It likely goes without saying that one too many alcoholic beverages don’t exactly have you feeling your best. But have you ever wondered if that uncomfortable reaction you get after drinking alcohol could be an allergy? It might sound surprising, but yes, it is possible to be allergic to alcohol, although it's rare. More commonly, what many people experience is an alcohol sensitivity. So, how do you tell the difference? Let’s break it down.

Alcohol Allergy vs. Alcohol Sensitivity

An alcohol allergy occurs when your immune system overreacts to alcohol, seeing it as a harmful substance. When this happens, your body produces antibodies that trigger an allergic reaction. This can cause symptoms like difficulty breathing, hives, swelling, or even anaphylaxis in extreme cases. True alcohol allergies are quite uncommon, and they're usually related to an allergic reaction to the ingredients in alcoholic beverages (such as grains, grapes, or yeast), rather than the alcohol itself.

On the other hand, an alcohol sensitivity or intolerance happens when your body struggles to metabolize or digest alcohol. This isn't caused by your immune system but by a deficiency in an enzyme called aldehyde dehydrogenase (ALDH2), which is responsible for breaking down alcohol in your body. People with an alcohol sensitivity often experience symptoms like headaches, flushing, and nausea shortly after consuming even small amounts of alcohol. This condition is more common in certain populations, especially people of East Asian descent.

Common Symptoms

Whether you’re dealing with an allergy or a sensitivity, alcohol-related reactions can cause a range of symptoms.

Symptoms of an alcohol allergy can include:

• Rashes or hives
• Difficulty breathing
• Stomach cramps
• Swelling of the face, mouth, or throat
• In severe cases, anaphylaxis (a life-threatening emergency)

Symptoms of alcohol intolerance may include:

• Facial flushing (redness)
• Stuffy or runny nose
• Headache
• Rapid heartbeat
• Nausea and vomiting
• Diarrhea

What Can You Do?

If you think you might be allergic or sensitive to alcohol, it’s important to talk to your doctor. They can help you figure out if you have an actual allergy or sensitivity by running allergy tests or evaluating your symptoms. Be sure to keep track of your symptoms, note what you drink and how it affects you. This information can be valuable when talking to your doctor.

As far as treatment goes, it will depend on if you have an allergy or simply just have a sensitivity.

For an alcohol allergy, the solution is simple but strict: avoid alcohol entirely. Even small amounts could trigger a serious reaction. It’s also important to check labels, as alcohol can be found in unexpected places like certain medications, mouthwashes, and foods. If you have a severe allergy, always carry an epinephrine auto-injector and wear a medical alert bracelet just in case.

For alcohol sensitivity, you don’t necessarily have to give up alcohol, but you should be mindful of your limits. Drinking in moderation or choosing beverages with fewer irritants, such as clear spirits instead of beer or wine, might reduce symptoms. You could also keep antihistamines on hand if your reactions tend to be mild but always consult with a doctor first.

When to Seek Help

While an alcohol sensitivity can be uncomfortable, an alcohol allergy can be dangerous. If you experience severe symptoms, like swelling of the throat, difficulty breathing, or a rapid drop in blood pressure, seek emergency medical attention. This could be a sign of a life-threatening reaction known as anaphylaxis.

If you're not sure which category you fall into, a consultation with an allergist or your primary care provider can offer clarity and help guide your choices.

Understanding the difference between an allergy and a sensitivity is key to making informed decisions about your health and safety, and remember that your health and comfort are important. If alcohol doesn't agree with you, there's no shame in opting for non-alcoholic alternatives.

Staying on top of your health is not only important to you, it’s also important to us. If you are looking for a doctor, Texas Health Resources offers an easy-to-use tool. Simply choose the specialty, type in your zip code, and select a range. Once a list of physicians appears, you can click on a physician and access contact information, educational background, and a list of insurance plans the doctor accepts.

Sources:

• Mayo Clinic: Alcohol intolerance and allergy symptoms explained
• National Institute on Alcohol Abuse and Alcoholism (NIAAA): Alcohol and health impacts
• Cleveland Clinic: Managing alcohol sensitivity and allergies

This post provides guidance, but it’s no substitute for professional medical advice. Be sure to speak with your doctor if you have any concerns about alcohol and your health.