What is Alcohol Intolerance?


Published On: December 6, 2023

Alcohol affects people in different ways. Whilst most people can drink alcohol without major complications, some people can find that they are intolerant to alcohol.

Alcohol intolerance is defined as having an allergic reaction to alcohol, meaning that it can trigger an inflammatory response to the proteins that exist within ethanol, fruits, or other ingredients within the drink (1).

With beer, this could be the hops present, and in wine, it could be the grapes used during the fermentation process. With yeast being used in many alcohol-making processes, yeast can also be a cause of alcohol intolerance.

Is Alcohol Intolerance Similar to Alcohol Intoxication?

Beer

The short answer to this is no, they are two different things. Alcohol intolerance doesn’t mean that a person will feel the expected effects of alcohol sooner, or that they would need to consume less to get drunk.

Having an alcohol intolerance will also not increase the person’s blood alcohol level either. It is often observed that those who have an alcohol intolerance will drink less than others due to how unpleasant the effects can be.

What Is an Alcohol Allergy?

two anatomically drawn humans

Having an allergy to alcohol will mean that your body will see alcohol as a harmful chemical, and start creating antibodies that will start fighting it off. This is what causes the allergic reaction.

Whilst they are not commonplace, alcohol allergies can be triggered with very small quantities of alcohol. As little as a sip of wine or beer can be enough to trigger a reaction.

With an allergy, the reactions will normally show as blushing of the skin, especially around the neck and face, sometimes even becoming rashes.

Is Alcohol Intolerance the Same as an Alcohol Allergy?

Alcohol

Whilst the two conditions are often confused, there are many key differences between the two.

Alcohol intolerance is a genetic condition, meaning that it’s normally inherited, causing metabolic disorders in the digestive system. This causes the body to incorrectly process alcohol in the way it should (2).

Being allergic to alcohol means that it’s an immune system response. This causes an overreaction in the immune system to an ingredient within the alcohol. It could be that you are allergic to one of the substances within the drink itself, or an ingredient used during the production process.

Whilst the symptoms between the two vary, they are both known to cause nausea. The usual sign of alcohol intolerance is redness of the skin, normally in the neck, chest and face.

Alcohol allergy symptoms, on the other hand, cause itchiness, severe stomach cramps, rashes and swelling. The symptoms of an alcohol allergy are often more uncomfortable and painful than an intolerance, with alcohol allergy even becoming fatal if untreated in severe cases

How is Alcohol Intolerance Caused?

Close up of man in shirt and tie clutching stomach

As alcohol intolerances are down to the ingredients found within the drinks, there are a few common ingredients that can cause it:

  • Grapes – Used in the production of many wines
  • Gluten – A lot of popular lagers contain gluten
  • Hops – Craft ales use hops in their production.
  • Proteins – Seafood and egg proteins are found in many alcoholic beverages.

So, whilst you may only be intolerant to one of the ingredients within the drink, this ingredient could potentially be found across many different drinks, depending on the ingredient that the intolerance is coming from.

How Common is Alcohol Intolerance?

People seated at table drinking beer

Whilst there isn’t much evidence out there, one particular study of 948 people found that 7.2% of respondents had a self-reported wine tolerance. As this is a small sample, it’s difficult to see if these numbers would be accurate for the general population.

Of those who responded, it was found that women reported having a wine tolerance more than men, with 8.9% of women reporting compared to 5.2% of men (2).

What Are The Symptoms of Alcohol Intolerance?

anxious 2

The main noticeable symptom in people with alcohol intolerance is what’s known as “alcohol flushing syndrome“, which is when the neck, chest and face become pink and warm to the touch, almost straight after drinking alcohol.

Other symptoms also known to be caused by an intolerance to alcohol are:

  • Rapid heartbeat (Tachycardia) or heart palpitations.
  • Vomiting and/or Nausea
  • A decrease in blood pressure
  • Heavy hangovers, throbbing headaches coupled with fatigue
  • A blocked or stuffy nose (3)

Whilst the milder symptoms are manageable for some, it’s recommended for those with intolerances to avoid drinking alcohol.

What Does Alcohol Intolerance Feel Like?

alcohol allergy

Here in the UK, we have quite a large drinking culture, which can make it seem that living without alcohol is difficult. This can cause many individuals with intolerances to still drink alcohol, with it becoming a difficult intolerance to deal with.

Despite these pressures, it would always be advised to avoid drinking if possible. During the first drink, you will start to feel warmness in your chest and face, with the colour often becoming slightly pink.

After a couple of drinks, your face and chest can turn to more of a deep red/pink colour, and some may start to feel their nose become stuffy, especially if drinking high-histamine drinks, such as wine.

If someone with an intolerance keeps drinking, they can quickly experience nausea and vomiting, followed by a terrible hangover the following day.

The increase in heart rate, coupled with low blood pressure, can cause a feeling of anxiety amongst individuals, making the night less enjoyable for them overall, and also attributing to the nausea.

How Long Can it Take For Alcohol Intolerance Symptoms to Show?

MAN POURING WINE

Whilst this varies between individuals, some people will start to feel the effect shortly after drinking, as soon as 20-30 minutes. The early reports are that of a runny nose and flushed face being the first symptoms (4).

