What is alcohol intolerance?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Alcohol intolerance is a condition where your body reacts negatively to drinking alcohol. The results are often immediate and intense. Anyone can develop intolerance to alcohol, but some ethnic groups, particularly those of East Asian descent, are more prone to it.

You’ll know you’re alcohol intolerant if you feel awful soon after drinking. The symptoms include a flushed face, upset stomach, heart palpitations, and a splitting headache, even from just a glass or two.

If you consistently feel awful after drinking, it’s time to quit. Our alcohol rehab center offers comprehensive treatment programs, evidence-based therapies, and a supportive environment to help you start your journey to recovery.

What causes alcohol intolerance?

The sources of alcohol intolerance range from genetic factors to underlying health conditions. These triggers can cause or worsen alcohol intolerance:

Genetic factors: Some people inherit a deficiency in the enzyme aldehyde dehydrogenase (ALDH2), which is crucial for breaking down alcohol. A 2014 study reveals that this is more common in people of East Asian descent. Those with this genetic variation experience flushing and other symptoms even with small amounts of alcohol.
Liver disease: Cirrhosis or hepatitis can impair the liver’s ability to process alcohol efficiently. As the liver struggles, alcohol intolerance symptoms may develop or worsen. This can happen gradually or suddenly, depending on your liver’s condition.
Allergies or intolerances: Some people react to the ingredients in alcohol, such as wheat, barley, yeast, or sulfites. These reactions mimic alcohol intolerance. For example, someone with celiac disease might react to beer or grain-based spirits.
Hodgkin’s lymphoma: Alcohol intolerance is a symptom of this cancer. People with Hodgkin’s lymphoma might experience pain after drinking alcohol, particularly in lymph node areas.
Medications: Certain medications interact with alcohol and cause intolerance-like symptoms. Antibiotics, antidepressants, and diabetes medications are common culprits. Always check with your doctor about potential alcohol interactions with your medications.
Histamine intolerance: Some alcoholic drinks, especially red wine, are high in histamines. Histamines are chemicals our bodies produce to regulate physiological processes, but they are also present in many foods and drinks. People with histamine intolerance may experience symptoms similar to alcohol intolerance when consuming histamine-rich drinks. Their bodies struggle to break down excess histamine from external sources.
Age-related changes: As we age, our body’s ability to metabolize alcohol decreases. This triggers intolerance symptoms even if you’ve never experienced them before.
Gut health issues: Conditions such as irritable bowel syndrome (IBS) or small intestinal bacterial overgrowth (SIBO) can make you more sensitive to alcohol. These conditions affect how your body processes alcohol and other substances.
Hormonal changes: Fluctuations in hormones, such as during menopause or pregnancy, can affect how your body responds to alcohol. This can lead to temporary alcohol intolerance.
Sulfite sensitivity: Sulfites are often added to wine as preservatives. Some people are sensitive to these compounds, triggering symptoms that can be mistaken for alcohol intolerance.

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From medically supervised detoxification to cognitive behavioral therapy and nutritional counseling, we provide a range of evidence-based services to support your journey toward a healthier, alcohol-free life.

What are the symptoms of alcohol intolerance?

Alcohol intolerance causes uncomfortable and sometimes alarming symptoms that appear soon after drinking. Here’s what to watch out for:

Facial flushing or redness
Stuffy nose
Nausea and vomiting
Rapid heartbeat
Headache or migraine
Dizziness or lightheadedness
Skin rash or hives
Difficulty breathing
Stomach pain or cramps
Diarrhea
Low blood pressure
Swelling of the face, mouth, or throat

These adverse reactions are your body’s way of saying it can’t process alcohol properly—not even small amounts. If you consistently experience these reactions, it’s time to listen to your body and avoid alcohol.

If you find it difficult to stop on your own, don’t hesitate to reach out to Ardu. We’re here to help you navigate this change and reclaim your well-being.

Can you suddenly become intolerant to alcohol?

Alcohol intolerance is a metabolic disorder where the body lacks sufficient enzymes to properly break down alcoholic beverages. Toxic byproducts accumulate when you drink alcohol, which leads to uncomfortable and often severe physical reactions.

You can develop alcohol intolerance unexpectedly, even if you’ve previously drunk without issue. It’s not a matter of willpower or tolerance built up over time, but rather a shift in how your body processes alcohol. This change can happen for many different reasons, and it’s often unpredictable.

Unlike an alcohol allergy, which involves an immune system response, alcohol intolerance is primarily a digestive issue. It can be inherited or acquired, and its severity is different for each person.

Is alcohol intolerance dangerous?

The severity of alcohol intolerance is different for every drinker, but if they’re consistently ignoring their body’s negative reactions to alcohol, they may be in for serious health problems.

