Are you suffering from Alcohol Allergy in Singapore?

In comparison to flushing, toxic as well as irritant reactions, allergic reactions to alcohol are less common. Regardless, it is important to learn about allergies, because even though they are very rare, they do occur. Just like any other type of allergy, alcohol allergies shouldn’t be ignored. This is because leaving them untreated could potentially result in severe allergic reactions.

Among individuals with alcohol allergy, as little as 10ml of wine (equivalent to 1ml of pure ethanol) is sufficient to trigger symptoms such as difficulty breathing, severe rashes, collapse, or stomach cramps. What’s more, alcohol significantly enhances the likelihood of a condition known as anaphylaxis from other causes such as food.

It is imperative to note that allergy tests for alcohol are often negative. Perhaps this is due to the fact that your body naturally produces small amounts of alcohol itself. Your blood contains normal amounts of 100ml or 0.01 to 0.03 alcohol. Contrastingly, the blood alcohol limit for driving of 0.05% is equal to nearly 50mg of alcohol per 100ml of blood.

And because human blood contains a certain amount of alcohol, it is hard to explain or find the reason why some individuals develop alcohol allergies. As earlier mentioned, an allergy test involving alcohol are usually negative. However, these tests may sometimes turn positive due to the presence of ethanol byproducts such as acetic acid or acetaldehyde, also known as vinegar.

Is flushing an allergic reaction?

Some individuals experience flushing after taking alcohol. It is important to mention that flushing isn’t an allergic reaction. Studies have proven that flushing is relatively more common among the Asian population. Other potential side effects of flushing include feeling excessively hot, fluttering of the heart, stomach discomforts, and perhaps a dramatic decrease in blood pressure. It is imperative to note that some or all of these symptoms may be related to the high levels of acetaldehyde in your blood.

It is worth mentioning that not all flushing incidences are caused by alcohol. Flushing can also occur during menopause, can be caused by skin conditions such as rosacea, low blood levels of sugar in your blood, or can also occur as a response to certain medications or antibiotics that are used to treat high blood fat levels of diabetes.

So, what are the potential allergens in alcohol?

Alcohol beverages not only contain ethanol, but other substances as well. Your liver breaks down ethanol that you consume, subsequently converting it into a chemical known as acetaldehyde. Afterward, this chemical is transformed into vinegar. Issues usually arise when your system is unable to break down the alcohol. Besides ethanol, alcohol contains a complex mixture of yeast, grape, barley, hop, or wheat-derived substances, wood-derived substances, and natural food substances as well.

Severe allergic reactions have been reported among people with allergies to proteins present in yeast, grapes, wheat, barley, and hops. These individuals are not sensitive to the ethanol itself. What’s more, sometimes, fining agents such as seafood, or egg may be used to eliminate fine particles. Unfortunately, whether these are available in sufficient amounts to trigger an allergic reaction remains a misery.

I am worried that alcohol might worsen my asthma.

Studies have shown that nearly 33% of individuals suffering from asthma symptoms usually see their symptoms worsen after taking wine. Wine, beer, and champagne contain sodium metabisulfite, which has been used as a preservative since time immemorial. Unfortunately, individuals with poorly controlled or unstable asthma will wheeze after consuming these drinks.

Generally, there is relatively more preservative in white wine compared to red wine. What’s more, metabisulfite content in wine varies from brand to brand. Of course, some wines feature a fairly lower content of sulfite. However, those who are highly sensitive to sulfite may not be able to tolerate these brands as well. Perhaps this is because some grape farmers usually spray sulfur powder over grapes a few weeks before harvesting. Other potential sources of metabisulfite may include pickled onions, crustaceans, vinegar, fruit salads, dried fruit as well as some restaurant salads.

Even though wine can potentially trigger asthma symptoms in some people, metabisulfite isn’t the only cause of this.

Does enzyme deficiency cause asthma symptoms?

Research has also proven that individuals with relatively lower levels of aldehyde dehydrogenase can potentially accumulate higher levels of acetaldehyde in their blood after drinking alcohol, perhaps because they are unable to break it down easily. Studies have also shown that acetaldehyde is responsible for close to 50% of asthmatic Japanese people.

Histamine are particles that trigger allergic symptoms such as a runny nose, sneezing, stomach aches, or even wheezing. Even though the actual amounts usually vary depending on wine brands, it has been proven that red wine contains relatively higher amounts of histamine than red wines. Shiraz also has higher histamine levels compared to Cabernet.

Some contradicting studies tend to show that antihistamines may minimize the severity of allergic reactions after drinking alcohol. However, because the symptoms were caused by only a single glass of wine, these drugs may not be able to prevent a hangover. Other substances available in alcohol may also result in problems, but these are not well defined.

What are other potential sources of alcohol in our diet?

It is important to note that other alcoholic beverages, there are sources of alcohol in our diets, including tomato puree, or food marinades, spiked drinks, mixes as well as soft drinks. Also, excessively ripe fruits may ferment, leading to the production of alcohol that is enough to trigger an allergic reaction.

Certain drugs such as cough syrups and some injections also contain a certain amount of alcohol to help them dissolve and remain in liquid form.

How can I manage my alcohol allergy?

Even if you don’t drink alcohol, accidental exposure to it can result in allergic reactions. Severe alcohol allergy should be tackled or managed in the same way as other serious allergic reactions. Below are a few tips on how to manage your alcohol allergy:

  • Put on a medical identification bracelet.
  • Identify and avoid the trigger to your symptoms.
  • Always carry epinephrine or adrenaline as part of an emergency action plan, especially if you are at risk of suffering a potential life threatening allergic reaction.

It is also important to note that milder reactions to alcohol may happen. What’s more, alcohol may aggravate the symptoms in individuals suffering from hives. Though rare, alcohol can also trigger hives. As with more allergic reactions, how this occurs is still a misery. Contact rashes caused by alcohol are relatively less common.

Are all adverse reactions to alcohol caused by allergy?

Apart from allergic reactions, alcohol can also cause other problems. For instance, it may affect your liver, stomach, brain, and can also result in reduced mental capacity, especially when consumed in larger amounts. While alcohol is known to have a relaxing effect on the brain, some people may experience anxiety and agitation. These are not allergy symptoms!

My face usually turns red after consuming alcohol, is this a result of allergy?

The chances are high that you are not allergic to alcohol. Instead, you might be suffering from a condition referred to as Asian flush syndrome, which is usually characterized by headaches, rapid heartbeat, nausea, facial blushing.

So, what is Asian flush syndrome?

Your body metabolizes alcohol through the help of two main enzymes:

1. Alcohol dehydrogenase which first converts alcohol into acetaldehyde
2. Acetaldehyde dehydrogenase (ALDH2) which breaks down acetaldehyde into harmless compounds.

As a result of genomic differences, nearly 80% of Asians have a highly reactive alcohol dehydrogenase. And this simply implies that they tend to break down alcohol into acetaldehyde relatively quicker (up to 100% quicker.) Because the alcohol is metabolized much faster, as a result, you will experience little to no alcohol buzz.

Most Asians, on the other hand, have the so-called inactive variant of the liver enzyme, ALDH2, implying that the acetaldehyde, which is the byproduct, takes relatively longer to subside from their bloodstream.

This accumulation of acetaldehyde causes facial blood vessels to dilate and turn red resulting in the Asian flush syndrome.

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