After this, issues with breathing and the heart rate can happen quickly, with shortness of breath and an increase in heart rate. Each individual is different though, and it will depend on their tolerance and how much alcohol has been consumed.

How Long Can Someone Expect the Symptoms to Last?

Consequences

As every person is different, the longevity of the symptoms can vary between individuals. If it’s a severe intolerance, the headaches, for example, could last for several hours. As before though, each person is different, and the severity can vary.

The best way to avoid experiencing the symptoms of alcohol intolerance is to abstain from any alcohol consumption or reduce it to as little as possible. Whilst this can be difficult in social situations, especially here in the UK with the drinking culture that exists, many alcohol-free alternatives exist.

One way to find out if you have an intolerance is to take an intolerance test. These tests help you to understand which ingredients within the alcohol you are intolerant to, as it could be a specific ingredient within the product that is causing the issues.

For example, if you are a wine drinker, but find it causes the symptoms of intolerance, it could be the grapes within the wine that is causing the intolerance. By switching to different types of alcohol, you could find the symptoms of the intolerance do not surface.

Taking a test could be an important step if you don’t want to abstain from alcohol altogether. By identifying the ingredient causing the issues, you can choose drinks that won’t cause the same reaction, although it may change drinking habits.

Alcohol Intolerance Diagnosis

Diagnosis

Whilst the symptoms may seem mild, if you do think you have alcohol intolerance, it’s a good idea to speak to your GP. To help understand the problem, you may be asked several questions relating to family history, as well as asking about your symptoms.

By getting to know more of your family history, they can see if alcohol intolerance has been an issue before, as intolerances can be passed down through generations. If some of your relatives also have issues, it could further help the diagnosis

They will also ask about your symptoms themselves, so it’s worth making a note of when you notice them if it’s more with certain alcohols, and if sometimes they don’t occur.

It could be they decide that you need further tests, which could be a skin-prick test, to see if you are allergic to any specific ingredients.

This test will show if you are allergic to a specific ingredient that can be found across many different alcohol types. They may want to do a full blood test; this would involve them taking a sample of your blood to be sent for further testing (5).

One of the things that could be recommended is that someone suffering from an intolerance should abstain from drinking alcohol. By doing this, it could help to see if the symptoms subside. You could then start introducing drinks back in one by one, to see if you react to a specific drink. If a specific drink causes the issues, you then know which drink to avoid.

Alcohol Intolerance Treatment and Prevention

Man with pen

The only guaranteed way to avoid alcohol-related reactions is to avoid alcohol itself. As this may not be the best option, we would recommend seeking help from professionals.

They will be able to advise the best course of action to take. Many services exist, from advising which tests to take to how best to seek help.

As alcohol intolerance can develop at any point in life, you may find that despite years of drinking, you are suddenly experiencing symptoms.

If you are an alcoholic, you can find this process even more difficult. If you are addicted to alcohol, you may find that the symptoms won’t appear after the first drink, as you will have a higher tolerance. It could be that you start to notice symptoms much later on, with hangovers becoming worse the following day.

Alcohol Use Disorder and Intolerance

Man exhausted

As people get older, they will find that their tolerance to alcohol will decrease. With this decrease in tolerance, alcohol intolerance may begin to have more severe effects. As an alcohol intolerance can appear at any point in someone’s life, it could be many years before you notice the symptoms.

With an alcohol addiction, the usual advice of abstaining from alcohol can be very difficult. Luckily, there are many services out there to support people suffering from addiction. From support groups to therapy, there is a solution for most people.

Getting Support

HANDS HOLDING

Talking to your local GP can be a great place to seek help, however difficult it may seem to begin with. Many people have been in the same situation, and your GP is there to help.

They can check your physical and mental health as well as put you in touch with the local support networks available, such as drug and alcohol services run by the NHS.

At Rehab 4 Alcoholism, we understand that every individual will require different levels and types of assistance.

This can range from a chat over the phone with one of our friendly and professional team members to the beginning of the admittance process to a dedicated rehabilitation centre.

To speak to someone today about taking the next step, give Rehab 4 Alcoholism a call on 0800 111 4108 where our addiction support hotline is available 24/7.

References

[1] Allergy UK, Reactions to alcohol: https://www.allergyuk.org/resources/reactions-to-alcohol/ 08/03/2022

[2] Wigand P, Blettner M, Saloga J, Decker H. Prevalence of wine intolerance: results of a survey from Mainz, Germany. Dtsch Arztebl Int. 2012 Jun;109(25):437-44. doi: 10.3238/arztebl.2012.0437. Epub 2012 Jun 22. PMID: 22787508; PMCID: PMC3391999.

[3] Agarwal, Dharam P.; Goedde, H. Werner (1990). Alcohol Metabolism, Alcohol Intolerance, and Alcoholism. pp. 57–59.

[4] Crabb, D W; Edenberg, H J; Bosron, W F; Li, T K (1989-01-01). “Genotypes for aldehyde dehydrogenase deficiency and alcohol sensitivity. The inactive ALDH2(2) allele is dominant”. Journal of Clinical Investigation. 83 (1): 314–316.

[5] National Health Service, Food intolerance: https://www.nhs.uk/conditions/food-intolerance/ 25/11/2022

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