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Alcohol intolerance symptoms — or symptoms of a reaction to ingredients in an alcoholic beverage — can include:

• Nasal congestion
• Warm, red, itchy skin
• Worsening of pre-existing asthma
• Runny or stuffy nose
• Headache
• Rapid heartbeat
• Nausea
• Vomiting
• Heartburn
• Abdominal pain

When to see a doctor
You may not need to see a doctor if you have a mild intolerance to alcohol or something else in alcoholic beverages. You may simply need to avoid alcohol, limit how much you drink or avoid certain types of alcoholic beverages that seem to be causing your symptoms. However, if you have a serious reaction or you suspect your symptoms could be linked to an allergy or underlying health problem or a medication you're taking, see your doctor.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Alcohol intolerance occurs when your body doesn't have the proper enzymes to break down (metabolize) the toxins in alcohol. This is caused by inherited (genetic) traits.

Intolerance reactions can also be caused by a number of other ingredients commonly found in alcoholic beverages, especially in beer or wine. These include:

• Sulfur dioxide or other preservatives
• Chemicals, grains or other ingredients
• Histamine, a byproduct of fermentation or brewing

In some cases, reactions can be triggered by an allergy to a grain such as corn, wheat or rye or to another substance contained in alcoholic beverages.

Rarely, severe pain after drinking alcohol is a sign of a more serious underlying disorder, such as Hodgkin's lymphoma (Hodgkin's disease).

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Risk factors for alcohol intolerance or other reactions to alcoholic beverages include:

• Being of Asian descent. A large percentage of people of Asian descent have flushing and other intolerance symptoms after drinking alcohol, even in very small amounts.
• Having an allergy to grains or another food allergy.
• Having Hodgkin's lymphoma.
• Taking certain antibiotic or antifungal medications.
• Taking disulfiram (Antabuse) for alcohol abuse or alcohol dependence. When you drink, disulfiram can cause reactions that include flushing, racing heartbeat, nausea and vomiting.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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Depending on the cause, complications of alcohol intolerance or other reactions to alcoholic beverages can include:

• Migraines. Histamines, contained in some beverages and also released by your immune system during an allergic reaction, have been shown to trigger migraines in some people.
• A severe allergic reaction. In very rare cases, an allergic reaction can be life-threatening (anaphylactic reaction) and require emergency treatment.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Although alcohol intolerance usually isn't a serious issue, you may want to discuss it with your doctor at your next appointment. Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to prepare ahead of time. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

• Write down any symptoms you've had, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes. Stress can sometimes worsen allergic reactions or sensitivities.
• Make a list of all medications, as well as any vitamins or supplements that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. Some basic questions to ask your doctor include:

• Is my reaction to alcoholic beverages likely due to an allergy or something else?
• Are any of my medications likely causing or worsening my reaction to alcohol?
• Other than the most likely cause, what are other possible causes of my symptoms?
• What kinds of tests do I need?
• If my symptoms are caused by an underlying condition, is it most likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach that you're suggesting?
• What restrictions do I need to follow?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may save time to go over any points you want to spend more time on. Your doctor may ask:

• When did you first notice a reaction to alcoholic beverages?
• What beverages seem to trigger your symptoms? For example, are they triggered by beer, wine, or a particular type of liquor or mixed drink?
• How severe are your symptoms?
• How long does it take for symptoms to appear after drinking the beverage?
• How much of the beverage do you drink before you notice a reaction?
• Have you tried any over-the-counter allergy medications such as antihistamines for your reaction, and if so, did they help?
• Do you have any known food allergies or other allergies?

What you can do in the meantime
Avoid the beverage or beverages that seem to cause your reaction until your doctor's appointment. If you do drink an alcoholic beverage that causes a mild reaction, over-the-counter antihistamines may help relieve symptoms. If you have a more severe reaction — such as a severe skin reaction, weak pulse, vomiting or trouble breathing — seek emergency help right away.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Your doctor will try to figure out whether you have an alcohol intolerance, you have a reaction to other ingredients in alcoholic beverages or your symptoms are caused by something else. You may need to answer a number of questions or have certain medical tests. The following may help determine the cause of your symptoms:

• Description of your symptoms. Be prepared to tell your doctor exactly what symptoms you have and what drinks cause them. Your doctor may want to know whether you have any blood relatives with food allergies or other allergies.
• Physical examination. A careful exam can identify or exclude other medical problems.
• Skin test. A skin prick test can determine whether you may be allergic to something in alcoholic beverages — for example, grains in beer. In this test, your skin is then pricked with a tiny amount of a substance that could be causing your reaction. If you're allergic to the substance being tested, you'll develop a raised bump or other skin reaction.
• Blood test. A blood test can measure your immune system's response to a particular substance by checking the amount of allergy-type antibodies in your bloodstream known as immunoglobulin E (IgE) antibodies. For this test, a blood sample taken in your doctor's office is sent to a laboratory to check reactions to certain foods. However, these blood tests aren't always accurate.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
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The only way to avoid alcohol intolerance symptoms or an allergic reaction is to avoid alcohol or the particular beverage or ingredients that cause the problem. For a minor reaction, over-the-counter or prescribed antihistamines may help reduce symptoms. These drugs may help relieve symptoms such as itching or hives. However, antihistamines can't treat a serious allergic reaction.

If you've had a severe allergic reaction to a certain food, wear a medical alert bracelet or necklace that lets others know that you have an allergy in case you have a reaction and you're unable to communicate. Ask your doctor if you need to carry emergency epinephrine (adrenaline) in the form of an autoinjector (EpiPen or Twinject). This prescription device has a concealed needle that injects a single dose of epinephrine when you press it against your thigh.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Unfortunately there are no medications or other treatments that can prevent reactions to alcohol or other ingredients in alcoholic beverages. The only way to avoid a reaction is to avoid alcohol completely or avoid whatever particular substance causes your reaction. Read beverage labels carefully to see whether they contain ingredients or additives you know cause a reaction, such as sulfites or certain grains. But, be aware that labels may not list the ingredient or ingredients that cause your reaction.

The key treatment is to do your best to avoid the beverage in question. Work with your doctor to identify what steps you can take to relieve your symptoms and how to spot and respond to a severe reaction.

©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.