Allergic To Alcohol

Do you think you’re allergic to alcohol? Don’t worry, you’re not alone. We recently hosted a round table discussion about Alcohol Allergies, and we wanted to write a follow up blog post on this topic to share with those researching the topic on line. However, because there are many different alcohol allergens found in liquors, wines and beers, we are going to break this topic down into a few different posts. 

Let’s first understand the differences between alcohol allergies and alcohol intolerance. 

Reactions to alcohol, whether true alcohol allergies or just intolerances, are some of the most common complaints we get at Hudson Allergy.  Determining if it’s a true allergy is really the first step, because this can be life-threatening. An allergic reaction is typically felt shortly after consuming whatever you’re allergic to. Symptoms can include wheezing, abdominal pain, cramping, hives, difficulty swallowing, and throat swelling. In severe cases it can even be fatal.

Many people have reactions to alcohol that are NOT true allergies. These symptoms include facial flushing, nasal congestion and headache. This can be due to an inherited defect in a protein that normally breaks down alcohol. Alcohol is seen by the body as a toxin, and the body has two proteins that are turned on to help break the alcohol down into something more benign.   

One of the proteins is called ADH1B, which breaks the alcohol down into a chemical called acetaldehyde. This chemical is more toxic than alcohol, and needs to be broken down further by a second enzyme. In some people, their ADH1B works so well that the body turns alcohol into acetaldehyde faster than the second enzyme can break it down. That causes a buildup of the acetaldehyde in the blood.  Acetaldehyde then causes the symptoms of flushing, headache and nasal congestion.  Although not imminently dangerous like an allergic reaction, people with this intolerance to alcohol have a higher risk of esophageal and liver cancer if they continue to drink.

True allergies to alcohol are different than intolerances. Instead of reacting to the buildup of a small molecule like acetaldehyde, truly allergic people react to very large proteins.  Each of the three main types of alcoholic beverages (wine, beer and hard liquor or spirits) can present with different types of allergies. 

If you are interested in reading about specific allergies that are triggered by beer, wine or spirits, please read the following blog posts. Cheers!