Here are some potential immediate and long-term health implications of intolerance to alcohol:

Drinking with intolerance exacerbates asthma, migraines, or skin disorders and causes or worsens acid reflux, stomach pain, and diarrhea.
People with genetic alcohol intolerance have a higher risk of throat and esophageal cancers. This is a direct result of the buildup of toxic acetaldehyde when they drink.
Despite intolerance, repeated drinking strains your liver. This can lead to alcoholic liver disease, cirrhosis, or other liver issues.
Some people may have severe allergic reactions to ingredients in alcoholic drinks. In some cases, this can be life-threatening.
Booze is notoriously bad for your skin. Flushing and hives are common symptoms that can become more severe or frequent with continued drinking.
Alcohol intolerance can cause rapid heartbeat and blood pressure changes, straining your heart.
Regular drinking despite intolerance can compromise your body’s ability to fight off infections. Read more about the devastating effects of alcohol on your immune function.
Alcohol intolerance can interfere with nutrient absorption. Booze irritates the lining of your stomach and intestines and makes it harder for your body to absorb essential vitamins and minerals from food. Over time, this manifests as deficiencies in B vitamins, vitamin A, zinc, and other important nutrients.
Drinking despite intolerance can worsen mental health issues such as anxiety, depression, and bipolar disorder.
Alcohol intolerance deteriorates sleep quality. The uncomfortable symptoms make it difficult to relax and fall asleep, even after consuming small amounts of alcohol. This can lead to restless nights and daytime fatigue.

Don’t let alcohol intolerance or heavy drinking control your life. At Ardu, we offer expert, compassionate care to address these challenges head-on. Our specialized alcohol detox program offers a safe, medically supervised environment to begin your recovery journey.

We combine cutting-edge medical care with compassionate support to manage withdrawal symptoms and lay the foundation for lasting sobriety. Whether you’re struggling with alcohol intolerance or long-term heavy drinking, our comprehensive approach addresses both your physical and emotional needs.

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How is alcohol intolerance diagnosed?

Alcohol intolerance is diagnosed through a combination of the following methods:

Medical history: Your doctor will ask about your symptoms, when they occur, and your drinking habits.
Physical examination: This rules out other conditions that might cause similar symptoms.
Blood tests: Doctors check for immune system responses to alcohol or its components.
Skin prick tests: These identify allergies to specific components in alcoholic beverages.
Breath test: This detects alcohol dehydrogenase deficiency, a common cause of alcohol intolerance.
Elimination diet: You might be asked to avoid alcohol and then reintroduce it to observe reactions.
Genetic testing: This identifies inherited enzyme deficiencies that cause alcohol intolerance.

If your doctor suspects alcohol intolerance, they may recommend avoiding it and observing if symptoms improve. With a proper diagnosis, you can better understand your body’s reactions and make informed decisions about your alcohol consumption.

It’s always better to stop drinking before alcohol wrecks your health in other ways. Proactive steps to limit or stop your alcohol use today can safeguard your health against future complications.

“Ardu Recovery Center is truly exemplary in every aspect of substance abuse rehabilitation. From the moment I arrived, I was met with compassion and professionalism that set the tone for my entire journey towards recovery… If you or a loved one are seeking the best substance abuse rehab facility in the state, look no further than Ardu Recovery Center. They have truly set the standard for excellence in care and support…”

—Gavin

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Quit alcohol safely with Ardu

Dealing with alcohol intolerance and dependency is challenging because symptoms often develop gradually and it becomes difficult to recognize the extent of the problem. At Ardu Recovery Center in Provo, Utah, our skilled medical professionals are committed to providing personalized care tailored to your unique situation, whether you’re struggling with alcohol intolerance, addiction, or both.

Our comprehensive alcohol detox and rehab programs include:

Medically supervised detox to safely manage withdrawal symptoms
Personalized treatment plans addressing both alcohol intolerance and alcohol use disorder (AUD)
Cognitive behavioral therapy (CBT) to develop coping strategies
Nutritional counseling to support overall health and manage intolerance symptoms
Holistic therapies such as yoga and meditation for stress management
Family therapy to build a strong support system
Aftercare planning for long-term success

Everyone’s journey to sobriety is different and unique. Our team will work with you to create a recovery plan that addresses your specific needs. We strive for a path to sobriety that is as safe, comfortable, and effective as possible.

To begin your journey towards a healthier, alcohol-free life, contact Ardu online or call us at 801-872-8480. Let us help you navigate the challenges of alcohol intolerance and addiction, guiding you through detox and beyond to lasting recovery.

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Alcohol intolerance FAQ

What does alcohol intolerance feel like?

Alcohol intolerance causes a range of unpleasant symptoms. They often start soon after consuming even small amounts of alcohol. The most common sign is the alcohol flush reaction, where your face becomes red and feels hot. Other symptoms include nasal congestion, headaches, nausea, and rapid heartbeat. Some people experience stomach cramps, diarrhea, or difficulty breathing.

The severity of the symptoms you’ll experience varies from mild discomfort to more severe intolerance reactions. Many people confuse alcohol intolerance with the symptoms of a true alcohol allergy, which is rare but can be more dangerous. If you consistently experience these effects, it might indicate an issue with alcohol metabolism.

How do you get rid of alcohol intolerance?

There’s no cure for alcohol intolerance. Most of the time, alcohol intolerance is a genetic condition affecting how your body processes alcohol. You can manage the symptoms and reduce their impact, with the most effective approach being avoiding alcohol completely.

