What Is an Alcohol Allergy?

An alcohol allergy is an allergic reaction to the consumption of alcoholic drinks or other products that contain alcohol as an ingredient, including mouthwashes, cough syrups, salad dressings, and tomato sauces. People can also develop allergies to the plant and fungal sources of alcoholic beverages, such as grapes, hops, barley, rye, wheat, and yeast.

Alcohol allergies are rare but can have serious medical consequences, including death. A related condition, called alcohol intolerance, is more common. It is a metabolic disorder with unpleasant side effects, caused by the body’s inherited disability to properly break down and dispose of alcohol in the bloodstream.

Allergies are a common form of illness. It is estimated that as many as 50 million Americans may suffer from some type of allergy. Symptoms range from moderate to severe. In rare cases, allergies can lead to anaphylactic shock and death. If you or a loved one are dealing with allergy symptoms, see your Baptist Health physician for consultation and treatment.

What Is the Difference Between an Alcohol Allergy and Alcohol Intolerance?

Allergies occur when a person’s immune system reacts defensively to the presence of a substance or chemical within the body that most people find harmless (at least in the short run). Alcohol intolerance is different. It is a genetic condition in which the enzymes responsible for breaking down and expelling alcohol from the body operate ineffectively. The buildup of unconverted alcohol in the body can lead to:

• Flushed skin (redness)
• Rapid heartbeat (tachycardia)
• Low blood pressure
• Headaches and fatigue
• Nausea and vomiting

Other sources of alcohol intolerance include:

• Histamines - a chemical associated with immune responses
• Sulfites - a product additive that limits yeast growth

Individuals with Hodgkin’s lymphoma can also exhibit symptoms of alcohol intolerance. Additional at-risk groups include:

• Asthma and hay fever sufferers
• Food allergy sufferers
• Persons of Asian descent (the gene mutation behind alcohol intolerance appears to have originated in southern China)

Having an alcohol allergy may look similar to having an alcohol intolerance, as they share many symptoms. However, it is important to remember that an alcohol allergy occurs when your immune system overreacts to alcohol being in the body, whereas an alcohol intolerance occurs because of a genetic condition that makes it difficult for your body to process alcohol in your body.

Am I Allergic to Alcohol? What Are the Symptoms?

You might be allergic to alcohol if, after consuming a product with alcohol, you experience any or a variety of the following symptoms:

• Runny nose
• Ragged or labored breathing
• Coughing or wheezing
• Dermatological reactions, such as itching or hives
• Swelling of the lips, tongue, face, or hands
• Nausea, vomiting, and diarrhea
• Light-headedness, disorientation, and loss of consciousness

What Food Allergens are Common in Alcoholic Beverages?

There are several food allergens that are common in alcoholic beverages. Alcohol allergy symptoms occur when the body cannot either break these foods down appropriately, or when your immune system has an overreaction to one or several of the food allergens in your alcohol. Common food allergens in alcoholic beverages may include:

• Barley
• Egg protein (usually in wine)
• Gluten
• Grapes
• Histamines
• Hops
• Rye
• Seafood proteins
• Sodium metabisulfite
• Sulfites
• Wheat
• Yeast

Red wine seems to be the most common alcohol for allergic reactions, followed by beer and whiskey.

What Are the Risks of Alcohol Sensitivity?

Besides symptom unpleasantness, the primary risk of an alcohol allergy is anaphylaxis, which is the sudden and severe onset of multiple allergy symptoms, and may result in difficulty breathing, accelerated pulse, dizziness, drops in blood pressure, a state of shock, and death.

Anaphylaxis should be addressed as a medical emergency. It is treated by medical personnel with the administration of intravenous fluids and one or more epinephrine (adrenalin) injections. Allergy sufferers should carry an epinephrine autoinjector with them at all times.

Although alcohol allergies (as opposed to intolerances) are uncommon, they represent a serious threat to your health. If, after consuming alcohol, you experience any of the symptoms listed above, please see your physician right away.

Alcohol Allergy Tests and Diagnosis - How Do I Know if I’m Allergic?

To determine an alcohol allergy diagnosis, a doctor typically conducts a physical examination, takes a thorough medical and family history, and asks about your symptoms and symptom severity. Additionally, your doctor may recommend skin testing and blood testing. Determining a diagnosis may include:

• Physical exam
• Family and medical history
• Symptom and symptom severity
• Skin prick test
• Blood test

Additionally, your doctor may have you do an elimination diet, where you cut out alcoholic beverages and add them back in one by one, to see if you have an allergy to a specific type.

What Treatments Are Available for Alcohol Allergy Symptoms?

Treatment for alcohol allergy symptoms depends on what the symptoms are and how severe they are. Avoiding alcohol is the only definite way to eliminate symptoms. If you are having an allergic reaction, such as a rash or itching, an over-the-counter antihistamine may be sufficient to alleviate symptoms. If you are having a more severe reaction, such as anaphylaxis, administering an EpiPen or calling 911 is critical.

Additionally, trying an elimination diet, where you cut out alcoholic beverages and add them back in one by one, to see if you have an allergy to a specific type, can be an effective treatment.

How Do I Prevent an Adverse Reaction to Alcohol?

There is no cure for an alcohol allergy. The best way to prevent an adverse reaction is to avoid any item containing alcohol. This includes alcoholic beverages (wine, beer, and spirits), as well as other culinary or medicinal products with alcoholic content.

In addition to carrying an epinephrine autoinjector, persons with an alcohol allergy should wear a medical-identification bracelet highlighting their condition.

If you are sensitive to an additive rather than alcohol itself, you may have options with regard to beverages. Red wines contain relatively few sulfites; white wines are low in histamines.

Learn More About Alcohol Allergy and Intolerance from Baptist Health

While alcohol allergies are rare, the consequences of this condition can be serious. Alcohol intolerance is more common. For diagnosis and prevention of either condition, schedule an appointment with a Baptist Health provider.

FAQ

How Do You Know If You Are Allergic to Alcohol?

If you have an alcohol allergy, even small amounts of alcohol can be intolerable and cause symptoms. Some common symptoms that may indicate an allergy include:

• Itchy mouth, eyes, or nose
• Hives, eczema, rashes, itchy skin
• Swelling of your face, throat, or other body parts
• Abdominal issues (pain, nausea, vomiting, or diarrhea)
• Wheezing or difficulty breathing
• Nasal congestion
• Dizziness or lightheadedness
• Loss of consciousness
• Anaphylaxis

Can You Suddenly Become Allergic to Alcohol?

It is possible to suddenly develop an allergy to alcohol. Your immune system may experience changes as you age, as well as the way your body metabolizes substances. Changes in diet or a health condition may also contribute to suddenly developing an allergy to alcohol.

Why Does My Nose Get Stuffy When I Drink Alcohol?

Getting a stuffy nose after you consume alcohol is a common occurrence. This is usually related to the effects that alcohol has on your blood vessels. Alcohol causes your blood vessels to dilate and expand. This can cause swelling inside the nose and produce symptoms of congestion. Additionally, those who have an alcohol allergy may experience a histamine response after consuming alcohol, which can cause symptoms of congestion.

What Are the Symptoms of Alcohol Flush?

The most common symptom of alcohol flush is facial flushing. You may also experience flushing or redness on your chest or back. Other symptoms may include:

• Increased heart rate
• Headache
• Dizziness
• Overheating sensation
• Nausea or vomiting
• Weight gain
• Bad hangovers