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Alcohol intolerance

Alcohol intolerance can cause immediate, unpleasant reactions after you consume alcohol. The most common signs and symptoms of alcohol intolerance are nasal congestion and skin flushing. This condition is sometimes inaccurately referred to as an alcohol allergy. Alcohol intolerance is caused by a genetic condition in which the body is unable to break down alcohol. The only way to prevent alcohol intolerance is to avoid alcohol altogether.

In some cases, what may seem to be alcohol intolerance is caused by a reaction to something else in an alcoholic beverage — such as chemicals, grains or preservatives. In other cases, reactions are caused by combining alcohol with certain medications. In rare instances, reactions to alcohol can be a sign of a serious underlying health problem that requires diagnosis and treatment.

Symptoms Causes Risk factors Complications Prevention

Alcohol intolerance symptoms — or symptoms of a reaction to ingredients in an alcoholic beverage — can include:

  • Facial redness (flushing)
  • Warm, red, itchy bumps on the skin (hives)
  • Worsening of pre-existing asthma
  • Runny or stuffy nose
  • Headache
  • Low blood pressure
  • Nausea
  • Vomiting

When to see a doctor

You may not need to see a doctor if you have a mild intolerance to alcohol or something else in alcoholic beverages. You may simply need to avoid alcohol, limit how much you drink or avoid certain types of alcoholic beverages that seem to be causing your symptoms. However, if you have a serious reaction or you suspect your symptoms could be linked to an allergy or underlying health problem or a medication you're taking, see your doctor.

Alcohol intolerance occurs when your body doesn't have the proper enzymes to break down (metabolize) the toxins in alcohol. This is caused by inherited (genetic) traits.

Intolerance reactions can also be caused by a number of other ingredients commonly found in alcoholic beverages, especially in beer or wine.  These include:

  • Sulfites or other preservatives
  • Chemicals, grains or other ingredients
  • Histamine, a byproduct of fermentation or brewing

In some cases, reactions can be triggered by an allergy to a grain such as corn, wheat or rye or to another substance contained in alcoholic beverages.

Rarely, severe pain after drinking alcohol is a sign of a more serious underlying disorder, such as Hodgkin lymphoma.

Risk factors for alcohol intolerance or other reactions to alcoholic beverages include:

  • Being of Asian descent. Some people of Asian descent have flushing and other intolerance symptoms after drinking alcohol.
  • Having an allergy to grains or to another food.
  • Having Hodgkin lymphoma.
  • Taking certain antibiotic or antifungal medications.
  • Taking disulfiram (Antabuse) for alcohol abuse or alcohol dependence. When you drink, disulfiram can cause reactions that include flushing, racing heartbeat, nausea and vomiting.

Depending on the cause, complications of alcohol intolerance or other reactions to alcoholic beverages can include:

  • Migraines. Histamines, contained in some alcoholic beverages and also released by your immune system during an allergic reaction, may trigger migraines in some people.
  • A severe allergic reaction. In very rare cases, an allergic reaction can be life-threatening (anaphylactic reaction) and require emergency treatment.

Unfortunately, no medications or other treatments can prevent reactions to alcohol or other ingredients in alcoholic beverages. The only way to avoid a reaction is to avoid alcohol completely or avoid whatever particular substance causes your reaction. Read beverage labels carefully to see whether they contain ingredients or additives you know cause a reaction, such as sulfites or certain grains. But, be aware that labels may not list the ingredient or ingredients that cause your reaction.

The key treatment is to do your best to avoid the beverage in question. Work with your doctor to identify what steps you can take to relieve your symptoms and how to spot and respond to a severe reaction.

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