An alcohol allergy is rare but possible, ranging in potential severity. Symptoms are comparable to other allergic reactions, such as those some people have to bee stings or peanuts.
It is also possible to be allergic to a substance commonly found in certain alcoholic drinks or to be intolerant to alcohol through a genetic condition that is distinct from having an allergy.
Can You Be Allergic to Alcohol?
An alcohol allergy is rare, but possible. Generally, even people who have a severe allergic reaction to drinking alcohol will test negative for an alcohol allergy on an allergy test.
More common is testing positive for the products alcohol breaks down to in the body, acetaldehyde or acetic acid (vinegar).
Allergy vs. Intolerance
An alcohol allergy is a rare allergy that causes a person’s immune system to react in a combative way to alcohol.
An alcohol allergy and alcohol intolerance are two similar conditions that are easily confused.
Alcohol intolerance is different, caused by the body being unable to break down alcohol efficiently. This is a genetic condition some people, dominantly those of Asian descent, have. This genetic condition, called acute alcohol sensitivity, is defined as a rare disease, affecting or directly impacting less than 200,000 people in the U.S.
Signs & Symptoms of Alcohol Allergies
An alcohol allergy is characterized by the following:
- Difficulty breathing
- Stomach cramps
- Weakness or collapse
The severity of this reaction can vary, with some people experiencing significant symptoms with as little as 10 ml of wine or a mouthful of beer. It won’t always be obvious to a person why they’re experiencing the symptoms they are.
It is possible to have an allergic reaction to other elements of an alcoholic beverage, such as the barley in beer or grapes in wine, rather than the alcohol itself.
Additionally, some people may consume alcohol without realizing it, with some less obvious sources of alcohol including the following:
- Some medications, including some cough syrups
- Over-ripened fruit
- Food marinades
- Tomato puree
Causes of Alcohol Allergies
Alcohol allergic reactions aren’t fully understood, as the human body actually produces a small amount of alcohol on its own, which doesn’t cause this reaction in people affected by this kind of allergy.
The broader mechanism of allergic reactions is better understood. Allergies are the result of the immune system improperly interpreting substances as a threat, essentially entering a combative mode despite the substance representing no or a disproportionately small danger to the body.
The immune system then produces antibodies to attack the allergen, which can then cause allergic symptoms. Because the immune system can’t “think” and is only reacting to stimuli, this can actually cause normally harmless allergens to lead to such a severe reaction that an allergy is life-threatening.
Risk Factors for Alcohol Allergies
Alcohol allergies are fairly rare, with limited data available on how often they occur and among what populations. They are also easily confused with alcohol intolerance and allergies to substances commonly found in alcoholic beverages that aren’t alcohol itself. This makes determining one’s risk of developing an alcohol allergy difficult.
Typically, the first sign a person will have that they might have an alcohol allergy is simply a negative reaction to alcohol.
Even if your symptoms are mild, you should see a doctor if you experience allergic symptoms or unexpected symptoms of any kind after drinking alcoholic beverages. If it is an allergy, the severity of your reaction may change over time or if you consume more than you did when you first noticed symptoms.
Getting a Diagnosis
Getting a diagnosis for an alcohol allergy can be more difficult than a diagnosis for other allergies. It is rare, meaning doctors may have less familiarity with it, and it’s possible to get a false negative unless you’re also tested for substances alcohol breaks down into.
If you’re concerned you may have an allergy to alcohol, talk to your doctor about getting tested for alcohol (also called ethanol), the substances it can break down into, and other potential allergens commonly found in alcoholic beverages.
Severe allergic reaction, called anaphylaxis, can be deadly if a person does not receive treatment.
A person must carefully manage their diet and the product they use if they have an allergic reaction to a fairly common substance, such as alcohol. They may need to research common sources of alcohol and remain aware that some people may not realize they have an allergy or even that certain products contain the allergen.
Treatment & How to Prevent an Allergic Reaction
There is no cure for an allergy. In the case of an alcohol allergy, the best treatment is lifestyle changes designed to help you avoid alcohol, keep people aware of your allergy, and prepare for emergencies in the event of accidental exposure.
The following are generally recommended:
- Wear a medical bracelet identifying you as allergic to alcohol.
- Cary epinephrine (EpiPen) and know how and when to use it.
- Make a serious effort to avoid exposure to alcohol.
Epinephrine can help a person survive an otherwise life-threatening allergic reaction, but it is important to also call 911 or take them to the emergency room right after using it.
- Acute Alcohol Sensitivity. (November 2021). Genetic and Rare Diseases Information Center.
- Alcohol Allergy. (2019). Australian Society of Clinical Immunology and Allergy.
- Allergic and Intolerance Reactions to Wine. (September 2018). Allergologie Select.
- Adverse Reactions to Alcohol and Alcoholic Beverages. (December 2013). Annals of Allergy, Asthma & Immunology.
- Allergic and Asthmatic Reactions to Alcoholic Drinks. (April 2003). Addiction Biology.
- Alcohol-Induced Anaphylaxis to Grape. (July 2007). Allergologia et Immunopathologia.
- Genetics and Genomics of Alcohol Sensitivity. (January 2014). Molecular Genetics and Genomics.
- Ethanol as a Cause of Hypersensitivity Reactions to Alcoholic Beverages. (August 2002). Clinical & Experimental Allergy.