An alcohol allergy is a rare toxic reaction to alcohol that can be fatal in rare cases. Often, what people consider to be an alcohol allergy is, in fact, alcohol intolerance.
People may also have an allergic reaction to specific ingredients in alcoholic drinks rather than the alcohol itself.
If someone has a true allergy to alcohol, they should avoid the substance entirely. People with alcohol intolerance could still consume alcohol, although they will likely experience side effects.
In this article, we explore alcohol allergies. We will also look at what causes alcohol allergies and review the differences between alcohol allergy and intolerance.
An alcohol allergy occurs when the immune system overreacts to alcohol entering the body.
The immune system usually produces antibodies to fight harmful substances in the body. However, in people with an alcohol allergy, the system mistakenly produces antibodies to attack alcohol following exposure to the substance, triggering various symptoms.
An alcohol allergy can occur when a person with an alcohol allergy comes into contact with alcohol, which is also known as ethanol.
The immune system overreacts to this exposure in the body, treating alcohol as a threat. The body produces antibodies, and when they encounter alcohol, they set off a systemic allergic reaction.
Genuine alcohol allergies are extremely rare. Symptoms are more likely to be a reaction to the ingredients in a drink, or the alcohol causing other types of allergies to worsen. For example, alcohol may exacerbate preexisting asthma conditions.
Some components of alcoholic beverages that could trigger an allergic reaction include:
- gluten
- grapes
- wheat
- hops
- barley
- rye
- yeast
- traces of egg
- seafood proteins
- artificial fruit flavorings
Alcohol allergy symptoms can range from mild, such as an itchy mouth or eyes, to severe, including vomiting or anaphylaxis.
Anaphylaxis is a life threatening condition that involves a series of symptoms, such as a rash, low pulse, and shock.
Symptoms of an allergic reaction include:
- itching in the mouth, eyes, or nose
- a red, itchy rash, or hives
- swelling of the face, mouth, throat, or other body areas
- difficulty swallowing
- shortness of breath or wheezing
- feeling lightheaded or dizzy
- nausea or vomiting
- pain in the abdomen or diarrhea
Symptoms may occur within seconds or minutes of alcohol exposure and could trigger after exposure to even tiny amounts of the allergen.
An allergic reaction might not occur the first time a person encounters an allergen. However, they can come on suddenly, and a person could develop an alcohol allergy at any point in their life.
If people experience symptoms after drinking alcohol, they should speak with a doctor for further advice.
An alcohol allergy and alcohol intolerance are two different conditions.
With an alcohol allergy, a person’s immune system overreacts to alcohol. Alcohol intolerance is a genetic condition where an individual’s digestive system cannot properly break down the substance.
Symptoms of alcohol intolerance can make a person feel uncomfortable. In contrast, an alcohol allergy could become life threatening.
Symptoms of alcohol intolerance may include:
- facial redness
- hives
- a runny or stuffy nose
- nasal congestion
- hot flashes
- nausea and vomiting
- diarrhea
- headache
Symptoms of alcohol intolerance that people may confuse with alcohol allergies could include:
- low blood pressure
- a fluttering sensation of the heart
- high blood pressure
- swelling of the lips or tongue
- coughing
- fainting or chest pain
An allergy or intolerance to alcohol is not always responsible for symptoms occurring after drinking alcohol. Other explanations may include the below.
Histamine intolerance
Some alcohols, such as wine, contain histamine. The amounts of histamine vary between wines, but generally, there is more histamine in red than white wine.
The enzyme diamine oxidase
Histamine release can trigger:
- sneezing
- a runny nose
- wheezing
- stomach upset
- headache
Sulfite intolerance
Sulfites are preservatives, and most countries permit their addition to alcoholic drinks such as beer and wine. However, some people may experience allergy-like reactions after consumption.
Symptoms of sulfite intolerance may include:
- wheezing
- coughing
- allergic rhinitis, also known as hay fever
- shortness of breath
- hives
Hodgkin lymphoma
Hodgkin lymphoma is a blood cancer that can affect a person’s lymphatic system. People with this condition usually experience swelling in the lymph nodes in areas including the neck, armpits, or groin.
Usually, swollen lymph nodes do not cause pain. However, some people with Hodgkin lymphoma experience pain in their lymph nodes after consuming alcohol. It is unclear why this reaction sometimes occurs.
If a person thinks they have an alcohol allergy, they should eliminate alcohol from their diet and consult with a healthcare professional.
If someone experiences a severe allergic reaction, they should go to the emergency room immediately. If they do not have an epinephrine injection to treat anaphylaxis right away, it could be fatal.
There are several ways for a doctor to diagnose an alcohol allergy or intolerance, including the approaches below.
Questions
A healthcare professional may initially ask a person questions, including:
- what symptoms they experience
- which alcoholic beverages appear to be causing the symptoms
- whether alcohol allergies or intolerances run in the family
- whether they have any other medical conditions
The doctor may refer the person to an allergy specialist for further testing and treatment.
Skin prick test
A doctor may diagnose an alcohol allergy using a skin prick test on the inner forearm.
The healthcare professional uses a lancet to pierce a person’s skin and apply a small amount of the suspected allergen to see if it causes a reaction. However, standardized skin testing using different types of alcohol is not currently available.
A skin prick test should take place in a medical setting in case of a severe allergic reaction.
Other tests
Occasionally, a doctor may ask a person to consume alcohol in a medical setting and observe any reactions or symptoms. They may also carry out blood tests.
Depending on whether a person has an alcohol allergy or intolerance, they may need to avoid alcohol entirely.
If a person is allergic to a particular ingredient found in some drinks, they could switch to drinks that do not contain it. A doctor can advise further.
Depending on the allergy severity, a person may treat symptoms with over-the-counter medications, such as oral antihistamines, if the reaction is mild.
If the allergic reaction is more severe, people may require epinephrine, also known as an EpiPen. A person with severe allergies should carry one with them at all times, in case of a serious allergic reaction.
An alcohol allergy is rare but could potentially be fatal. However, a person is usually allergic or intolerant to certain ingredients in the drink, rather than the alcohol itself.
If someone believes they have an alcohol allergy or intolerance, they should stop drinking alcoholic drinks and visit their healthcare provider for testing and advice.
A person experiencing a severe allergic reaction should go to the emergency room immediately.