What Is An Alcohol Allergy?

An alcohol allergy is a toxic reaction to alcohol, or ethanol more specifically. Allergies to alcohol are fairly uncommon but can be fatally serious. The effects of alcohol on the body, as a central nervous system depressant, are hardly beneficial. In addition to physical and mental impairment, flushed skin, nausea, and headaches are typical bodily reactions to alcohol consumption. These symptoms lead many to misdiagnose themselves with an alcohol allergy – instead of an intolerance to ingredients within alcohol.

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What Causes An Alcohol Allergy?

People with an alcohol allergy experience a reaction after as little as 1 milliliter of pure alcohol or a mouthful of wine or beer (about 10 milliliters). Why some people experience allergic reactions to alcohol – when small amounts are already produced by the body naturally – is yet unknown to researchers. However, in some cases, severe reactions to alcohol are mistaken for allergies when the culprit is Hodgkin’s Lymphoma, a cancer of the lymph nodes.

Other foods that may cause an alcohol allergy are:

  • Food marinades
  • Tomato puree
  • Overripe fruit that has fermented
  • Cough syrup
  • Mouthwash

Doctors are able to diagnose an allergy based on the production of antibodies. Antibodies known as immunoglobulin E (IgE) cause an allergic reaction in the body accompanied by common allergic reaction symptoms. Also, skin and blood tests are able to measure immune system responses to certain substances.

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What Are the Symptoms Of An Alcohol Allergy?

The symptoms of an alcohol allergy include:

  • Rash
  • Difficulty breathing
  • Stomach pain or cramps
  • Collapse
  • Anaphylaxis (including rapid, weak pulse, and nausea)

Is There Treatment For An Alcohol Allergy?

Just as there are no true cures for pollen or food allergies, there is no cure for an alcohol allergy. In fact, treatment for an alcohol allergy will focus primarily on any present symptoms (i.e. alleviating rashes with a topical cream). Beyond that, an individual must avoid drinking completely to prevent suffering the symptoms of an allergic reaction and possible death.

Alcohol Allergy vs. Alcohol Intolerance

The primary difference between an alcohol allergy and an alcohol intolerance is the reaction each produces. Alcohol allergies are caused by the immune system and intolerance is a reaction from the digestive system. Usually, an alcohol intolerance is a reaction to one of the ingredients in alcohol and not necessarily the ethanol itself.

Symptoms of alcohol intolerance include:

  • Red, flushed face
  • Hives
  • Headaches
  • Increased heart rate
  • Low blood pressure
  • Runny or stuffy nose
  • Nausea or vomiting
  • Diarrhea
  • Aggravation of asthma

People of Asian descent are more likely to experience the symptoms of alcohol intolerance due to a genetic variant resulting from the domestication of rice in southern China centuries ago. An enzyme known as aldehyde dehydrogenase (ALDH2) is responsible for turning ethanol into acetic acid (a primary compound in vinegar) within the liver. Those of Asian ancestry may have the less-active variant of ALDH2, making it more difficult for them to properly digest alcohol. ALDH2 Deficiency, as it is known, is a common cause of alcohol intolerance.

Ingredients In Alcohol That May Cause A Reaction

To determine if an ingredient in alcohol is the cause of sickness, always check the label. However, beware that some ingredients may not be listed.

Type of Allergy Ingredients and Types of Alcohols Affected
Gluten Barley, wheat, hops, and rye are common ingredients in beer, vodka, whiskey, gin, and bourbon.
Histamines Red wine is high in histamines, and yeast in some alcohols can produce them.
Grapes Though rare, some grape proteins can cause a reaction after drinking wine, champagne, Armagnac, cognac, vermouth, port, pre-mixed martinis, wine coolers, and some premium vodkas.
Fining agents Used to remove small particles from wine. These may include egg, milk, or fish proteins.
Sodium metabisulfite Known as additives 220 and 221. These have been used as preservatives in beer and wine since the Roman era. They produce asthmatic reactions in about 10% of those with asthma.
Tree nuts Some bourbons and whiskeys are fermented in oak (or other tree) barrels, which can produce a reaction. Many distillates and extracts also contain nuts.

Finding Treatment

Just as treatment for an alcohol allergy requires total abstinence, recovery from an alcohol use disorder calls for the same. Don’t be afraid to ask for help. Talk with a treatment provider today to begin your road to recovery.

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