Could You Be Allergic to Alcoholic Beverages?

Alcohol Allergy
Alcohol can cause various reactions. Serge Krouglikoff Collection/The Image Bank/Getty Images

We’ve all enjoyed alcoholic beverages, and many of us have experienced the unpleasant side effects of enjoying these drinks a bit too much. But imagine if you couldn’t drink alcohol, not even a little because you experienced uncomfortable reactions as a result.

There are many reasons for these reactions, most of which are not actually caused by allergies. 

Allergic Reactions to Alcoholic Drinks

It's true that you can experience an allergic reaction after drinking alcoholic beverages.

The alcohol content, however, is most likely not to blame for your symptoms.

Another ingredient, such as grapes in wine, various grains in beers (for example, hops, barley, rye, corn, or wheat), and the addition of yeast (for fermentation of sugars and generation of alcohol) may be the cause.

The symptoms of these reactions may be exactly like those with any other  food allergy reactions like skin problems (for example, itching, hives, swelling), wheezing, shortness of breath, and lightheadedness.

It's important to note that if you have chronic urticaria (hives) or angioedema (swelling in the deep layers of the skin, most often the face and lips), you may notice an increase in your symptoms after consuming alcohol. This does not mean you are allergic to beer, wine, or liquor, rather, alcohol may simply worsen your underlying condition. 

Other potential ingredients in alcoholic beverages that may cause an allergic reaction are sulfites, histamine, gluten, and wheat.

Sulfites

Sulfites are preservatives added to various foods in order to prevent spoilage. Sulfites are known to worsen asthma symptoms and can cause hives and anaphylaxis, a life-threatening allergic reaction.

Histamine

Some alcoholic beverages contain histamine, a byproduct of yeast and bacteria fermentation.

  Histamine is the same chemical released by mast cells during an allergic reaction, and can cause symptoms of itching, hives, sneezing, and wheezing.

If an alcoholic beverage contains a large amount of histamine, you may experience allergic symptoms after consuming it. If you already have allergies, such as seasonal allergies, the increase of histamines may make your underlying, non-alcohol-related allergies worse. 

Gluten and Wheat

People with celiac disease have a gluten allergy, and gluten is found in some beers and hard ciders. Certain beers also contain wheat, which can cause problems for people with a  wheat allergy. Distilled alcoholic beverages like vodka, whiskey, gin, and bourbon, may also be made from wheat, rye, or barley (and so may contain gluten or wheat).

The good news is that many manufacturers make alcoholic drinks that are free of gluten and/or wheat. In addition, wine, sake, most brandies and wine coolers are gluten-free. Even so, be sure to always check the ingredient label yourself.

Non-Allergic and Flushing Reactions

Aldehyde dehydrogenase is an enzyme that helps break down alcohol after it is consumed. A deficiency of this enzyme can result in flushing after consuming alcohol, as well as nausea and a rapid heart rate.

Such reactions can be confused for an allergic reaction, but they are actually more often due to this enzyme deficiency, which is most common in people of Asian descent.

In addition, taking certain medications like the antibiotic Flagyl (metronidazole) or the Nizoral (ketoconazole)  may trigger a flushing reaction. Likewise, the medication Antabuse (disulfiram), which is prescribed to treat alcohol abuse (although not as much anymore) blocks the enzyme aldehyde dehydrogenase. When consumed with alcohol, Antabuse may cause severe flushing, nausea, vomiting, and a low blood pressure. 

A final risk factor for developing an alcohol-related flushing reaction is Hodgkin lymphoma.

This phenomenon is not well understood but may be due to the dilation of blood vessels within the affected lymph node's capsule when exposed to ethanol. 

Lastly, it's important to note that some people experience non-allergic rhinitis (symptoms of nasal congestion, runny nose, and/or sneezing) after the consumption of alcohol. This is likely due to the dilation of blood vessels in the nose, resulting in mucus production and nasal symptoms. 

A Word From Verywell

In the end, if you experience a severe reaction after drinking alcohol, it's important to avoid the particular alcoholic beverage that caused the reaction or avoid alcohol altogether. Also, in the case of severe reactions, you should carry a rescue medication, like an epinephrine injector, should the allergy-offending beverage accidentally be consumed.

For minor reactions, it's worthwhile to talk to your doctor about a medication you can take to ease symptoms (for example, an antihistamine). 

Sources:

American Academy of Allergy, Asthma, and Immunology. (2014). Alcohol Angioedema and Urticaria. 

The American Academy of Allergy, Asthma and Immunology. (2014). Food Allergy Practice Parameters Update. 

Bryant AJ, Newman JH. Alcohol intolerance associated with Hodgkin lymphoma. CMAJ. 2013 May 14;185(8):E353.

Fazio SB. (2016). Approach to flushing in adults. In: UpToDate, Aronson MD (Ed), UpToDate, Waltham, MA. 

Continue Reading