Alcohol Intolerance vs. Alcohol Allergy: Understanding the Difference and Testing Options

Alcohol Intolerance vs. Alcohol Allergy: Understanding the Difference and Testing Options

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Alcohol is a widely consumed social beverage, but it can trigger unpleasant reactions in some individuals, such as headaches, nausea, and skin rashes. These reactions are frequently caused by alcohol intolerance or alcohol allergy, which are often misunderstood and incorrectly diagnosed. 

This article aims to clarify the differences between alcohol intolerance and alcohol allergy, explore their symptoms and causes, and stress the significance of accurate diagnosis. Moreover, the article will provide an overview of the various testing options available to determine whether an individual has alcohol intolerance or an alcohol allergy. By the end of this article, readers will better comprehend these conditions and be better equipped to make informed decisions about their alcohol consumption.

Understanding Alcohol Intolerance and Alcohol Allergy

Understanding Alcohol Intolerance and Alcohol Allergy

Alcohol intolerance and alcohol allergy are two conditions that can cause adverse reactions in individuals who consume alcoholic beverages. While both conditions are related to alcohol consumption, they have distinct differences in their symptoms and causes.

Definition of alcohol intolerance

Alcohol intolerance is a genetic disorder that arises when the body has trouble processing alcohol. It is not an allergic response but an incapacity to metabolize alcohol. Individuals who suffer from alcohol intolerance do not possess the requisite enzymes to transform alcohol into acetaldehyde, a harmful byproduct that can result in several symptoms.

Symptoms of alcohol intolerance

The symptoms of alcohol intolerance can vary in severity but typically include:

  • flushing or redness of the face
  • headache
  • nasal congestion
  • rapid heartbeat
  • nausea
  • stomach cramps
  • diarrhea

These symptoms can occur within minutes of consuming alcohol and can last for several hours.

Causes of alcohol intolerance

Alcohol intolerance is predominantly caused by a genetic insufficiency of enzymes required to metabolize alcohol. The enzyme acetaldehyde dehydrogenase, which breaks down acetaldehyde, is the most frequently deficient enzyme. When alcohol is ingested, the body accumulates acetaldehyde, leading to the manifestation of symptoms related to alcohol intolerance.

Definition of an alcohol allergy

An allergic reaction to alcohol takes place in response to the consumption of alcoholic beverages and is categorized as an immune system response. It arises as a result of the production of immunoglobulin E (IgE) antibodies by the body in response to a particular component in the alcohol, such as grapes, hops, or barley.

Symptoms of an alcohol allergy

difficulty breathing or wheezing

The symptoms of alcohol allergy can range from mild to severe and can include:

  • hives or skin rash
  • itching
  • swelling of the lips, tongue, or throat
  • difficulty breathing or wheezing
  • nausea or vomiting
  • rapid heartbeat
  • low blood pressure
  • anaphylaxis (a life-threatening reaction)

Causes of an alcohol allergy

The exact causes of alcohol allergy are not comprehensively understood. However, it is believed to result from the body's response to particular components found in alcohol. Some individuals may also be allergic to the additives or preservatives found in alcoholic drinks.

To sum up, although alcohol intolerance and alcohol allergy may exhibit similar symptoms, they are distinct disorders caused by different underlying factors. Genetic insufficiency leads to alcohol intolerance, while alcohol allergy is an immune system response to specific components present in the alcohol. It is crucial to comprehend the disparities between the two conditions to prevent misdiagnosis and take appropriate measures. If individuals encounter unfavorable reactions after consuming alcohol, they should consult a medical professional to identify the underlying cause of their symptoms.

Differences Between Alcohol Intolerance And Alcohol Allergy:

While alcohol intolerance and alcohol allergy share some similar symptoms, they are two separate conditions with distinct underlying causes. Alcohol intolerance is a genetic disorder that hinders the body's ability to process alcohol, leading to symptoms such as headaches, nausea, facial flushing, and rapid heartbeat. In contrast, alcohol allergy occurs when the immune system reacts to the ingestion of alcohol, causing symptoms like hives, itching, wheezing, and breathing difficulties.

