What Is Alcohol Intolerance?

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What Is Alcohol Intolerance? 

Do you start to feel nauseous or sick after consuming even the most negligible amounts of alcohol? Do you feel unusually warm or notice that your skin turns pink? These might be signs that you have alcohol intolerance.

Alcohol intolerance is a metabolic disorder that affects the way your body breaks down alcohol. It's typically passed down genetically and can affect you even if it doesn't affect your parents or grandparents.

Alcohol intolerance is sometimes referred to as alcohol sensitivity. A person with alcohol intolerance might think that they get drunk too quickly, but in reality, their bodies are unable to break down alcohol in the same way a person without the condition would.

In a small 2012 study, researchers found that about 7.2% of 4,000 participants were intolerant to wine and alcohol in general. They reported experiencing flushing and a stuffy nose. They also found it to be more common amongst women than men.

Symptoms of Alcohol Intolerance 

If you have alcohol intolerance and consume an alcoholic beverage, the most immediate symptom you might notice is your skin going flush and feeling warm.

Other symptoms of this condition include:

  • A stuffy nose 
  • Your face, neck, and chest turn pink or red 
  • Diarrhea
  • Rapid heartbeat 
  • Fatigue 
  • Headache
  • Low blood pressure 
  • Worsening asthma 

For most people with this condition, symptoms will vary from one person to another. However, the most common symptoms to look out for are your skin flushing and feeling sick whenever you consume alcohol. 

Diagnosing Alcohol Intolerance

Alcohol intolerance is often confused with being allergic to alcohol. While alcohol intolerance is a metabolic disorder passed down in your genes, an alcohol allergy has more to do with the way your immune system reacts to certain ingredients in alcohol.

People who are allergic to alcohol are rarely allergic to ethanol (the main ingredient used in making alcoholic beverages), they are typically allergic to other ingredients like barley, yeast, sulfates, hops, wheat, and histamines. Symptoms of an allergic reaction to alcohol include nausea, hives, and cramps. 

An alcohol patch test can also be used to diagnose alcohol intolerance. This is done by putting a bit of alcohol on a cotton pad and taping it to your arm. The pad is left on for some minutes. When it’s removed, your skin will be checked for signs of swelling, hives, or redness.

What Happens When You Drink Alcohol?

This is what happens when you consume an alcoholic beverage:

  1. When you drink alcohol, your body uses an enzyme called alcohol dehydrogenase (ADH) to break down the alcohol.
  2. Your liver then converts it to acetaldehyde which can be damaging for your body. This is where ALDH2 comes in.
  3. ALDH2 works by turning acetaldehyde into acetic acid, otherwise known as vinegar, which is safe for your body.
  4. When the ALDH2 enzyme is inactive or less active, your body doesn't do a proper job at making this final conversion, resulting in the symptoms you experience if you have alcohol intolerance. 

Even in people who don’t have alcohol intolerance, a build of acetaldehyde in your body is what causes you to feel sick when you’ve had too much alcohol. 

It can be difficult to diagnose conditions that are genetically inherited. In trying to make a diagnosis, your doctor or healthcare provider will look into your medical history and conduct a physical exam. Your doctor might also conduct lab tests.

In a 2010 study, researchers found that the popularity of rice in the diet of people in Southern China might be responsible for the genetic mutation that causes aldehyde dehydrogenase 2 (ALDH2) to be inactive.

Alcohol intolerance is genetic. So, if you have this condition, someone else in your family passed down a mutated gene.

Certain risk factors also make it more likely for some people to develop alcohol intolerance. They include:

  • Being asthmatic 
  • Being Asian or of Asian descent 
  • Having a condition called Hodgkin's lymphoma

Differentiating between the two gets confusing because symptoms of both alcohol intolerance and an alcohol allergy can be identical since they both tend to begin shortly after alcohol has been consumed.

All of these tests will help your doctor rule out any other conditions that may be causing your adverse reaction to alcohol. It's best to find a doctor who specializes in alcohol-related conditions to get an accurate diagnosis.

Causes of Alcohol Intolerance 

It’s a little unclear what exactly causes alcohol intolerance. Research shows that the enzyme aldehyde dehydrogenase 2 (ALDH2), an enzyme that helps break down alcohol, may be inactive or less active in people with alcohol intolerance.

Treatment for Alcohol Intolerance 

There is currently no cure for alcohol intolerance. The most effective treatment is to avoid alcohol and alcohol-based foods altogether.

If you’ve consumed an alcoholic beverage and notice mild intolerance symptoms, you might be prescribed an antihistamine to help you clear up symptoms such as a stuffy nose or a reddened face. It’s essential to remember that antihistamines don’t treat the symptoms, and you should not continue drinking if you have alcohol intolerance. 

Having alcohol intolerance doesn’t preclude you from struggling with alcohol addiction. What happens in such a case is that you experience even more severe consequences than the average person with alcohol addiction.

If you or someone you know is struggling with alcohol addiction in addition to alcohol intolerance, it’s essential to seek treatment. Enrolling in an alcohol treatment program is the first step to recovery. 

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Coping With Alcohol Intolerance 

Alcohol intolerance is a metabolic disorder that has no cure. While its symptoms can be inconvenient and uncomfortable, they are typically not fatal. The condition is also genetically inherited, which means there's nothing you can do to prevent it.

There are, however, tips that can help you cope with this condition:

  • Cut out alcohol completely or restrict alcohol consumption to the barest minimum
  • Avoid drinking alcohol while taking medication. While this is a rule of thumb, it’s especially important if you have alcohol intolerance. Taking alcohol with medicine can worsen your symptoms. 
  • Quit smoking and avoid secondhand exposure to smoke. Smoking can exacerbate symptoms of alcohol intolerance.

It’s most advisable to completely quit drinking alcohol if you have alcohol intolerance. It’s a lifelong condition and won’t go away with time. Continuing to consume alcohol, especially in large quantities, could lead to complications such as: 

7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Cleveland Clinic. Alcohol intolerance: symptoms, tests & alcohol allergy. August 24, 2020

  3. U.S. Department of Health & Human Services. Alcohol Metabolism: An Update. April 2007

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By Toketemu Ohwovoriole
Toketemu has been multimedia storyteller for the last four years. Her expertise focuses primarily on mental wellness and women’s health topics.