When it comes to alcohol intolerance, it does not matter how much you consume. All it takes is one drink to make you experience unpleasant reactions. 

Alcohol intolerance is often mistaken for alcohol allergy, but the former is distinctly different from the latter. An allergy to alcohol occurs when your immune system overreacts to a drink, according to this Healthline report. 

An intolerance toward alcohol, on the other hand, is an inherited metabolic disorder that affects the enzyme that regulates alcohol metabolism states the Cleveland Clinic. In other words, alcohol intolerance occurs because your digestive system is unable to break down alcohol properly.  However, people can also experience intolerance symptoms due to the ingredients in alcoholic beverages (more on this later). 

It’s worth noting that intolerance has nothing to do with an addiction to alcohol or dependence.

Read on to learn more about the signs and symptoms of this condition. 

What Causes Alcohol Intolerance?

One sip of beer or red wine can set off alcohol intolerance. The most common signs associated with this condition, are stuffy nose and skin flushing. 

To understand how alcohol intolerance occurs, one must understand how the body is supposed to work when it encounters beer or a glass of red wine. 

When someone drinks an alcoholic beverage, the ethanol or ethyl alcohol is converted into acetaldehyde. According to the Cleveland Clinic, an enzyme called alcohol dehydrogenase (ADH) controls the metabolism of ethanol, and another protein called aldehyde dehydrogenase 2 (ALDH2) regulates the conversion of acetaldehyde to acetic acid. That conversion renders the harmful acetaldehyde to acetic acid, which is a non-toxic byproduct.   

When people have alcohol intolerance, it’s because the ALDH2 enzyme is less active or completely inactive — the result of a genetic mutation. This mutation means that the harmful acetaldehyde will build up in the blood and tissues. This action is why people with alcohol intolerance will experience facial flushing. 

Unless the acetaldehyde is converted into the less harmful acetic acid, various symptoms can bloom, according to the Cleveland Clinic.

Symptoms of Alcohol Intolerance

The common symptoms of alcohol intolerance, states WebMD, are as follows: 

  • Stuffy nose
  • Hot feeling
  • Trouble breathing
  • Headaches
  • Heartburn
  • Trouble breathing
  • Rapid heartbeat or palpitations
  • Diarrhea
  • Hives
  • Facial redness (flushing)
  • Rash
  • Low blood pressure
  • Stomach pain, nausea or vomiting

If you have asthma, alcohol intolerance can make your symptoms worse. 

Other Factors That Cause Intolerance

People can experience symptoms of intolerance when they encounter certain ingredients in alcoholic beverages.

According to the Mayo Clinic, the ingredients that can generate symptoms of intolerance include: 


Sulfites are added to beer and wine to limit yeast growth and act as a preservative, says Healthline. Potassium bisulfite and potassium metabisulfite are common sulfite compounds employed in this process. Healthline reports that some sulfites can trigger asthma attacks in people with that condition.


This naturally occurring chemical in your body is found in beer, champagne, and wine, particularly red wine. It is also found in foods like smoked meats, aged cheese, salted fish, vinegar, and yogurt. When your body does not have enough diamine oxidase, an enzyme, to break down histamine, allergic reactions can result. Healthline states that red and itchy skin, shortness of breath, diarrhea, abdominal pain, and nasal congestion can occur from the histamine found in alcohol or other products.


The gluten derived from grains found in beer can also result in allergic reactions. These reactions can also occur from alcoholic beverages that are made with gluten grains but are distilled, according to Verywell Health. Distilled beverages that are made from wheat, rye, and barley include vodka, gin, and whiskey.

Risk Factors For Alcohol Intolerance

People of Asian descent are prone to having alcohol intolerance because of an inherited genetic trait. This report from The Conversation states that people of Chinese, Japanese, and Korean descent tend to have a deficiency in aldehyde dehydrogenase, the enzyme mentioned above responsible for converting acetaldehyde into acetic acid. 

You can also be at risk for intolerance if you:

  • Are allergic to grains or have other food allergies
  • Are asthmatic or have hay fever
  • Have Hodgkin’s lymphoma

Alcohol Intolerance Is Not Alcoholism

Again, an intolerance is a genetic condition rather than an alcohol use disorder, which occurs from excessive consumption and addiction. 

Nevertheless, alcohol is one of the most dangerous substances you can put into your body. 

Excessive consumption in the form of binge drinking — that’s four or more drinks for women and five or more for men in the space of two hours —  can result in a litany of damaging effects, including liver disease, circulatory system issues, and numerous cancers. Heavy consumption, which is defined as 15 or more drinks per week for men and eight or more for women, can also make one prone to incurring those disastrous effects.  

If you believe you fall into either category, then professional treatment is necessary before alcohol takes over your life and leaves you subject to life-threatening health conditions. 

How Treatment Can Help You If You Need It

Professional treatment can help you by removing the alcohol from your body and treating you for any withdrawal symptoms that arise. This process is called detox. 

Depending on the severity of your drinking, you can enter into residential or outpatient treatment. 

A residential treatment program will allow you to reside at the treatment site, where you will receive intensive counseling and therapy. 

An outpatient program still gives you access to evidence-based treatment and care, but on a part-time basis. 

A professional program can also connect you to a recovery community once treatment is over, to provide you long-term support. An example of a recovery community is a 12-Step program for alcohol addiction. 

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