Some people find taking an antihistamine before drinking reduces flushing and other allergy symptoms. There are ingredients in alcoholic drinks that might cause mild to severe reactions, such as sulfites in wine. If symptoms of intolerance are severe, seek medical attention.

Pushing through the symptoms can be dangerous and may increase your risk of developing other alcohol-related health issues. Stay hydrated and eat food to slow alcohol absorption, but a much better way to get rid of alcohol intolerance is not to drink at all.

Can a person develop an allergy to alcohol?

While rare, it is possible to develop an alcohol allergy. What most people experience is alcohol intolerance rather than a true allergy. An alcohol allergy involves an immune response, is dangerous, and can even lead to anaphylaxis (anaphylactic reaction), a life-threatening allergic reaction requiring immediate medical attention.

More commonly, people develop allergies or intolerances to common ingredients in alcoholic drinks, such as grains, preservatives, or sulfites. Alcohol intolerance can also develop or worsen over time because of changes in enzyme production or liver function.

If you suspect you’ve developed an allergy to alcohol, see an allergist for proper testing and diagnosis.

How can I test myself for alcohol intolerance?

Professional medical diagnosis is always recommended, but there are some other ways to assess your reaction to alcohol at home such as:

Keep a food and drink diary. Note what you consume and any symptoms of alcohol intolerance that follow.
Try the ethanol patch test. Apply some alcohol to a gauze pad and tape it to your inner arm for 7 minutes. If the area becomes red and itchy, you may have an intolerance.
Pay attention to how different types of alcohol affect you. Some people with alcohol intolerance react more strongly to certain kinds.
Notice if you have symptoms after using other products containing alcohol, such as mouthwash or cough syrup.
Take your family history into consideration. Alcohol intolerance can be genetic, especially in people of East Asian descent.

These self-tests aren’t definitive. If you suspect alcohol intolerance, consult a healthcare professional for accurate diagnosis and advice.

How long does alcohol sensitivity last?

The duration of alcohol sensitivity depends on the cause and individual factors. For immediate reactions, symptoms usually last as long as alcohol is in your system, typically a few hours up to a day. If sensitivity comes from medications or a temporary health condition, it may last until the medication is stopped or the condition resolves.

Genetic alcohol intolerance is lifelong, though symptom severity might fluctuate. Sensitivity as the result of liver damage or other long-term health issues could be permanent. Acute alcohol sensitivity, such as a hangover, typically lasts 24–72 hours. The accumulation of acetaldehyde, a toxic byproduct of alcohol metabolism, plays a key role in many of these symptoms.

Does alcohol intolerance get worse with age?

Alcohol intolerance can worsen with age. Here’s why:

As we get older, our bodies may produce fewer enzymes needed to break down alcohol efficiently.
Liver function can decline which affects alcohol metabolism.
Older adults often take more medications, which can interact with alcohol and increase sensitivity.
Changes in body composition can affect how we process alcohol.
Age-related medical conditions might exacerbate alcohol intolerance symptoms.
Years of drinking can lead to increased sensitivity over time because of cumulative negative effects on the body.

These effects aren’t universal. Some peoples’ tolerances remain stable or even increase (which comes with its own risks).

How do you know if you can’t tolerate alcohol?

Signs of alcohol intolerance include:

Skin flushing (alcohol flush reaction)
Nasal congestion
Nausea
Rapid heartbeat
Headaches
Skin reactions such as hives or itching after drinking even small amounts of alcohol

You might experience worsened asthma symptoms, diarrhea, or a noticeably lowered alcohol tolerance. These unpleasant symptoms occur consistently when you drink, not just occasionally. You might also notice adverse reactions to other products containing alcohol, such as mouthwash or cough syrup.

If you have a genetic predisposition, especially if you’re of East Asian descent, you’re more likely to experience alcohol intolerance. If you notice these signs consistently, consult a healthcare provider for proper diagnosis and advice.

How do you know if your liver is sensitive to alcohol?

Liver sensitivity to alcohol can manifest in several ways. You might experience abdominal pain or discomfort, especially in the upper right part of your abdomen. Nausea or vomiting after drinking, even in small amounts, could indicate liver sensitivity.

Other signs include:

Unexplained fatigue
Yellowing of the skin or eyes (jaundice)
Dark urine or pale stools
Loss of appetite
Swelling in your legs or abdomen

You might notice an increased sensitivity to alcohol’s adverse effects. In more advanced cases, you could experience mental confusion or difficulty concentrating. Regular heavy drinking can lead to different forms of alcohol-associated liver disease, even without immediate noticeable symptoms.

If you’re experiencing these symptoms, especially if they persist or worsen, see a healthcare provider immediately. They can perform liver function tests and provide appropriate advice or treatment.

Resources

Morozova, T. V., C. Mackay, T. F., & H. Anholt, R. R. (2014). Genetics and genomics of alcohol sensitivity. Molecular Genetics and Genomics, 289(3), 253-269. https://doi.org/10.1007/s00438-013-0808-y