How to know if you are allergic to alcohol

If even a tipple or two gives you a terrible reaction, you may be suffering from an alcohol allergy or intolerance to alcohol. Here’s what you need to know.

Tempting as it may be, we all know we will regret that extra glass of wine in the morning.

But for an unlucky few, even a single sip can cause immediate reactions ranging from shortness of breath to hives, or in rare cases, anaphylaxis.

Here’s how to tell if you’re suffering from an alcohol allergy or intolerance to alcohol.

Alcohol allergy versus intolerance

An alcohol allergy is a toxic reaction to alcohol, or ethanol, and is extremely uncommon, according to allergist Dr Celia Zubrinich.

“There are cases where people are allergic to the acetic acid in alcohol, but that’s unbelievably rare,” Dr Zubrinich says.

Even the tiniest drop will produce immediate, severe reactions for those people.

Everyday Nutrition dietician and nutritionist Liz Radicevic says alcohol intolerance is a reaction from the digestive system and is likely caused by an ingredient in the alcohol, not the ethanol itself.

Symptoms of alcohol intolerance and allergy

The Food Intolerance Dietitian’s Frances Walker says common symptoms of an intolerance to alcohol include headaches, stuffy nose, heartburn, low blood pressure, stomach ache and flushing.

“Feeling as if you’re drunk, or hungover, way out of proportion to the amount you have consumed is another symptom,” Frances says.

Liz says alcohol allergy symptoms are more extreme and should never be ignored; they include severe rashes, difficulty breathing and anaphylaxis.

Common allergens in alcohol

Ingredients in alcoholic drinks, such as wheat, barley, rye, gluten, hops, yeast, egg proteins and grapes can provoke a reaction in someone with an underlying condition.
Other allergens include histamines, and artificial colours and flavours.

A 2000 study found the preservative sodium metabisulfite in wine triggered asthma in up to one-third of participants.

“Wine can cause a reaction in people with a sensitivity to sulfites,” Dr Zubrinich says.

“But this may go away if the underlying asthma is properly controlled.”

Risk factors of reaction to alcohol

Asthma, hay fever or pre-existing allergies are all risk factors for a reaction to alcohol.

Research has also revealed a genetic link to alcohol intolerance, including a 2009 study that found people of East Asian descent often have an enzyme deficiency causing flushing and increased heart rate when consuming alcohol.

“If you have allergies, you may be more likely to have a reaction because allergies can travel together,” Frances says.

Treatment and prevention

If you are allergic to alcohol, abstinence is the only answer, and you will need an EpiPen to treat anaphylaxis, Liz says.

“You may be able to consume in moderation and manage your symptoms,” she says.

Frances says if that’s not possible, the trigger ingredient must be removed.

The good news is that intolerances can improve over time.

“Once you’ve taken the triggers away, the body can settle, and you may be able to reintroduce the trigger to your diet,” Frances says.

Written by Dimity Barber.