Everyone knows a hangover in the morning, feelings of warmth and flushing of the face after drinking alcohol. But what if these symptoms occur after very little alcohol, no more than a quarter? Then one speaks of a pathological alcohol intolerance and colloquially of an alcohol intolerance .

What is alcohol intolerance?

Anyone suffering from alcohol intolerance should rather refrain from consuming alcohol. When alcohol is consumed, symptoms such as facial reddening or strong heat radiation usually follow initially.

An intolerance to alcohol sounds like an excuse from a dry alcoholic or abstainer to those who are not affected. Until he experiences the affected person under the influence of light alcohol.

Then there is a drunkenness like that only at 2 per mille to would expect a badly reddened and swollen face, palpitations, stomach pain, hot flashes and a hangover for days if the food contained an amount of alcohol that others would hardly notice or if only a sip was drunk.

These strong reactions are known from Asians, whose alcohol intolerance is attributed to a genetic cause, and from liver damage. But even healthy people in Western Europe who do not have to take any medication can suffer from these violent, allergy-like reactions to alcohol.

Causes

The causes of alcohol intolerance are mostly to be found in gene mutations and a resulting reduced performance of the alcohol- and aldehyde-degrading enzymes alcohol dehydrogenase (ADH) and aldehyde dehydrogenase 2 (ALDH). Due to the inadequate performance of ADH and ALDH, the alcohol level rises faster and falls more slowly than in people who are not affected by this genetic defect.

Not only alcohol intolerance is problematic, but also the resulting increased concentration of alcohol and acetaldehyde in the body. Because an excessively high alcohol level in the blood is poisoning the body, which can cause further damage to the person concerned.

It has been scientifically proven today that Asian population groups, i.e. Vietnamese, Japanese, Koreans and Chinese, suffer from alcohol intolerance more often than Europeans and Americans. The reasons for this significant increase have not been adequately researched. Evolutionary biologists suspect the strong selection pressure of the Middle Ages to be the cause.

While people with a pronounced alcohol resistance were in demand in the European Middle Ages, alcohol played a less dominant role in the Asian region of that time. Another reason could be that, since ancient times in Europe, drinks have often been mixed with alcohol, such as wine or beer. In Asia, on the other hand, tea was mostly drunk. This could have led to a gene mutation in Europe.

Other causes of alcohol intolerance are liver and kidney damage, for example from earlier increased alcohol consumption, and autoimmune diseases . Those affected by Hashimoto’s thyroid disease in particular report violent reactions to alcohol. A rare cause of alcohol intolerance is temporary and comes to light when taking medication.

Symptoms, ailments & signs

An alcohol intolerance typically manifests itself as headache and nausea . If large amounts of alcohol are drunk, the face becomes red and swollen. At the same time, the heart rate rises – the heart racing and rarely also cardiac arrhythmias . The blood flow to the vessels also increases and there is increased heat radiation, a so-called hyperthermia.

This increases the risk of hypothermia, which in turn manifests itself as tremors , freezing, a slow pulse, and the lips and fingers turning blue. The digestive tract can no longer process the alcohol, which can lead to stomach pain, diarrhea, and constipation. Externally, alcohol intolerance can be recognized by the rapid reddening of the face and a glassy look after drinking alcohol.

Gait disorders and malfunctions can also occur. Alcohol intolerance also causes typical symptoms of an allergic reaction. Those affected often suffer from dizziness , fever or skin irritation. Typical signs also include aches and pains in muscles and limbs, as well as a prolonged hangover. Alcohol intoxication is associated with severe malaise and gastrointestinal complaints. In severe cases, withdrawal symptoms such as the characteristic finger tremors and increased blood pressure occur .

Diagnosis & course

There is no clear diagnosis of alcohol intolerance. Because although some holistic doctors consider alcohol intolerance to be a food allergy, recognition and research have so far been neglected. While many food allergies can be clearly identified by the prick test and other allergy tests , those affected by alcohol intolerance are dependent on self-diagnosis.

This requires good, realistic introspection: just because you reacted violently to alcohol once does not mean that you are intolerant to alcohol. Circumstances can also be decisive, so you may not have eaten enough that day. But if you always react violently and far more extreme than others to even very small amounts of alcohol, you should avoid it and assume an intolerance.

Complications

Alcohol intolerance occurs only in a few people and is not very common in Europe and the West. Anyone suffering from alcohol intolerance should rather refrain from consuming alcohol. When alcohol is consumed, symptoms such as reddening of the face or strong heat radiation usually follow.

The affected person feels sick and becomes warm. The body cannot break down alcohol properly, which can also lead to panic in some people. In a few cases, alcohol intolerance is followed by an increased heart rate, headaches and stomach problems. These occur above all if the alcohol intolerance was developed through an abuse of alcohol.

However, alcohol intolerance can also be genetic and occur even if the person concerned has never consumed alcohol. There is no truly recognized treatment because the liver cannot be trained to break down alcohol better. The person concerned should therefore not consume alcohol and should always prefer the non-alcoholic variant of alcoholic beverages.

This primarily spares the liver. As a rule, the symptoms are similar to those that occur in a healthy person. However, only a very small amount of alcohol is required for this in people with alcohol intolerance.

When should you go to the doctor?

If signs of intolerance occur again and again after consuming alcohol, a doctor should be consulted as soon as possible. An immediate doctor’s visit is recommended if there are severe physical symptoms such as fever, breast stitches or stomach cramps. Medical advice should also be obtained in the event of symptoms such as diarrhea, itching or skin changes so that the cause can be clarified quickly and suitable therapy can be started. In the case of mild complaints, an allergy test by your family doctor is recommended .