Alcohol intolerance results from a genetic deficiency in the enzymes needed to break down alcohol. The primary deficiency is often in the acetaldehyde dehydrogenase enzyme, which breaks down acetaldehyde. Consuming alcohol causes acetaldehyde to accumulate in the body, resulting in the symptoms of alcohol intolerance. On the other hand, alcohol allergy is a result of an immune system response to a specific component of alcohol. The body produces immunoglobulin E (IgE) antibodies in response to particular components in alcohol, such as barley, hops, or grapes.

To manage alcohol intolerance, individuals should limit or avoid alcohol consumption, take antihistamines, and manage symptoms like headaches and nausea. In contrast, for alcohol allergy, the most effective treatment is complete avoidance of alcohol, including alcohol-containing foods. In severe cases, antihistamines and epinephrine may be necessary to manage the symptoms of alcohol allergy.

Alcohol intolerance and alcohol allergy can both have significant impacts on an individual's daily life. For those with alcohol intolerance, regular consumption of alcohol can result in discomfort, leading them to limit or avoid alcohol altogether, which can impact their social life. Individuals with alcohol allergies may need to avoid certain foods and drinks that contain alcohol, which can limit their choices when dining out or attending social events. Additionally, severe allergic reactions to alcohol can be life-threatening and require immediate medical attention.

In summary, understanding the differences between alcohol intolerance and alcohol allergy is essential in identifying the appropriate treatment and management strategies. It is advisable for individuals who experience adverse reactions after consuming alcohol to consult a medical professional to determine the underlying cause of their symptoms and to receive appropriate treatment.

Testing Options for Alcohol Intolerance and Alcohol Allergy:

Alcohol intolerance and alcohol allergy can have similar symptoms, making it challenging to differentiate between the two conditions. However, several testing options can help determine if an individual has alcohol intolerance or alcohol allergy.

Skin prick test

The skin prick test is a widely employed method for diagnosing allergies, including alcohol allergies. In this procedure, a small quantity of the suspected allergen, such as barley or grapes, is placed on the skin. Then, the skin is pricked or scratched to enable the substance to enter the body. If the person is allergic to the substance, a red, swollen bump will appear on the skin within 15 to 20 minutes.

Blood test

Blood test 

The levels of immunoglobulin E (IgE) antibodies in the blood can be measured to diagnose alcohol allergy as well. The immune system produces IgE antibodies in response to an allergen. A blood test can determine the levels of IgE antibodies in the blood, which can indicate an allergic reaction to a specific component in alcohol if they are high.

Elimination diet

An elimination diet is another option for testing alcohol intolerance and alcohol allergy. It involves removing alcohol and any alcoholic foods or drinks from the diet for a specific period, usually between two to four weeks. If symptoms improve or disappear during this period, it may suggest that the individual has either alcohol intolerance or allergy.

Breath test

The detection of hydrogen and methane gases in a person's breath after alcohol consumption is another method to diagnose alcohol intolerance. A breath test can determine whether the individual's body has difficulty metabolizing alcohol by measuring the amount of these gases produced by the body.

Challenge test

Lastly, a challenge test can be used to determine if an individual has alcohol intolerance. This test involves consuming small amounts of alcohol and monitoring for symptoms. If symptoms appear, it can indicate that the individual has alcohol intolerance. However, this test should only be conducted under medical supervision, as it can be risky for those with severe alcohol allergies.

In conclusion, several testing options are available to diagnose alcohol intolerance and alcohol allergy. A skin prick test, blood test, elimination diet, breath test, and challenge test are some of the most commonly used tests. It is essential to consult with a healthcare professional before conducting any testing to determine the most appropriate option and ensure safety.

How to Manage Alcohol Intolerance And Alcohol Allergy:

Alcohol intolerance and alcohol allergy can both have a significant impact on an individual's daily life. Fortunately, several management strategies can help alleviate symptoms and improve overall well-being.

Avoiding alcohol or limiting consumption

Avoiding alcohol or limiting consumption

To manage alcohol intolerance and alcohol allergy effectively, it is essential to avoid consuming alcohol entirely. Even small amounts of alcohol can trigger uncomfortable symptoms in individuals with alcohol intolerance, while those with alcohol allergies may experience severe and potentially life-threatening reactions. However, if avoiding alcohol consumption altogether is not feasible, limiting alcohol intake may help reduce symptoms.

