When you or someone you know has an odd or bad reaction after drinking alcohol, it can bring up a lot of concerns. Sudden side effects like flushed skin, redness of the face, nausea, or vomiting can all happen after drinking alcohol for a variety of reasons.
The two things that may come to mind are that it could be an alcohol allergy or a reaction to alcohol (known as alcohol intolerance). What’s the difference, and how can you tell them apart?
We have all the information you need to know in this article about alcohol allergy vs. intolerance. We’ll provide you with the symptoms of an alcohol allergy, signs of an alcohol intolerance reaction, and when reactions to alcohol can signify greater concerns. Read on for all the details.
What Is an Alcohol Allergy?
An alcohol allergy is a true immune response to ethanol (the main ingredient in alcohol) or other additives in an alcoholic beverage.
Research shows that alcohol allergies are rare, but they can happen. One study assessed over 4,000 participants to determine how often people have negative reactions to wine. 68 people reported an adverse reaction after drinking wine, with only 2 of the 68 who showed symptoms having a true allergy to one of the ingredients in the wine, and none of them having an allergy to ethanol.
Someone with an alcohol allergy would drink alcohol, and the immune system would react to it as a harmful element, releasing antibodies to protect the body. The release of antibodies is what causes symptoms like an alcohol rash, hives, or swelling that signify an allergic reaction.
More severe symptoms can also occur with an alcohol allergy, like anaphylaxis, which occurs rapidly after being exposed to an allergen and can consist of breathing difficulties, serious blood pressure drops, and loss of consciousness. Someone experiencing these symptoms would need immediate medical attention, and you should call 911 right away.
What Is Alcohol Intolerance?
Alcohol intolerance is an inability to break down ethanol or other ingredients like histamines, sulfites, or gluten.
The reaction someone with an alcohol intolerance has can look like an allergic reaction, which is why the terms are often confused. An intolerance can result in symptoms like a rash, hives, facial flushing, headache, nausea, or a rapid heartbeat. These symptoms typically aren’t as severe as the ones that come with an alcohol allergy.
Alcohol intolerance can be caused by many things, such as genetic predispositions, metabolic disorders, or other health conditions. Genetics is a primary cause of alcohol intolerance, where someone has a deficiency in enzymes that prevent them from properly digesting ingredients in alcohol, leading to a reaction.
Common Ingredients That Cause Reactions
Several common ingredients in alcohol can cause allergic or intolerant reactions. Those include:
Sulfites and Other Preservatives
Preservatives, such as sulfites used in wine, are meant to keep beverages from spoiling. However, they can cause allergic reactions. Sulfite allergies are most common in people with asthma, with 4-5% of people with asthma having a sulfite sensitivity.
Histamines from Fermentation
Alcohol that’s fermented during production, like beer, often contains histamines. Most people aren’t allergic to histamines, but instead, are intolerant to them. Limited research suggests that about 1-3% of adults have a histamine intolerance.
Additives, Flavors, or Contaminants
When you order mixed drinks like cocktails, the additives or extra ingredients in them may cause allergies. That’s especially common if someone orders a beverage and they aren’t aware it contains an ingredient they’re allergic to.
Common ingredients or additives in mixed drinks that can cause reactions are:
- Artificial sweeteners or food coloring used in a variety of drinks
- Dairy (cream/milk) for creamy cocktails like White Russians or Irish Mints
- Egg to create foam or froth in drinks like whiskey sours
- Peanut derivatives often used in vegan cocktails
Contaminants in alcohol can also cause reactions. One of the main ones is mycotoxins that appear when crops like barley, corn, or grapes contain mold and are then used to produce alcohol. Consuming them can cause an immune response similar to an allergy.
What Is a Sudden Alcohol Intolerance?
While someone with a genetic predisposition will usually experience alcohol intolerance throughout their life, you can also develop a sudden intolerance to alcohol, where you used to be fine drinking and now start having reactions.
New health conditions, medications, or hormonal changes can all affect your body’s ability to process alcohol and can lead to sudden reactions. Therefore, identifying changes in your health or medication regimen can help you determine what’s causing the reactions.
Additionally, the effects that alcohol abuse has on the body can contribute to a sudden intolerance that happens later in life. For example, liver damage resulting from frequent alcohol abuse can affect the body’s ability to process alcohol, leading to a buildup of toxic byproducts in the body that cause a reaction.
When to See a Doctor
Typically, when a sudden alcohol intolerance occurs, it’s a good idea to see a doctor to help identify the cause and get advice. Sudden symptoms that weren’t happening previously could be a result of changes in your health and physical well-being, so it’s a good idea to review your health markers to be sure.
Additionally, if serious reactions occur after drinking, like trouble breathing or persistent pain, it’s a good idea to get it checked out by a doctor to rule out any major health concerns.
Alcohol Sensitivity and Addiction Risk
As mentioned, health conditions or damage to the body that occur from an ongoing alcohol addiction can contribute to an alcohol intolerance. It can be a sign from the body that things need to change before the impact on health and well-being gets worse.
Common signs of alcohol addiction include:
- Continuing to drink despite negative reactions to alcohol
- Having withdrawal symptoms when you stop drinking
- Worsening performance at work or school because of alcohol use
- Family, financial, or legal problems resulting from alcohol use
- Isolating or not participating in activities once enjoyed
If you or a loved one is experiencing these signs, resources are available that can help recover and avoid worse health complications.
How United Recovery Project Can Help
United Recovery Project is a rehab center that helps with drug and alcohol addiction treatment. Our alcohol rehab programs are evidence-based and customized based on your needs to ensure the highest possible chance of success.
Treatment typically starts with a safe medical detox program to monitor for health and comfort when stopping drug or alcohol use. After detox, completing a full inpatient or outpatient treatment program is a good idea to receive well-rounded support, therapy, and implement lifestyle changes that lead to long-term success and sobriety.
If alcohol is causing negative reactions in your body or your life, it may be time to reassess your relationship with drinking. We’re here to support you at United Recovery Project. You can get in touch with us today to schedule a free consultation or learn more about how we can help.
References
- Wigand, Petra, et al. “Prevalence of Wine Intolerance.” Deutsches Aerzteblatt Online, 22 June 2012, doi:10.3238/arztebl.2012.0437. https://pmc.ncbi.nlm.nih.gov/articles/PMC3391999/
- Morozova, Tatiana V., et al. “Genetics and Genomics of Alcohol Sensitivity.” Molecular Genetics and Genomics, vol. 289, no. 3, 2014, pp. 253–269, doi:10.1007/s00438-013-0808-y. https://pmc.ncbi.nlm.nih.gov/articles/PMC4037586/
- Clinic, Cleveland. “Sulfite Allergy & Sensitivity: Symptoms, Tests & Treatments.” Cleveland Clinic, 2024, https://my.clevelandclinic.org/health/diseases/11323-sulfite-sensitivity
- “Histamine Intolerance: Fact or Fiction?” org, 2023, https://www.aaaai.org/tools-for-the-public/latest-research-summaries/the-journal-of-allergy-and-clinical-immunology-in/2023/histamine