Recurring symptoms after consuming alcohol are a sign of alcohol intolerance. A doctor’s visit is necessary if the symptoms mentioned appear unusually strong or repeatedly. Risk groups such as pregnant women and people with previous diseases of the cardiovascular system should see a doctor immediately if they have symptoms in order to avoid health complications.

If there are severe symptoms such as vomiting, shortness of breath or cardiovascular complaints, a hospital should be visited. If an anaphylactic shock is suspected, an ambulance service must be called in immediately. At the same time, first aid measures must be initiated, as there may be an acute danger to life.

Treatment & Therapy

For understandable reasons, there are no measures against alcohol intolerance:

If such a product were to be brought onto the market, it would at the same time enable those not affected to consume more alcohol.

The enzymes ALDH and ADH react to medication, but they cannot regulate themselves whether the alcohol level is still within limits or whether it is too high. Medicines that enable alcohol intolerance to be consumed or that can avert severe symptoms after accidental ingestion would therefore not be approved and are therefore not part of the research.

Outlook & forecast

As a rule, alcohol intolerance does not lead to particular complications or complaints if the person concerned refrains from alcohol. For some people, this waiver can restrict everyday life and quality of life, but it does not represent a restriction on the health of the person concerned.

However, should the patient consume alcohol despite an alcohol intolerance, reddening of the skin and swelling of the face may occur. There is also a faster heartbeat and patients often suffer from severe stomach discomfort and pain in the abdomen. Furthermore, there is also a relatively long-lasting hangover. Headaches and body aches also occur in the patient.

Alcohol intolerance can be determined relatively easily by means of an allergy test, so that there is no need to delay diagnosis or treatment.

The treatment itself usually takes place by excluding alcohol from daily life. This allows the complaints and symptoms of alcohol intolerance to be completely isolated. The life expectancy of the patient is also not reduced by this disease. As a rule, it cannot be predicted whether the alcohol intolerance will resolve spontaneously in the further course of life.

Prevention

Those affected are therefore advised to take preventive measures to prepare for their intolerance. Due to the very different tolerance limits, some affected people can tolerate a few milliliters and others not a sip, attention must be paid to the individually correct amount.

For many people it is important to note that, contrary to popular belief, alcohol does not boil away. In fact, with every type of preparation there is such a large amount of alcohol left that those affected can experience symptoms when they seem to be “enjoying”.

After the diagnosis of alcohol intolerance, patients have a high level of personal responsibility. You have to limit or even stop the consumption of alcoholic beverages and food. The decision to take is a voluntary decision. Drugs against alcohol intolerance do not exist.

They would raise the tolerance of alcohol, which is counterproductive given the health risks. Examinations by a doctor have no influence on the development. You can only document the current situation. Follow-up care is therefore of no great importance.

However, if sick people cannot keep their hands off alcoholic products and the well-known symptoms of alcohol intolerance occur again and again, a doctor can order therapy. It helps those affected to develop a willpower in everyday life that does not lead to ingestion at all. Since there are temptations throughout life, it makes a lot of sense.

Forms of aftercare outside the psycho-social field are not possible. Ultimately, the fact that a life without alcohol just works out also makes follow-up care less important. Drinks or dishes without the addition of the liquid are available in large numbers. If they are prepared themselves, those affected can usually do without the alcohol content without any loss of taste.

Aftercare

After the diagnosis of alcohol intolerance, patients have a high level of personal responsibility. You have to limit or even stop the consumption of alcoholic beverages and food. The decision to take is a voluntary decision. Drugs against alcohol intolerance do not exist.

They would raise the tolerance of alcohol, which is counterproductive given the health risks. Examinations by a doctor have no influence on the development. You can only document the current situation. Follow-up care is therefore of no great importance. However, if sick people cannot keep their hands off alcoholic products and the well-known symptoms of alcohol intolerance occur again and again, a doctor can order therapy.

It helps those affected to develop a willpower in everyday life that does not lead to ingestion at all. Since there are temptations throughout life, it makes a lot of sense. Forms of aftercare outside the psycho-social field are not possible.

Ultimately, the fact that a life without alcohol just works out also makes follow-up care less important. Drinks or dishes without the addition of the liquid are available in large numbers. If they are prepared themselves, those affected can usually do without the alcohol content without any loss of taste.

You can do that yourself

The most effective remedy for an alcohol intolerance is to refrain from alcoholic drinks and food. Depending on the severity of the intolerance, alcohol consumption must either be greatly reduced or completely stopped. It is advisable to note the type and severity of the symptoms in a complaint diary.

In this way it can be determined whether the symptoms are related to alcohol and which ingredients are responsible for the physical symptoms. Appropriate measures against alcohol intolerance can then be taken in conversation with the doctor.

The typical measures help against the actual symptoms: drink a lot , exercise and home remedies such as ginger or chamomile tea . In addition, alcohol intolerance can be reduced by consuming only unsweetened, chilled drinks. Fresh air and mineral water prevent a hangover as well as a refreshing shower and a full meal before bed.

If the alcohol intolerance occurs in connection with a histamine intolerance, dietary supplements such as cromoglicic acid and antihistamines can be taken. In general, if you have a pronounced alcohol intolerance, you should avoid excessive alcohol consumption. If you experience severe symptoms all of a sudden, it is advisable to see a doctor.