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Can You Become Intolerant to Alcohol? Causes, Symptoms, and When It Develops Suddenly
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Key Points
- A person can develop alcohol intolerance as they age due to genes, certain medications, and health conditions.
- A person who has an alcohol intolerance has trouble metabolizing alcohol; a person with an allergy is reacting to an ingredient in the alcohol by activating the body's immune system.
- The common symptoms associated with sudden alcohol intolerance include redness of the face, nasal congestion, nausea, elevated heart rate, headache, and an upset stomach.
- When symptoms of alcohol intolerance occur suddenly, it is recommended that you seek out medical attention from your healthcare provider if those symptoms are extreme, or if you are having breathing difficulties.
If you have noticed that your body reacts differently to the same amount of alcohol now than it did when you were younger, you’re probably not imagining it. Many people notice that alcohol affects them differently as they age, although this does not necessarily mean they have developed true alcohol intolerance.
Alcohol intolerance can happen at any time during your lifetime, leading to symptoms you may be unfamiliar with.
This article will walk you through what alcohol intolerance is, what it looks like, how it develops, and what symptoms are normal versus which you should seek immediate care for.
Can Alcohol Intolerance Happen Suddenly?
The Quick Answer
Yes. The reasons for sudden onset symptoms depend on the reasons why it happened.
Some people have a genetic predisposition to struggle to break down alcohol, while others may become alcohol intolerant due to an illness, a reaction caused by a medication, or a metabolic issue.[1] Identifying how your intolerance happened is the best way to find relief from your discomfort.
Factors That Contribute to Alcohol Intolerance
Many people notice they have developed a sudden intolerance to alcohol, and it seems like no matter what they do, they will always be uncomfortable after drinking.
There are many different reasons why this happens. Below are the most common:
- Aging tends to slow the body’s ability to process alcohol, so older adults tend to develop intolerance to alcohol faster than younger adults.
- Liver problems also make it difficult for the body to metabolize alcohol and can lead to intolerance.
- Some prescription medications can react with alcohol, causing adverse effects.
- Histamines are compounds produced by the body during an immune response and can cause facial redness and sinus congestion.
- Sulfites are preservative compounds used in many types of wines and other beverages that can also trigger adverse effects.
- Certain viruses and illnesses can affect the digestive system, making it difficult to digest foods containing alcohol.
- Changes in metabolism can occur due to many factors, including weight loss, hormonal imbalances, and overall poor health.
- Hormonal changes due to conditions like menopause or hypothyroidism can also cause intolerance to alcohol.
What Can Cause Someone to Be More Sensitive To Alcohol?
Genetic Enzyme Deficiency (ALDH2):
Most people who are intolerant to alcohol experience this due to a genetic deficiency in their ability to produce sufficient amounts of ALDH2 (Aldehyde Dehydrogenase 2) enzymes.[2]
These enzymes assist in breaking down acetaldehyde (an extremely toxic chemical by-product formed during the partial breakdown of alcohol) into non-toxic forms. In those with insufficient amounts of ALDH2 enzymes, acetaldehyde continues to accumulate in their system and may lead to symptoms of flushing, headaches, and nausea. The incidence of this deficiency is higher than average in people of East Asian ancestry; however, anyone can be afflicted.[3]
Ingredients in Alcoholic Beverages:
True alcohol allergies are rare, and most of the time allergic reactions are due to ingredients in the alcoholic beverages rather than the alcohol.
Some of the most common include:
- Sulfites, which are preservatives used in wine
- Histamines, found naturally in both beer and wine
- Yeast, used in the fermentation process for many alcoholic beverages
- Grains like barley or wheat found in beer
- Artificial colorings or additives
Certain Health Conditions
There are several medical conditions that could contribute to impaired tolerance to alcohol.[4] These include:
- Liver disease
- Chronic sinusitis
- Mast cell disorders (medical conditions where excessive histamine and other chemicals are released from mast cells)
- Certain gastrointestinal diseases affecting how alcohol is absorbed and metabolized
Interactions Between Medications and Alcohol
Certain medications may also worsen sensitivity to alcohol, including antibiotics, various types of antidepressants, and medications prescribed for diabetes management.[5] Should you begin taking a new medication and notice changes in how you react to alcohol use, review all of your current prescriptions with your physician or pharmacist.
What Are the Symptoms of Alcohol Intolerance?
