Do you have terrible hangovers or do you feel sick drinking just a little alcohol? It could be a sign of intolerance — or even allergy — to alcoholic beverages.
What we understand by a “hangover” is a specific set of symptoms—typically, a searing headache, nausea, intense thirst, tiredness, and mental fog.
All this happens after the consumption of alcoholic beverages or, more specifically, as a result of a series of processes in the body triggered by alcohol.
Alcohol is toxic and the body needs to convert it into substances that are not toxic. But this takes time and causes symptoms to last a full day or even longer.
The duration and severity of a hangover can vary depending not only on the content and amount of alcohol that was consumed but also on the speed at which our bodies process it, which varies from person to person.
Dehydration is an important part of a hangover, as it can be responsible for many of the other typical symptoms, from headache and fatigue to anxiety and sensitivity to light and sounds, according to Timothy Watts, a specialist in adult allergies. from the British private hospital The London Clinic.
Anyone who drinks to excess is likely to experience these harmful effects, to a greater or lesser degree.
But people who have an alcohol intolerance often experience particularly serious hangover symptoms, due to a genetic metabolic disorder that “causes the body to process or metabolize alcohol incorrectly,” according to Watts.
When we drink alcohol, an enzyme in our body called alcohol dehydrogenase (ADH) breaks down into a compound called acetaldehyde. And another enzyme, aldehyde dehydrogenase (ALDH), turns acetaldehyde into acetic acid (vinegar), which is non-toxic.
Older adults have lower than average ALDH, which explains why our reaction to alcohol seems to get worse with age. But people with genetic intolerance have an ALDH mutation, according to Watts.
“The mutation of this fundamental enzyme generates accumulation of acetaldehyde in the body and several unpleasant symptoms”, explains the doctor. “Typically, they include extensive skin redness and other symptoms such as nausea, vomiting, palpitations, headaches and fatigue.”
Research indicates that this is one of the most common inherited disorders in the world, affecting 560 million people, or 8% of the world’s population. The highest incidence (35-40%) is in people of East Asian descent.
Other types of intolerance
In other cases, people may be intolerant of substances that provide color and aroma to alcoholic beverages rather than the alcohol itself. Histamine (found in red wine) and salicylates (found in wine, beer, rum and sherry) are common examples.
Some people are intolerant of alcohol preservatives called sulfites. They find that its consumption can bring on symptoms that include a runny or runny nose, severe headache, hives, itching, wheezing and stomach upset.
Research indicates that up to 10% of asthmatics are sensitive to sulfites, with reactions ranging from mild to potentially deadly.
“Wheezing and symptoms in the nasal region occur particularly due to the release of sulfur dioxide gas, which causes irritation of the airways,” Watts explains.
Alcoholic beverages high in sulfites and/or histamine include wine (red, white, rosé and sparkling wine), cider and beer. Some varieties of gin and vodka, in addition to “natural wines”, are low in sulphites. But asthma experts advise allergy sufferers to choose their drinks carefully, as even low-sulfite wines contain some of the substance.
“True alcohol allergy is rare,” according to Fiona Sim, chief medical consultant for the British alcohol organization Drinkaware. “Instead of alcohol, it’s much more common for people to be allergic to one of the ingredients in alcohol, such as wheat, barley or other grains.”
Another type of allergen is lipid transfer protein (LTP). It is found in fruits, vegetables, vegetables, seeds and cereals, and may also be present in some alcoholic beverages.
Symptoms of an allergic reaction to LTP typically appear within 15-30 minutes and include swelling, itching, digestive problems, breathing difficulties and, in extreme cases, anaphylaxis. LTP is not destroyed by heat.
“LTP allergy is an increasingly recognized cause of food allergy in the UK, certainly in the last five years,” says Watts. “Alcoholic beverages can trigger reactions in many cases, as well as other food groups.”
It is sometimes very difficult for consumers to know whether an alcoholic beverage contains allergens or ingredients that cause intolerance. However, in many countries, alcohol manufacturers are not required to include a complete list of ingredients or nutritional information on the label.
So Fiona Sim advises that anyone who knows they are allergic to certain foods, particularly cereals, remember that they can also be present in drinks.
“This risk must be considered,” she says. “Someone with a serious allergy, which can be deadly, needs to be advised to ask the manufacturer what the ingredients in a drink are before trying it.”
This is particularly important for people who drink cocktails or other drink mixes, who will have longer and more varied component lists. “Think of all the ingredients to avoid anything you’re allergic to,” the doctor advises.
Alcoholic beverages can also cause allergic reactions if you consume them with food, as alcohol can interfere with the intestinal lining. Someone who is allergic to wheat, for example, may experience a reaction only after eating wheat followed by alcohol or exercise. “This is called food-dependent cofactor-induced anaphylaxis,” according to Watts.
Many sweet and savory recipes contain alcohol, including stews and stews with red wine, as well as cakes soaked in liqueur. Is it possible to consume these foods when you have an alcohol intolerance or allergy?
“Alcohol and sulfites tend to evaporate during cooking, so the potential for intolerance is certainly reduced,” explains Watts. But if you are allergic to an ingredient found in certain alcoholic beverages, it is not safe to consume dishes that contain that beverage.
In case of doubt
It’s relatively simple to recognize the difference between a hangover and alcohol intolerance.
“Hangovers are usually strongest in the morning after a night of heavy drinking,” according to Timothy Watts. “But metabolic genetic intolerances occur more quickly, usually within an hour of drinking.”
Differentiating intolerance from allergy is more difficult, as the symptoms can be similar. Some allergic reactions are almost instantaneous, but not all.
“When in doubt, always consult a healthcare professional,” advises Watts. “Alcohol reaction tests typically consist of specialized blood tests for allergies, skin prick tests and maybe even a food challenge.”
Fiona Sim advises people with any type of alcohol intolerance to avoid drinking, but acknowledges that “many people are willing to put up with the discomfort of skin rashes and perhaps mild abdominal symptoms to continue to drink alcohol occasionally.”
It’s especially important not to drink alcohol if you have a genetic intolerance, as this “will increase your risk of organ damage from alcohol, including some cancers and liver disease.”
When it comes to allergy to any component of an alcoholic beverage, you should never consume it. “It can be deadly,” he concludes.
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