Alcohol Allergy

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Food allergies and tolerances are quite common across the world. However, many people are not aware that alcohol is capable of triggering similar reactions, particularly in people with high sensitivity. Known as true alcohol allergy, the phenomenon is extremely rare; however, it is real and does impact a certain percentage of the world population.

A Rundown of Alcohol Allergy and its Culprits

While many people remain unaware of alcohol allergy, it is not unusual to experience these symptoms following alcohol ingestion. The consequent allergic reaction is mostly very specific, such as to a specific type of wine, but it can also be caused by different types of alcoholic beverages. True allergy to alcohol is very rare, and most people with an underlying suspicion are the ones in which alcohol consumption only triggers their pre-existing allergies. Such sensitive people may experience skin flushes, headaches, and wheezes, even with the slightest alcohol use. Alcohol may also increase their gut permeability, allowing more food particles into the bloodstream and triggering allergies in people with pre-existing food intolerances.

Most people with underlying true alcohol allergy may experience the following symptoms:

Histamine

This component is commonly found in many alcoholic drinks, such as red wines, and may cause symptoms like flushing, nausea, headaches, and trouble breathing. Some people are particularly intolerant to histamine because their bodies cannot sufficiently break and eliminate it.

Yeasts

Yeast remains one of the many possible causes triggering a true allergic reaction in people secondary to alcohol use. However, studies have proven that most alcoholic drinks contain very low amounts of yeast allergens.

Sulfites/Sulfur Dioxide

Sulfur dioxide is quite commonly present in home-brewed wines and beers in the form of sodium metabisulphite. This chemical is commonly used during equipment cleaning and found at very high levels in the brewing process. Studies suggest that one in ten people with asthma are sensitive to sulfites and may experience wheezes and other signs of allergies if they consume alcohol that contains them. For this reason, authorities have instructed all restaurants to list sulfites in bold letters in all prepared foods that may contain them.

Sulfur dioxide is particularly common in home-brewed beers and wines as sodium metabisulphite. This is used in the cleaning of equipment and remains at very high levels in the brewing process. Around 1 in 10 asthmatics are sensitive to sulfites and may have a wheezy reaction to alcoholic drinks. Rashes and anaphylactic reactions are rare. Sulfites are one of the 14 allergens that must be listed and highlighted in bold in all prepared foods and restaurants.

Additives

Certain additives found in alcohol, such as sodium benzoate and tartrazine, can induce asthma and urticaria in sensitive individuals.

Plant-derived allergens

Certain fruit components found in alcohol, such as juniper berries, apples, grapes, oranges, and coconuts, may cause allergic reactions in sensitive individuals. Alternatively, these reactions may occur secondary to certain flavors (such as hops) or the presence of specific grains (such as malt) from which the drinks are made. Another unusual but potential source of allergic reactions due to alcohol use is fungal spores that may add to the drink from the corks of wine bottles. However, this sensitivity is rare and only investigated if signs of visible mold exist on the corks.

Common Alcohol Allergy Symptoms in Adults

People who suffer from a true alcohol allergy may react severely even to the consumption of small doses of alcohol. In some cases, alcohol may trigger anaphylaxis, a life-threatening condition that requires emergency medical care. Mentioned below are some common alcohol allergy symptoms that may occur in a sensitive individual:

• Itchy eyes, nose, or mouth
• Swelling of the throat, face, or other body parts
• Eczema, hives, or intense itchiness on the skin
• Lightheadedness, dizziness, or loss of consciousness
• Nausea, vomiting, diarrhea, or abdominal pain
• Wheezing
• Nasal congestion
• Labored breathing

Never ignore any of the symptoms mentioned above; if left untreated, they may lead to quick exacerbations, becoming fatal in some instances. A person with alcohol sensitivity can develop allergic symptoms at any point in life. The sudden onset of these symptoms may sometimes indicate an underlying newly-acquired intolerance. In rare circumstances, experiencing pain following alcohol ingestion may also be a sign of a certain type of cancer called Hodgkin’s lymphoma. Hence, always make an appointment with your doctor to discuss the possible reasons if you develop uncomfortable symptoms after drinking alcohol.

Alcohol Allergy Vs Intolerance: What is the Difference?

It is common for people to confuse the symptoms of alcohol intolerance with allergies. However, remember that both conditions are different. Alcohol intolerance is a metabolic disorder with genetic roots that affects the digestive system. This disorder renders the body unable to process alcohol the way it should. Alcohol allergy, on the other hand, is an immune system response when it comes in contact with alcohol. This immune system response occurs in people who are allergic to alcohol or one of its components, such as a grain or preservative.

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In terms of symptoms, both conditions may differ slightly. Both alcohol allergy and intolerance may cause nausea. The hallmark of alcohol intolerance is flushing of the skin of the neck, face, and chest which is not common in people with alcohol allergy. An allergic reaction to alcohol, on the other hand, may cause excessive itchiness, rashes, severe stomach cramps, and swelling. In rare cases, alcohol allergy can lead to potentially fatal outcomes.

Regardless of whether it is tolerance or allergy, it is imperative to seek help from a doctor if alcohol consumption makes you experience side effects. A doctor can analyze the nature and severity of your symptoms, investigate past and present medical history, and advise on the next best steps.

How to Test for Alcohol Allergy

If a person develops uncomfortable symptoms after drinking alcohol, it is imperative to make an appointment with a doctor. Depending on the nature and severity of symptoms, a doctor may refer the individual to an allergist for further testing and treatment. An allergist is a special type of doctor specializing in diagnosing and treating allergic issues.

