Remember that night you drank too much and woke up with a head-banging hangover? If you drank an excessive amount of alcohol, that’s a normal reaction. However, for some individuals, even a drink or two can make them feel unwell.
Sound familiar? If so, you could have an alcohol allergy or intolerance. Continuing to drink alcohol with an allergy or intolerance can have severe health aftereffects. Learning to identify the telltale signs of an alcohol allergy or intolerance can ensure you don’t damage your body long-term.
What is Alcohol Allergy?
A true alcohol allergy is rare. Most people who experience adverse effects from a small amount of alcohol are usually alcohol intolerant. However, it is possible to be allergic to alcohol – or a component of alcoholic drinks.
In true alcohol allergy, skin rashes are the most common reaction. Others notice that underlying conditions, like asthma, urticaria (itchy red rash), or rhinitis (nasal inflammation), become exacerbated.
Some of the components of alcohol people are commonly allergic to include:
- Grapes
- Wheat
- Barley
- Rye
- Yeast
- Hops
In these cases, individuals will only experience an allergic reaction to certain alcoholic beverages. For example, a person who is allergic to grapes would be allergic to wine but not beer. Sometimes, people will be allergic to lipid transfer protein (LTP) found in fruits, vegetables, nuts, seeds, and some alcoholic drinks.
Alcohol Allergy vs. Alcohol Intolerance: What’s the Difference?
In a true alcohol allergy, an immune reaction occurs because a person’s body identifies alcohol (or a component) as a threat. It launches an immune response, flooding the region with histamine and antibodies (IgE). Histamine is also naturally present in certain alcoholic drinks, like red wines, further adding to the reaction.
Alcohol intolerance, on the other hand, is caused by reduced levels of the enzyme aldehyde dehydrogenase (ALDH). Metabolising alcohol is a two-step process: first, alcohol is broken down to acetaldehyde by the enzyme alcohol dehydrogenase (ADH); next, ALDH turns acetaldehyde into non-toxic acetic acid (vinegar).
Because people with alcohol intolerance have a mutation in the ALDH gene, when consuming alcohol, acetaldehyde builds up to toxic levels. These individuals will experience nasal congestion, flushing, low blood pressure, nausea, vomiting, and headaches.
Symptoms of Alcohol Allergy
Most individuals with an alcohol allergy will experience a severe allergic reaction. Symptoms of an allergic reaction include:
- Itchy mouth, eyes, and nose
- Swelling in the face, throat, or other areas
- Urticaria (hives), skin irritation, or skin itchiness
- Stuffy nose, breathlessness, or troubled breathing
- Stomach pain, nausea, vomiting, or diarrhoea
- Feeling faint, dizzy, or blacking out
In extreme cases, a person may go into anaphylaxis. They may no longer be able to breathe due to an occluded airway, their speech will slur, and they’ll have difficulty swallowing. Anaphylaxis is a life-threatening condition, and you should seek immediate medical attention.
Diagnosing If You’re Allergic to Alcohol
You should always get tested regardless of whether your symptoms are mild or severe. Allergies can get worse, leading to a fatal reaction. It’s also possible to develop an alcohol allergy at any point in life.
Usually, you can tell if you’re allergic to alcohol based on your history. Consider some basic questions like:
- Are you only allergic to certain alcoholic beverages?
- What symptoms do you experience?
- How soon after drinking alcohol do the symptoms occur?
- Do any relatives have an alcohol allergy or intolerance?
If you suspect you have an alcohol allergy, there are three main tests:
- Antibody Blood Test. A blood sample is drawn to measure levels of specific antibodies (IgE and IgG4) related to alcohol components. Elevated antibody levels can suggest an allergic reaction to substances found in alcohol.
- Skin Prick Test. A diluted allergen, such as alcohol, is applied to the skin with a small prick, and the site is monitored for reactions. A raised, red bump on the skin indicates a potential allergic response.
- Oral Challenge Test. Under medical supervision, the individual consumes increasing amounts of alcohol to monitor for allergic reactions. Symptoms appearing after ingestion confirm an allergic response or intolerance to alcohol.
Treating Alcohol Allergy
As with all allergies, the only treatment is avoidance. In a true alcohol allergy, even small amounts of alcohol can trigger a severe reaction. You’ll want to be alert for alcohol in chocolate, cooking, and other foods. Many people wrongly believe that when added to dishes, the alcohol is all cooked off. That’s not true – some alcohol does remain in the dish.
If you’re only allergic to a component of alcohol, you can switch to a different alcoholic beverage. For example, barley is found in beer but not in wine. Wheat beer, confusingly, still contains barley.
You can also take oral antihistamines to counteract the allergic reaction. However, taking antihistamines to consume alcohol is not a sensible solution. You may also want to carry an EpiPen (an adrenaline auto-injector) if you’re severely allergic to alcohol and at risk of anaphylaxis.
Closing Thoughts
Alcohol allergy and intolerance are hard to tell apart. True alcohol allergy is extremely rare, and if you’re allergic to alcohol, you’re more likely allergic to a particular component. Our Allergy & Intolerance Test doesn’t check for alcohol allergy, but it does test for 117 common triggers, including wheat, yeast, gluten, grapes, rye, and more.
Try our comprehensive Allergy & Intolerance Test Plus today to discover the underlying causes behind your intolerance or allergy.
