Overview

Alcohol intolerance can cause immediate, uncomfortable reactions after you drink alcohol. The most common signs and symptoms are stuffy nose and skin flushing.

Alcohol intolerance is caused by a genetic condition in which the body can't break down alcohol efficiently. The only way to prevent these uncomfortable reactions is to avoid alcohol.

Although not a true allergy, in some cases, what seems to be alcohol intolerance might be your reaction to something in an alcoholic beverage — such as chemicals, grains or preservatives. Combining alcohol with certain medications also can cause reactions.


Symptoms

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

  • Facial redness (flushing)
  • Red, itchy skin bumps (hives)
  • Worsening of pre-existing asthma
  • Runny or stuffy nose
  • Low blood pressure
  • Nausea and vomiting
  • Diarrhea

When to see a doctor

Having a mild intolerance to alcohol or something else in alcoholic beverages might not require a trip to a doctor. Simply avoid alcohol, limit how much you drink or avoid certain types of alcoholic beverages.

However, if you have a serious reaction or severe pain, see your doctor. Also, if your symptoms seem to be linked to an allergy or a medication you're taking, see your doctor.


Causes

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 most often found in Asians.

Other ingredients commonly found in alcoholic beverages, especially in beer or wine, can cause intolerance reactions. 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 a true allergy to a grain such as corn, wheat or rye or to another substance in alcoholic beverages.

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


Risk factors

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

  • Being of Asian descent
  • Having asthma or hay fever (allergic rhinitis)
  • Having an allergy to grains or to another food
  • Having Hodgkin's lymphoma

Complications

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

  • Migraines. Drinking alcohol can trigger migraines in some people, possibly as a result of histamines contained in some alcoholic beverages. Your immune system also releases histamines during an allergic reaction.
  • A severe allergic reaction. In rare instances, an allergic reaction can be life-threatening (anaphylactic reaction) and require emergency treatment.

Prevention

Unfortunately, nothing can prevent reactions to alcohol or ingredients in alcoholic beverages. To avoid a reaction, avoid alcohol or the particular substance that causes your reaction.

Read beverage labels to see whether they contain ingredients or additives you know cause a reaction, such as sulfites or certain grains. Be aware, however, that labels might not list all ingredients.


Apr 06, 2023

  1. Fazio SB. Approach to flushing in adults. https://www.uptodate.com/contents/search. Accessed Feb. 9, 2018.
  2. Alcohol allergy. Australasian Society of Clinical Immunology and Allergy. https://www.allergy.org.au/patients/other-allergy/alcohol-allergy. Accessed Feb. 9, 2018.
  3. Out to eat with food allergies? Don't forget about your drinks. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/food-allergy-drinks. Accessed Feb. 9, 2018.
  4. Allergy testing definition. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/allergy-testing. Accessed Feb. 9, 2018.
  5. Aoki Y, et al. Quantification of skin erythema response to topical alcohol in alcohol-intolerant East Asians. Skin Research and Technology. 2017;23:593.
  6. Diet and migraine: Q&A with Dr. Vincent Martin. American Headache Society. https://americanheadachesociety.org/news/diet-migraine-qa-dr-vincent-martin/. Accessed Feb. 9, 2018.
  7. Ma L, et al. Hodgkin lymphoma presenting as alcohol-induced back pain. British Medical Journal. 2019; doi:10.1136/bcr-2018-228440.

CON-XXXXXXXX

3X your impact!

Your gift can go 3X as far to shape the future of healthcare.