Do you have alcohol intolerance?

Alcoholic beverages are often a cocktail of various food triggers used during production: eg. histamine, gluten, yeast, sulphites, tannins, egg white and preservatives. Since there are a number of problematic ingredients that could set off a reaction identifying the culprits is extremely difficult. People often ask us if we test for “alcohol intolerance”. It’s important to know what we are looking for.

Here we look at signs you have an alcohol intolerance and the different causes and solutions.

Types of alcohol intolerance

Enzyme deficiency: alcohol dehydrogenase

Alcohol dehydrogenase (ADH) is an enzyme that breaks down alcohol, also known as ethanol, in the liver. ADH catalyzes the conversion of ethanol to acetaldehyde, which is then metabolized into acetate. The metabolism of ethanol produces acetaldehyde, which can be toxic in high concentrations and contribute to the negative effects of alcohol consumption. East Asian descendants have a higher prevalence of genetic variations that reduce alcohol dehydrogenase (ADH). What then occurs is a buildup of acetaldehyde, resulting in symptoms of alcohol intolerance like flushing, nausea, and rapid heart rate. Even very small amounts of alcohol can trigger this reaction.

Enzyme deficiency: histamine intolerance

Alcohol does not contain histamine, however it is a potent inhibitor of Diamine Oxidase (DAO), the enzyme that breaks down histamine. Those who under-produce DAO cannot break down excess histamine quickly enough. Throwing alcohol in the mix (DAO is most active in the intestine) will probably lead to symptoms of histamine overload.

Symptoms of histamine intolerance include red flushes or rashes, itchy skin, sinus congestion or hayfever, nausea, headache and loose stools. A person with a DAO deficiency would be advised to minimise alcohol and histamine rich foods, or supplement with DAO. Find out if you have a histamine intolerance.

Immune reaction: IgG delayed food allergy

Alcohol can trigger symptoms of food intolerance if it contains ingredients you have developed IgG antibodies towards. Unlike enzyme deficiencies, the antibodies that develop (IgG) trigger inflammation and delayed symptoms. For example: if you have delayed IgG food allergy to gluten, you may bloat heavily an hour after drinking beer, or even certain spirits. If you have a yeast intolerance you may be affected by wines, cider or beer. Eggs whites can even be used in the filtration process for wine making. If you are intolerant to fruits like grapes or apples then it is best to avoid all wine and ciders.

Symptoms are usually more chronic and probably persist even when you are not drinking alcohol. Since the symptoms can show up hours or 3 days later, IgG intolerance to alcoholic beverages may not appear immediately as with enzyme deficiencies. As you can guess, this makes them harder to detect.

Alcohol, leaky gut and the gut microbiome

Alcohol effects the gut by disrupting the balance of gut bacteria, increasing gut permeability, and promoting inflammation. Studies have shown that alcohol disrupts the tight junctions between cells in the intestinal lining, which are responsible for gut barrier integrity. This can lead to the leakage of harmful substances, such as bacterial toxins, into the bloodstream, driving inflammatory symptoms.

Alcohol alters the composition and pH of the gut microbiota, setting the stage for bacterial overgrowths. This contributes to increased gut permeability and inflammation. Since alcohol is metabolized in the liver, reactive oxygen species (ROS) are produced which create oxidative stress throughout the body, including the gut.

During the 5-8 week ImuPro elimination diet, it is a great idea to avoid alcohol as much as possible to allow the gut to recover.