that it results in anaphylactic shock. This is potentially fatal.

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
  • Barley
  • Grapes

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Alcohol Allergy Symptoms

Symptoms of an alcohol allergy include:2

  • 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

Never ignore the symptoms of an allergic reaction to alcohol, even if they seem minor. 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. An allergic reaction causes the body to view alcohol as a threat and produce antibodies to protect itself.

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Alcohol Allergy vs. Alcohol Intolerance

An allergy causes the immune system to overreact. On the other hand, intolerance means the digestive system doesn’t process alcohol as it should.

If you have an alcohol allergy, you must avoid alcohol entirely. In rare instances, Hodgkin’s lymphoma can cause symptoms similar to an alcohol allergy or intolerance.

What Causes Alcohol Intolerance?

The most common cause of alcohol intolerance is a condition known as ALDH2 deficiency. This is caused by a genetic problem where your body does not produce enough enzymes to consume alcohol properly.

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 other people.

Other Causes of Alcohol Intolerance

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 histamine intolerance, their body does not produce enough of an enzyme called diamine oxidase (DAO). Their body cannot break down histamine.

This triggers a reaction to alcohol which causes the following symptoms:2

  • Red, itchy skin
  • Abdominal pain
  • Nasal congestion
  • Shortness of breath
  • Diarrhea

On the other hand, a sulfite intolerance causes a reaction to the sulfites in certain alcoholic drinks. Sulfites are a compound added to beer and wine to prevent yeast overgrowth.

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Can You Suddenly Develop Alcohol Intolerance? 

Even after years of drinking alcohol without experiencing any problems, you can still develop an intolerance. This can be a serious problem for anyone with an alcohol use disorder (AUD).

If the body determines that alcohol threatens your health, 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. If you are going to drink, anticipate the reactions and treat the symptoms on a case-by-case basis.

Alcohol intolerance is not as serious as an allergic reaction and won't cause severe reactions. However, it can be very unpleasant and cause secondary complications if ignored.

Alcohol Allergy Diagnosis

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 test an allergist will administer is the skin prick test. This exposes the body to the suspected allergen. Whether or not an allergy is present is based on how the skin reacts to exposure.

Allergy testing must be performed by a medical professional. Exposure can trigger a potentially dangerous allergic reaction.

Treatment Options For Alcohol Allergy and Intolerance

The only treatment available for a true alcohol allergy is avoiding alcohol. Even a small amount can trigger a reaction. If you have an alcohol allergy, avoid any food or drink with traces of alcohol.

If the allergy is linked to a particular alcohol component, treatment could be as simple as choosing a different drink.

For mild symptoms, an over-the-counter (OTC) oral antihistamine could be enough to prevent symptoms. If drinking triggers digestive distress, OTC medications are also helpful.

The best treatment for mild to moderate alcohol intolerance is to avoid over-drinking. People should also take medication to ease any symptoms that occur.

Can You Reverse an Alcohol Allergy?

Unlike most food allergies, you cannot reverse an alcohol allergy. However, it is possible to control the symptoms if you have a mild allergy or intolerance.

The best way to deal with the issue is to limit alcohol exposure. If you choose to drink, you’ll need to plan and do what you can to prevent symptoms from becoming severe.

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Updated on February 3, 2023

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