Alcohol Intolerance

Introduction

Alcohol intolerance is a condition that causes immediate, uncomfortable reactions after consuming alcohol.

  • It is caused by genetic traits most often found in Asians, where the body cannot produce the proper enzymes (e.g. alcohol dehydrogenase or aldehyde dehydrogenase) to break down the alcohol efficiently.

NOTE:

  • People often confuse alcohol intolerance and alcohol allergy, but they are not the same condition. Alcohol allergy is an immune system response.
  • Alcohol intolerance is not the same as being intoxicated or drunk. Nonetheless, people with alcohol intolerance often drink less, because the symptoms they experience are so unpleasant.
  • Histamine intolerance is considered a potential underlying contributor to alcohol intolerance. Red wine has 20-200% more histamine on average than white wine.



Symptoms

  • Facial redness (flushing) - major sign
  • Nausea and vomiting
  • Tachycardia or heart palpitations
  • Red, itchy skin bumps (hives)
  • Worsening of pre-existing asthma
  • Runny or stuffy nose
  • Low blood pressure
  • Diarrhoea



Management

To prevent these uncomfortable reactions, people may need to

  • Avoid certain types of alcoholic beverages (e.g. beer, wine)
  • Restrict alcohol consumption or simply avoid alcohol

Oral antihistamines might help reduce minor symptoms, such as itching or hives (NOT to be used as prevention).

  • People who experience serious reaction (e.g. severe allergy) should consult with a doctor.



Summary

Drinking alcohol can be a lifestyle choice for some people (e.g. as part of social events or to relax after a stressful day), but others may struggle with alcohol addiction and find it difficult to stop drinking.

Nonetheless, it is worth noting that people with alcohol intolerance who drink alcohol regularly are at higher risk for head and neck cancer, liver cirrhosis and late-onset Alzheimer's disease.



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