Do you flush immediately after a glass of wine or any other alcohol? Do you feel your nose gets stuffy after you drink? Do you feel uneasy? If you answered yes to any of these questions then you might be alcohol intolerant.
- What is Alcohol Intolerance?
- What Are The Signs And Symptoms Of Alcohol Intolerance?
- How Can It Be Diagnosed?
- What Are The Risk Factors?
- How Can Alcohol Intolerance Be Managed?
What is Alcohol Intolerance?
Alcohol intolerance is a genetic condition where your body cannot digest alcohol effectively, causing some side effects when you consume alcohol. It means experiencing unpleasant reactions which are very similar to allergic reactions even after consuming a small amount of alcohol.
What most people believe to be an alcohol allergy is nothing but alcohol intolerance. Most of the people are actually allergic to the components of the alcohol, like wheat, barley, rice, hops, rye, grapes and yeast.
1. Lack of appropriate enzymes - This intolerance occurs either when your body does not have the enzymes to break down the toxins present in alcohol or has enzymes that are dysfunctional. Many people, especially those of Asian descent have insufficient acetaldehyde dehydrogenase. This is the enzyme responsible to break down alcohol.
When this enzyme is insufficient, the toxin acetaldehyde from alcohol does not get converted to the less harmful acetic acid. Acetaldehyde accumulates in the liver, sometimes having carcinogenic effects on the body. This is commonly referred to as an Asian flush reaction.
2. Histamine Intolerance - Histamines are chemicals that naturally occur in our body and they are also present in alcoholic beverages. When this histamine is not properly ingested by the body, it accumulates causing an onset of allergic reactions and alcohol intolerance.
3. Sulfites Intolerance - Sulfites have been used since ancient times in the preservation of food and beverages to prevent bacterial growth. They also naturally occur in wine. Individuals who are allergic to sulfites could be alcohol intolerant due to their presence in alcoholic beverages.
4. Certain Drugs - Consumption of certain drugs like, disulfiram, metronidazole, or nilutamide, along with alcohol can cause intolerance.
What Are The Signs And Symptoms Of Alcohol Intolerance?
A stuffy nose and flushed skin are the most common symptoms for a person having alcohol intolerance. The other signs and symptoms include-
• Itchy skin, eyes mouth and nose.
• Hives, eczema and other skin rashes.
• Difficulty in breathing, wheezing.
• Worsening of pre-existing asthma conditions.
• Abdominal pain, diarrhoea.
• Headaches, heartburn or gas.
• Light-headedness, dizziness, loss of consciousness.
• Low blood pressure.
Most of these symptoms sound like those of a hangover. The difference being, you experience these immediately after you consume a few sips of alcohol, unlike a hangover which occurs the next day.
You could develop this intolerance at any point in life. These signs should not be ignored as they could prove to be fatal.
The length of this type of intolerance is unknown. It can be treated with some drugs, but the best solution is to avoid consuming alcohol altogether.
How Can It Be Diagnosed?
You need to make an appointment with your doctor when you see these symptoms develop.
1. Your doctor will start by asking you questions about the alcoholic beverage that caused these symptoms to occur, what symptoms you experienced, when the symptoms surfaced, if you have any other history of allergy, or if anyone else in your family has such an allergy, etc.
2. If your doctor does suspect a true allergy, allergic testing will be conducted. The most common test is the Skin Prick Test. In this, your doctor will prick or scratch your skin with a lancet. Then a drop of the allergen will be applied to this pricked/scratched part of the skin. The reaction is what determines if you truly have an allergy or not.
3. Another test they could perform is the Oral Challenge. In this test, you will be asked to consume a sample of what they suspect to be the trigger. Then the reactions will be observed.
4. Blood tests can also be used as a method to test alcohol intolerance.
Work with your doctor and find out what is really causing the intolerance, if it's a true allergy or is it just an allergy to one of the components of the alcoholic beverage, or is it the added sulfites and histamines that are causing your body to react to alcohol.
What Are The Risk Factors?
The risk factors of being alcohol intolerant are-
• Being of Asian descent.
• Having Hodgkin's lymphoma.
• Having hay fever or asthma.
• Having an allergy to grains or other foods.
• Taking antibiotics and antifungal medication.
• Taking disulfiram for alcohol abuse.
How Can Alcohol Intolerance Be Managed?
There is no specific drug to treat alcohol intolerance. If you have a true allergy, the best way is to avoid alcohol altogether. If you're allergic to certain components of alcohol, read labels before you consume it. But also be aware of the components that might not be listed in the ingredients section.
If you're mildly intolerant, a few over-the-counter drugs are available that can help you treat it. If you develop severe allergic reactions, you will need to receive doses of epinephrine, also called, adrenaline. It is available in pre-loaded syringes. If your doctor has suggested this drug, it is wise to carry it with you all the time.
Antihistamines or histamine blockers are mainly used for the Asian flush reaction. But these could be a little dangerous as they don't solve the main problem, the accumulation of the toxin acetaldehyde. The only treatment these offer are reducing facial redness.
If you have a non-allergic intolerance, your doctor will encourage you to limit or completely avoid certain types of alcohol.
When dining at restaurants, be sure to watch your food menu as a lot of foods, like a lot of sauces contain alcohol as the main ingredient. If you aren't sure and nothing is mentioned on the menu, ask the restaurant staff and get it clarified.
Your doctor can help you identify the right steps to relieve your symptoms and how to treat severe reactions if any may occur.
Be aware. Be safe.
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