Alcohol Allergy

An alcohol allergy is when your body reacts to alcohol as if it’s a harmful intruder and makes antibodies that try to fight it off. This causes an allergic reaction.

Alcohol allergies are rare, but if you do have one, it doesn’t take much to trigger a reaction. Two teaspoons of wine or a mouthful of beer may be enough.

Alcohol Allergy vs. Intolerance

Most people who have a reaction to alcohol aren’t allergic to it. They have an intolerance. They don’t have one of the active enzymes needed to process alcohol — alcohol dehydrogenase (ADH) or aldehyde dehydrogenase (ALDH). This is often called alcohol intolerance.

Alcohol allergy symptoms

The symptoms of alcohol allergy are usually more serious. Signs of an alcohol allergy include:

• Rashes
• Trouble breathing
• Stomach cramps
• Collapse
• Anaphylaxis, which is a severe reaction that can include a rapid, weak pulse, nausea, and vomiting. If you have this, swelling, or trouble breathing, call 911.

Alcohol intolerance symptoms

If you have alcohol intolerance, you may get:

• A red, flushed face
• Diarrhea
• A hot feeling
• Headaches
• Heartburn
• Hives
• A rash
• A fast heartbeat or palpitations
• Low blood pressure
• A stuffy nose
• Stomach pain, which may include nausea or vomiting
• Trouble breathing
• If you have asthma, your symptoms get worse

In a few cases, alcohol intolerance can be a sign of a more serious problem. If you think you have it, talk with your doctor and find out what’s causing it.

Common Food Allergens in Alcoholic Beverages

Alcoholic beverages are made from complex mixtures of grains, chemicals, and preservatives that your body needs to break down.

If your body can’t do this well enough, you will have a reaction.

Common allergens in alcoholic beverages include:

• Barley
• Egg protein (usually in wine)
• Gluten
• Grapes
• Histamines
• Hops
• Rye
• Seafood proteins
• Sodium metabisulfite
• Sulfites
• Wheat
• Yeast

Red wine is more likely to cause a reaction than any other alcoholic drink. Beer and whiskey also can cause reactions because both are made from four common allergens: yeast, hops, barley, and wheat.

Alcohol Allergy Risk Factors

You may be more likely to have an intolerance to alcohol or allergic symptoms if you:

• Are of Asian descent
• Have asthma or hay fever
• Are allergic to grains or have other food allergies
• Have Hodgkin’s lymphoma

If you’re taking medication, check with your doctor to see if it’s OK to drink alcohol while you take it.

Alcohol Allergy Diagnosis

If you think alcohol is causing your reactions, talk to your doctor. To find out what’s going on, they may do the following:

• Ask you about your family history. Much like allergies, alcohol intolerance can be passed down in families. Your doctor will ask if you have other relatives who have similar problems when they drink.
• Ask you about your symptoms
• Do a physical exam
• Do a skin prick test. It can show if you are allergic to an ingredient in alcoholic beverages. You’ll get a prick on your skin with a tiny bit of the substance you may be allergic to. If you are allergic, you’ll get a raised bump in that spot.
• Test your blood

Your doctor also may recommend that you stop drinking all alcoholic beverages for a while. Then you can start again, perhaps trying just one of your go-to drinks at a time. If the reactions return with specific drinks, then you know which ones cause problems for you.

Alcohol Allergy Treatment and Prevention

Avoiding alcohol is the only sure way to prevent an alcohol-related reaction.

If you do have a reaction, its effects can range from hives, which may not need medical care, to a more serious, possibly life-threatening reaction (anaphylaxis). Anaphylaxis caused by an alcohol allergy is treated the same as with any other type of allergy:

• Lie down right away.
• Take a shot of adrenaline (epinephrine) if possible.
• Call 911.

If you have an alcohol allergy, make sure to have epinephrine shots with you at all times and wear a medical ID bracelet that tells health professionals you have an allergy.