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Updated on February 4, 2022

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.

For example:

  • Wheat
  • Barley
  • Grapes

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

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.

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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 as a threat. In this case, it is alcohol.

The body produces antibodies to protect the body. This triggers an allergic reaction.

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.

An allergy causes the immune system to overreact.

On the other hand, intolerance means the digestive system doesn’t process alcohol as it should.

In 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 gene variant 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. 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.

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 and foods including:

  • Smoked meats
  • Aged cheeses
  • Sauerkraut 

Histamine intolerance produces many of the same symptoms as an allergic reaction.

Symptoms include:2

  • Red, itchy skin
  • Abdominal pain
  • Nasal congestion
  • Shortness of breath
  • 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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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. This can be a big problem for anyone with an alcohol use disorder (AUD).

If the body determines alcohol threatens 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. It will not cause any severe reactions such as anaphylaxis.

However, it can be very unpleasant. It can also 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. 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.

The only treatment available for a true alcohol allergy is avoiding alcohol. Even a small amount can trigger a reaction.

Someone with a true allergy should avoid drinking alcoholic beverages. They must also avoid foods and drinks that contain trace amounts of alcohol.

If the allergy is linked with a particular type of alcohol component, 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 responds 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. Patients should also take medication to ease any symptoms that occur.

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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.

Treatment Options for Alcohol Abuse & Addiction

Here are some of the best treatments for AUD:

Inpatient Programs

Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days. They may be longer in some cases.

Throughout an inpatient program, you'll live on-site in a safe, substance-free environment. You'll go through medically supervised detox first, then behavioral therapy. Other services may be added to your regimen.

Many of these treatment programs assist you with an aftercare program afterward.

Partial Hospitalization Programs (PHPs)

PHPs are the second most intensive alcohol addiction programs. They're sometimes called intensive outpatient programs (IOPs). PHPs provide comparable services to inpatient programs.

These services may include:

  • Detox
  • Medical services
  • Behavioral therapy
  • Support groups
  • Other holistic or custom treatments

The main difference between PHPs and inpatient programs is that you return home and sleep at your house during a partial hospitalization program.

Some PHPs provide food and transportation. This varies by program.

PHPs are ideal for new patients and those who have completed an inpatient program and still require intensive treatment.

Outpatient Programs

Outpatient programs are less intensive than inpatient programs and PHPs. They're best for people who are highly motivated to achieve sobriety. Patients usually have responsibilities at work, home, or school.

These programs customize your treatment sessions around your schedule.

Outpatient programs may be part of aftercare once a patient completes an inpatient program or PHP.

Medication-Assisted Therapy (MAT)

Certain people qualify for medication-assisted therapy. Some medications can assist you throughout detox and withdrawal. Others can reduce cravings and normalize your bodily functions.

The most common medications used to treat AUD are:

  • Disulfiram (Antabuse)
  • Acamprosate (Campral)
  • Naltrexone (Revia and Vivitrol)

MAT can help prevent relapse and increase your chance of recovery if combined with other therapies.

Support Groups

Support groups are peer-led organizations made of people dedicated to helping each other stay sober. They can be the first step towards sobriety or part of an aftercare plan.

Many of these programs follow the 12-step approach.

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Resources

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  1. “Alcohol Allergies: Do They Exist? - Alcohol & Other Drug Prevention (AOD) || Ramapo College of New Jersey.”, Alcohol & Other Drug Prevention (AOD).
  2. “Alcohol Intolerance.”, Cleveland Clinic.
  3. Schnedl, Wolfgang J et al. “Evaluation of symptoms and symptom combinations in histamine intolerance.” Intestinal research vol. 17,3 : 427-433
  4. Wüthrich, B. “Allergic and intolerance reactions to wine.” Allergologie select vol. 2,1 80-88. 1 Sep. 2018
  5. Vally, Hassan, and Philip J Thompson. “Allergic and asthmatic reactions to alcoholic drinks.” Addiction biology vol. 8,1 : 3-11
  6. Gonzalez-Quintela, Arturo et al. “Alcohol, IgE and allergy.” Addiction biology vol. 9,3-4 : 195-204

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