Symptoms typically appear shortly after drinking and can vary in severity from person to person.
|
Symptom |
Why It Happens |
|
Facial flushing |
Acetaldehyde buildup |
|
Warm skin |
Blood vessel dilation |
|
Rapid heartbeat |
Alcohol metabolism reaction |
|
Nasal congestion |
Histamine release |
|
Headache |
Blood vessel changes |
|
Nausea |
Poor alcohol metabolism |
|
Vomiting |
Body’s attempt to remove an irritant |
|
Dizziness |
Alcohol sensitivity |
|
Low blood pressure |
Vascular response |
|
Stomach discomfort |
Gastrointestinal irritation |
Alcohol Intolerance vs. Alcohol Allergy
Though the two are frequently confused, alcohol intolerance and an alcohol allergy are not the same condition.[6]
|
Alcohol Intolerance |
Alcohol Allergy |
|
Difficulty metabolizing alcohol |
Immune system reaction |
|
Often genetic |
May involve alcohol itself or an ingredient in the beverage |
|
Facial flushing |
Hives or itching |
|
Nasal congestion |
Swelling |
|
Headache or nausea |
Wheezing or difficulty breathing |
|
Usually uncomfortable rather than life-threatening |
Severe reactions may cause anaphylaxis |
Many people claiming to have an “alcohol allergy” may be experiencing an adverse reaction due to an ingredient in the beverage, such as grapes, barley, wheat, or sulfites, instead of ethanol. Studies have found that allergic reactions to ethanol are extremely rare compared to sensitivity to other ingredients in alcoholic drinks.[7]
What is Making Me Sick When I Drink?
There can be many reasons for developing new symptoms when you drink alcohol, even if it’s just one or two ounces — some include changes in medications, aging, developing a new food sensitivity, declining liver function, fluctuations in hormone levels, low tolerance for histamine, an existing medical condition, side effects from a prior viral infection, or a previously undiagnosed gastrointestinal disease.[8] If your symptoms do not resolve on their own after repeated exposure and/or persist, consult your healthcare provider.]
When Should You See a Healthcare Provider?
These signs may be severe enough to warrant immediate evaluation:
- Severe flushing
- Wheezing
- Trouble breathing
- Faintness
- Chest pains
- Symptoms occur after very little alcohol is consumed
- Symptoms get worse
Your doctor will be able to tell you whether you have an intolerance, an allergic reaction, or something else because the correct course of action depends on what is causing your problem.
How Is Alcohol Intolerance Diagnosed?
Because there is no one simple test that will identify all causes of alcohol intolerance, your doctor will likely use several different methods.
The primary ways in which they will attempt to establish a diagnosis include:
- A comprehensive look at your past medical history
- An open conversation about the nature and severity of your symptoms
- A list of medications currently being used to assess potential drug interactions
- Blood tests (as needed)
- Eliminating each suspect beverage from your diet for a short time and then seeing if your symptoms resolve.
Can Alcohol Intolerance Be Treated?
While treatment does involve some of the same principles as those used in managing food allergies and intolerances, including reading labels and avoiding the allergen, it also involves ensuring that any other health issues are properly managed with your physician and assessed for potential medication interactions.
As alcohol intolerance has no known cure, many people find relief through adherence to the suggested prevention strategies. For others, however, total abstinence is the safest course of action.
Alcohol Intolerance is Not the Same Thing as Low Alcohol Tolerance
Although both phrases are most often used in combination, low alcohol tolerance refers to the way someone becomes intoxicated with a relatively smaller amount of alcohol than others.
Someone with alcohol intolerance has a reaction to alcohol (flushing or nasal congestion) that may be caused by very little alcohol consumption and does not relate to how quickly one will become intoxicated.[9]
Living Well With Alcohol Intolerance
There are many ways to avoid letting alcohol intolerance disrupt your social activities:
- Find what is most likely to trigger a reaction in your body
- When you do go out, find some non-alcoholic beverages that will fit into your lifestyle as well
- Tell your loved ones about your needs so they can help support you
- Always read the label on alcoholic beverages before consuming them
- Inform your healthcare professional about any new or evolving symptoms
Conclusion
Even though it may occur at a later age than expected, alcohol intolerance can develop at almost any time, despite years of drinking without experiencing any problems.
The best approach is not to ignore sudden changes, but to identify if those changes were due to intolerance, allergies, medications, or other medical conditions. If your reaction to alcohol has developed recently, is getting worse, or is intense, contact your healthcare professional for an assessment.
If you find that you are unable to cut back or quit alcohol or notice withdrawal symptoms when you try, this may point to a larger issue. Alcohol use disorder is a real condition, but it is a treatable one. Reach out to Freedom Center today to speak with a member of our admissions team and see what treatment could look like for you.
If you or a loved one is ready to get help but finances are holding you back, give us a call. We can work with your health insurance provider.
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Frequently Asked Questions About Alcohol Intolerance
No. As we grow older, our bodies can become less able to process alcohol, and this could lead to developing a new intolerance to alcohol due to liver issues or medication, at any age.
Sources
[1] [2] [3] [8][9] Mayo Clinic. (2024). Alcohol intolerance. https://www.mayoclinic.org/diseases-conditions/alcohol-intolerance/symptoms-causes/syc-20369211
[4] National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol’s effects on the body. https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body
[5] National Institute on Alcohol Abuse and Alcoholism. (n.d.). Harmful interactions: Mixing alcohol with medicines. National Institutes of Health.
https://www.niaaa.nih.gov/sites/default/files/publications/NIAAA_Harmful_Interactions_English.pdf
[6] [7] American Academy of Allergy, Asthma & Immunology. (2024). Mild allergy symptoms with margarita, mixed drinks, champagne. https://www.aaaai.org/allergist-resources/ask-the-expert/answers/2024/drinks
