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Alcohol Allergy Vs. Alcohol Intolerance

Alcohol intolerance is a hereditary, metabolic condition of the digestive system, while an alcohol allergy occurs when your immune system overreacts to one or more ingredients in alcohol.

Many people confuse alcohol allergy and alcohol intolerance — two of the most common reasons for an adverse reaction to alcohol. But these two conditions are different.

An allergy occurs when the body mistakenly identifies one substance as something harmful and mounts an immune system response against it.

It can be present from birth or develop at any point in your life after alcohol exposure. Alcohol allergies can cause hives, swelling, wheezing, or life-threatening conditions, such as anaphylaxis.

Alcohol intolerance occurs when the body lacks enzymes to digest the toxins in alcohol. People of East Asian descent are more prone to alcohol intolerance.

Chemical preservatives in beer, wine, and other alcoholic beverages can also produce intolerance reactions. Most people will experience some form of alcohol intolerance, regardless of whether they have an alcohol allergy.

Causes Of An Alcohol Allergy

An alcohol allergy may occur due to various reasons, including:

Immune Response

Some people may have an immune response to alcohol, causing them to experience hives, itching, swelling, and difficulty breathing after consuming it.

This is often referred to as an alcohol allergy — although not a true allergy.

Hodgkin’s Lymphoma

Alcohol intolerance in people with Hodgkin’s lymphoma is estimated by one study at 1.5%-5%. In Hodgkin’s disease, the pathogenesis of alcohol-induced pain is not known.

However, it is assumed to be linked to the lymph node capsule’s vasodilatation.

People in their twenties and thirties and those over the age of 55 are most likely to be diagnosed with Hodgkin’s lymphoma.

Overripe Fruit

Some people may experience an allergic reaction to alcohol when they consume alcohol after eating overripe fruit, such as bananas or mangos.

This is a rare condition and is not caused by an immune response but rather by an enzyme in overripe fruit that causes an allergic reaction when consumed with alcohol.

Cough Syrup

You may experience an allergic reaction to alcohol when you consume cough syrup that contains codeine.

It is also a form of opiate and can cause similar symptoms to those caused by food allergies.

Causes Of Alcohol Intolerance

These are the causes of alcohol intolerance:

Digestive Response

Some people have a hard time digesting alcohol because of a lack of an enzyme called aldehyde dehydrogenase (ALDH2).

This enzyme is produced in your stomach and is responsible for breaking down alcohol into acetaldehyde, which is further broken down into acetic acid.

If you don’t produce enough ADH, acetaldehyde can build up in your body and cause symptoms like nausea or headaches.

Gallbladder Removal

If you’ve had your gallbladder removed, be careful about how much alcohol you drink. The gallbladder stores bile, which helps break down fat in food to be digested properly.

Without a gallbladder, bile will stay in your body longer and could cause symptoms like nausea or bloating after drinking. Gallbladder removals create more alcohol intolerance symptoms.

Chemicals And Other Ingredients

Some people have an allergy to certain chemicals or ingredients in alcohol, which can cause symptoms like hives, swelling, or breathing problems.

Common culprits include sulfites (found in red and white wine), histamines (usually found in red wine), and gluten (found in beer).


Alcohol intolerance increases with age. As people age, their body tends to have an increased body fat percentage, and fat impedes the body’s ability to absorb alcohol.

The function of many body systems are diminished with age as well, including the liver. This means it takes the liver longer to process alcohol in older adults than in younger adults.

If you’ve had your gallbladder removed, be careful about how much alcohol you drink. The gallbladder stores bile, which helps break down fat in food to be digested properly.

Without a gallbladder, bile will stay in your body longer and could cause symptoms like nausea or bloating after drinking.

Symptoms Of Alcohol Intolerance

When you drink alcohol, it travels to your liver, where the enzyme alcohol dehydrogenase processes alcohol.

Because ADH has a low affinity for ethanol, it is very slow at metabolizing the stuff and produces metabolites like acetaldehyde, which causes flushing symptoms.

Other alcohol intolerance symptoms include:

  • low blood pressure
  • diarrhea
  • hives
  • nausea and vomiting
  • stuffy nose or runny nose

People with a severe allergic reaction should seek immediate medical advice and visit an emergency room, because it can be fatal.

Symptoms Of Alcohol Allergy

An alcohol allergy is characterized by an allergic reaction to drinking or ingesting alcohol. Common symptoms include itchy skin, hives, and swelling of the face and throat.

Other alcohol allergy symptoms include:

  • severe stomach pain
  • sneezing
  • asthma attacks
  • tachycardia (rapid heartbeat)
  • lightheadedness and shock

Diagnosing An Alcohol Allergy

Your doctor may perform a physical exam or order a skin test or blood test to determine whether you have an alcohol allergy.

Physical Exam

During a physical exam, your doctor will look for signs of a skin reaction to alcohol, such as redness or swelling.

The doctor may also check for other signs of an allergic reaction, such as hives and difficulty breathing.

Your doctor may ask you about your medical history and whether you’ve had alcohol sensitivity in the past before conducting an allergy test.

Skin Prick Test

During a skin prick test, your doctor will use a small needle to prick your skin and inject a small amount of alcohol under your skin.

If you have an allergy to alcohol, you’ll likely develop redness or swelling at that spot within 15 minutes of injection.

Blood Test

Total IgE tests detect the total number of IgE antibodies in your blood. A specific IgE test analyzes the level of IgE antibodies in response to specific allergens.

Diagnosing Alcohol Intolerance

Your healthcare provider will ask you about the symptoms and reactions after drinking alcohol. In addition, the doctor may perform a blood test.

The doctor will take a sample of your blood and look for immunoglobulin E antibodies produced in response to alcohol. A positive reaction shows that you are intolerant to alcohol.

Treatment Options For Alcohol Addiction

What is best for you to address an alcohol use disorder (alcohol addiction) depends on your situation and what you hope to achieve. The mix of treatments that work best for most people can be found in a residential or inpatient program.

Some of them are long-term treatment programs, which means you’ll need to reside at a rehab facility for a while.

Other options include programs that allow you to live at home while still receiving treatment at a facility.

FDA-approved medications such as naltrexone (Trexan) and acamprosate (Campral) can also help control alcohol consumption or addiction.

Find Substance Abuse Treatment At Bedrock Recovery Center

If you or your loved one are battling alcohol abuse, it’s time to get help. Our alcohol rehab center is designed specifically for people who need assistance coping with addiction and related issues.

We understand that addiction can be challenging to overcome alone, so we’re here to help.

Get in touch with Bedrock Recovery Center today to learn more about our alcohol treatment programs.

Written by
Bedrock Recovery Editorial Team

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This page does not provide medical advice.

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