Allergy to Tequila, Beer and Wine

Anaphylaxis to Tequila, Beer and Wine

Allergic reactions can occur to beer, wine and tequila.

Many people, from time to time, have experienced unpleasant side effects of overindulging in alcoholic beverages. Most of the symptoms that occur with drinking too much alcohol probably aren’t caused by true allergic reactions, but rather from the expected pharmacologic effects of alcohol or non-allergic food intolerance to alcohol. However, it is possible to experience allergic reactions from drinking alcoholic beverages.

The alcohol, however, is not typically the reason for these reactions. Another ingredient -- such as grapes in wine, various grains in beers (such as hops, barley, rye, corn or wheat), and the addition of yeast (for fermentation of sugars and generation of alcohol) -- may be the cause. Allergic reactions have also been described with distilled liquor, such as tequila, possibly as a result of the process used to age the liquor.

Anaphylaxis to Tequila

A recent report, published in 2013, detailed a case of severe anaphylaxis as a result of drinking gold tequila. Tequila is distilled liquor derived from the agave plant, and is available in white/silver (little to no aging) and gold (aging in oak barrels for many months to years, which gives the tequila a golden color) versions. A 47-year-old woman experienced repeated episodes of anaphylaxis after drinking gold, but not silver, tequila. She also suffered from symptoms of allergic rhinitis and asthma as a result of exposure to oak pollen.

Skin testing to gold tequila was positive and actually resulted in symptoms of anaphylaxis as a result of the skin test itself. Since she was able to drink silver tequila and other alcoholic beverages without a problem, the researchers concluded that the gold tequila contained oak protein as a result of the aging process, which was responsible for the allergic reactions.

Anaphylaxis to Wine

Allergic reactions to wine have been blamed on a number of different causes, such as grapes, yeast, bacteria, and more recently – stinging insect venom. A study published in 2007 by a group of researchers from Spain described 5 people who experienced allergic reactions, including anaphylaxis, after drinking various wines (red and white) as well as grape juice. All of these people were found to be sensitized to Hymenoptera venom, although none of them were ever stung by Hymenoptera. Venom proteins were found in freshly-pressed wines and grape juice, but not in aged wines. The authors of this study concluded that drinking fresh wines and grape juice might actually sensitize a person to Hymenoptera venom.

Anaphylaxis to Beer

Allergic reactions to beer are rare, although do occur. A report of 1 patient, published in 2009, details a case of a 21-year-old man who experienced severe anaphylaxis as a result of drinking beer, but not with other alcoholic beverages. The man had positive skin tests to a number of different beers, as well as to various foods, including barley, oats, almonds, and peas.

He did not have any other type of food allergy and was able to eat all of the above foods, except for his reactions to beer.

Barley is the most common cause of beer allergy, although other possibilities include allergy to yeast and hops. Some people who experience allergic reactions to beer as a result of barley allergy are able to eat other barley-containing foods, such as bread. The authors of this study conclude that the reason for this is likely as a result of the processing of barley used to ferment beer. This process may change the barley allergen to make it more likely to cause allergic reactions. Interestingly, food processing may affect how other foods cause allergies, such as with peanut allergy.

Read more about the common causes of alcohol allergy.

Sources:

Coons BD, White K. Anaphylaxis to Gold Tequila. Ann Allergy Asthma Immunol. 2013;111:70-1.

Nusem D, Panasoff J. Beer Anaphylaxis. IMAJ. 2009;11:380-1.

Armentia A, Pineda F, Fernandez S. Wine-Induced Anaphylaxis and Sensitization to Hymenoptera Venom. N Engl J Med. 2007;357:719-20.

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