Alcohol Allergy or Alcohol Intolerance: What’s the Difference?

What most people believe to be an alcohol allergy is actually a reaction to an allergen in the alcohol such as barley, hops, yeast, rye, wheat, gluten, histamines (often found in red wine), and sulfites (most commonly found in white wines). An actual alcohol allergy is rare but the reactions can be severe. Alcohol intolerance to various ingredients in the beverage occurs much more frequently.

In people of Asian descent, reactions to alcohol are known as Asian flush syndrome or alcohol flush reaction. It is caused by the absence of an enzyme needed to metabolize the ethanol in the alcoholic beverages. Ethanol, in some people, is a non-specific activator of allergy cells (mast cells) that can cause hives and more severe reactions.

Reactions to various ingredients in alcoholic beverages will cause different symptoms. For example:

• someone who is allergic to sulfites may experience hives or anaphylaxis
• someone who is sensitive to histamine may experience nasal swelling or more serious reactions
• alcohol high in sulfates may increase asthmatic symptoms in those with asthma and allergy to sulfites
• alcohol increases the absorption of foods and may increase the reaction to food allergens

 Other symptoms related to the ingredients found in alcoholic beverages may include:

• headache
• nasal congestion including runny or stuffy nose
• abdominal pain
• nausea
• vomiting
• heartburn
• rapid heartbeat

The only way to avoid symptoms of an alcohol allergy or intolerance is to avoid alcohol. Switching to a different drink may solve the problem if you’re allergic to a particular ingredient. Antihistamines (either over-the-counter or prescribed) may be helpful to treat minor symptoms in some people.

Urticaria (hives) may occur within minutes to an hour of drinking alcohol and is sometimes due to an allergic reaction. Flushing and overheating after drinking alcohol may lead to hives in people who have physical urticarias that are triggered by heat or sweating.

If you believe you have had a reaction to alcohol, it is important to consult your allergist

Immediately, and get an evaluation to determine the cause. If you already know that you are allergic to a particular ingredient of an alcoholic beverage, switching to a different beverage might help. Antihistamines can also be helpful to resolve minor allergy symptoms for some people. For others, alcohol might have to be taken out of the picture altogether. There is only one way to know for sure, visit your allergist and get tested.