At a doctor’s appointment, the expert may start the consultation by asking several questions about the past medical history and current symptoms. These symptoms may include the following:

• What types of alcoholic beverages trigger your symptoms?
• When did you start getting these symptoms?
• What symptoms do you experience?
• Do you suffer from any other medical conditions?
• Do you have relatives with allergies?

If a doctor has a strong suspicion about a true alcohol allergy or an allergy to a certain ingredient found in alcoholic beverages, they will proceed with allergy testing. Skin prick test remains the most common type of allergy test that an allergist may resort to. During this test, the doctor uses a lancet to scratch or prick the skin, followed by applying a drop of alcohol to the pricked area. As the skin comes in contact with the allergen, which is alcohol in this case, it may react in different ways. Depending on this reaction, a doctor may determine if a person suffers from a true alcohol allergy or not.

In some cases, an expert may use an oral challenge to confirm the diagnosis of an alcohol allergy or tolerance. In this test, they may ask an individual to consume a sample consisting of the allergen under investigation, for example, alcohol. Following this, they will monitor the individual for any allergic symptoms while conducting several blood tests. Remember that testing for alcohol allergy must always occur in a medical facility as it may trigger a severe reaction in some cases for which medical treatment might be needed.

Treating Alcohol Allergy: Steps to Take

People with true alcohol allergy only have one way to avoid the associated symptoms: refraining from alcohol completely. Consuming even a small amount of alcohol can trigger severe reactions in such individuals; hence, they must be careful while checking the drinks and food ingredients list. Moreover, they must ask the restaurant staff about their menu items and avoid those that contain alcohol.

For people who are allergic to one particular ingredient found in certain alcoholic drinks or products, switching to a different beverage can be an option. For instance, people allergic to barely may not be able to drink beer but can safely consume wine. However, it is always a good idea to ask a doctor for guidance before experimenting.

People who accidentally consume alcohol and develop a mild allergic reaction can take help from an over-the-counter oral antihistamine. Alternatively, those who develop severe symptoms may have to take one or more doses of epinephrine to keep the situation under control and stop it from any further progress. Also known as adrenaline, the medication comes in preloaded syringes and autoinjectors like EpiPens. If a doctor prescribes an EpiPen to you, you must carry it with you at all times and not hesitate to use it when you suspect alcohol allergy symptoms are developing. Following the injections, doctors advise visiting the nearest emergency room for follow-up care.

Alternatively, people with non-allergic intolerance to alcohol or one of its additives or components may benefit from limiting certain types of alcohol. They may also find relief in prescribed or over-the-counter medications after consulting with their doctor. Seek an appointment with a doctor to explore more options about how to keep symptoms under control and avoid them as much as possible.

FAQs

Who is at risk of experiencing alcohol allergy?

Some people are naturally more likely to suffer from an alcohol allergy than others. The risk is higher in people who:

• Have an Asian descent
• Suffer from Hodgkin’s lymphoma
• Have a history of hay fever or asthma
• Are allergic to grains
• Have other food allergies

People taking other medications must check with their doctor to see if they can safely drink alcohol while continuing the medication.

Can you be allergic to alcohol? What causes it?

People with an allergy have a highly sensitive immune system that over-reacts when it comes in contact with a possible allergen or trigger. In the case of alcohol allergy, the allergen is alcohol, and the immune system treats it as a threat. As soon as such a person drinks alcohol, the immune system responds by synthesizing certain antibodies called immunoglobulin E or IgE, which eventually trigger an allergic reaction.

What are the possible risks of having alcohol sensitivity?

Besides the highly unpleasant symptoms, the primary risk of having alcohol sensitivity is anaphylaxis. The condition describes the sudden onset of multiple allergic symptoms with very high severity, leading to accelerated pulse, breathing issues, dips in blood pressure, shock, and potential death. Anaphylaxis is a medical emergency and requires help from a team of medical professionals who administer adrenalin injections along with intravenous fluids. Because of the high risk of quick mortalities, experts also advise people with alcohol sensitivity to always carry emergency injections with them.

How can I prevent experiencing an alcohol allergy attack?

Unfortunately, there is no cure for managing alcohol allergy. The best method is to prevent it by avoiding any item that may possibly contain alcohol, such as wine, spirits, wine, and other medical or culinary products. Experts also advise carrying an epinephrine auto-injector with you to save your life in case you accidentally come in contact with something that includes alcohol. Moreover, wearing a medical-identification bracelet that identifies the underlying alcohol sensitivity is also important.

Should I avoid all types of alcohol if I am sensitive to it?

People with a higher sensitivity to alcohol must avoid anything that potentially includes it. However, those who are sensitive to one of its additives may have more options to consume when it comes to alcoholic beverages safely. For instance, people who are allergic to histamines can drink white wines, and those allergic to sulfites may be able to safely drink red wines.

Which other substances should I avoid if I have a risk of developing an alcohol allergy?

People who are allergic to alcohol must avoid everything that may potentially contain alcohol. These items may include the following:

• Cough mixtures and medicines
• Hand sanitizers
• Perfumes
• Skincare products
• Mouth wash
• Hygiene products
• Tomato purée
• Injectable medicines
• Sauces
• Marinades
• Cakes
• Soft drinks
• Deserts
• Non-alcoholic drinks

Which types of alcohol can cause alcohol allergy?

Red wine is the most common culprit triggering an underlying allergic reaction. This is followed by whisky, beer, and other kinds of wine.