Identifying triggers and making lifestyle changes

Apart from abstaining from alcohol, it is crucial to identify other triggers that could worsen symptoms. Some foods, such as those containing histamines or sulfites, could trigger reactions in people with alcohol intolerance or allergy. You can use Advanced Food Intolerance Lab (AFIL) test kits to identify what can trigger or worsen your symptoms. Environmental factors, including stress, may also contribute to the onset of symptoms. Adopting lifestyle changes, such as stress reduction techniques and avoiding trigger foods, could assist in managing symptoms.

Seeking medical advice and treatment

It is crucial to seek medical advice and treatment if the symptoms of alcohol intolerance and allergy persist or become severe. Antihistamines and other medications can effectively manage the symptoms of alcohol intolerance and allergy. However, if the symptoms are severe, such as difficulty breathing or anaphylaxis, immediate medical attention is necessary, and epinephrine may be required. Consulting with a healthcare provider can also guide in managing symptoms and preventing future complications.

Communicating with others and ensuring safety

Individuals who suffer from alcohol intolerance or allergy should inform their friends, family, and healthcare providers about their condition to ensure their safety. Additionally, reading labels carefully and inquiring about ingredients in food and drinks can help avoid accidental exposure to allergens.

To manage alcohol intolerance and allergy, it is crucial to avoid consuming alcohol altogether or limit its consumption as even a small amount can trigger uncomfortable or life-threatening symptoms. Identifying and avoiding trigger foods and other environmental factors can also help manage symptoms. In case of persistent or severe symptoms, seeking medical advice and treatment is essential. Treatment options may include antihistamines or other medications, and in severe cases, epinephrine may be necessary. Healthcare providers can guide how to manage symptoms and prevent complications.

Overall, individuals with alcohol intolerance or allergy can improve their quality of life by adopting these strategies to manage their condition effectively.


To summarize, this article explained the differences between alcohol intolerance and alcohol allergy and outlined various testing options and management strategies for these conditions.

It is crucial to understand the distinctions between alcohol intolerance and alcohol allergy to avoid incorrect diagnoses and take the necessary measures. Individuals with alcohol intolerance can experience unpleasant symptoms even with minimal alcohol consumption, whereas those with alcohol allergies can suffer from severe, life-threatening reactions upon consuming alcohol. Communication with others and careful reading of labels are essential to prevent accidental exposure to allergens.

If you experience adverse reactions after drinking alcohol, seek medical advice to determine the underlying cause of your symptoms. Testing options are available, and appropriate management strategies can be implemented to manage symptoms and improve your quality of life. Don't hesitate to seek help and take control of your health. By understanding the differences and seeking appropriate care, individuals with alcohol intolerance or allergy can improve their well-being and live more comfortably.

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advanced food intolerance labs kit


  1. Mayo Clinic Staff. (2021, February 11). Alcohol intolerance. Mayo Clinic.
  2. National Institute on Alcohol Abuse and Alcoholism. (2020, November). Alcohol Use Disorder.
  3. American Academy of Allergy, Asthma, and Immunology. (2021). Alcohol Allergy.
  4. National Institute of Allergy and Infectious Diseases. (2021, March 23). Food Allergy.
  5. Westwood, M., et al. (2018). Tests for diagnosing and managing alcohol-related problems: a systematic review. Clinical Medicine, 18(2), 146-153. doi: 10.7861/clinmedicine.18-2-146
  6. Vlieg-Boerstra, B. J., et al. (2015). Management of food allergy symptoms and anaphylaxis: Outcomes of an online survey. Journal of Allergy and Clinical Immunology, 3(1), 98-103. doi: 10.1016/j.jaip.2014.06.017

Author: Dr. Sony S. | Panel Expert, Medical Doctor Dr. Sony is known for her medical articles, written with in-depth detail and accuracy owing to her vast medical knowledge and thorough research of each article. She completed her degree with multiple scholarships from Guangzhou Medical University and is a board-certified Clinical Doctor. She is currently working as a Medical Officer in the emergency department of a renowned hospital and continues to publish numerous medical papers and articles. Dr. Sony continues to lead the way in medical breakthroughs, unparalleled by her high level of detail, knowledge and passion for discovering new sciences and innovative healthcare treatments.

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