Alcohol allergy and intolerance

If drinking alcohol (also known as ethanol) gives you food allergy symptoms, such as flushing, itching, and diarrhea, you may be allergic or intolerable to alcohol. Food allergies are abnormal immune responses to what we eat, while food intolerances are adverse reactions to foods that do not involve the immune system.

Although true allergies to alcohol are rare, ingredients in alcoholic beverages can cause allergy or intolerance symptoms. These include:

  • Gluten (protein found in grains like wheat, barley, and rye)
  • histamine (an organic compound in fermented foods)
  • Sulfites (a sulfur-containing compound found in beer, cider, and wine)
  • Yeast (commonly used in alcoholic fermentation)

Some may even react to the grapes or corn used to make wine and distilled spirits.

This article looks at some possible causes of alcohol allergy or intolerance. It also provides tips on how to drink alcohol safely if you are allergic or intolerant to any of the ingredients used to make wine, beer or distilled spirits.

gluten sensitivity

Gluten is the protein that triggers the symptoms of celiac disease and is found in three main grains: wheat, barley, and rye. Celiac disease, an immune response to eating gluten, can trigger inflammation of the small intestine and symptoms such as diarrhea and bloating.

Barley malt is used to make beer and other bottled beverages. Some beers also contain wheat and/or barley. So if you have celiac disease or non-celiac gluten sensitivity, you need to steer clear of traditional beer.

If you are allergic to wheat, you can drink beer made with barley instead of wheat.

When it comes to distilled spirits, things get more complicated. Gin, vodka, and whisky are all made from gluten-containing grains like wheat, rye, and barley. Even so, the American Dietetic Association (ADA) considers these distilled spirits safe for people with celiac disease.

unless gluten-containing flavorings are added back During the distillation process, distilled spirits are considered gluten-free. The same applies to distilled spirits made from wheat if you are allergic to wheat.

Even so, many people with celiac disease or gluten sensitivity report reactions to distilled spirits made from gluten grains. If this is you, you might consider drinking potato or grape vodka. There are also some whiskies made from sorghum, a gluten-free grain.

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Wine and most brandies also contain gluten.


People with celiac disease, non-celiac gluten sensitivity, or wheat allergies may need to avoid traditional beer. Wine and distilled spirits are generally considered safe.

histamine intolerance

Many foods, including red wine and aged cheese, are rich in histamine. This is the same chemical involved in allergic reactions in the body.

Reactions to foods high in histamine may be a sign of histamine intolerance. Your body has two enzymes that break down histamine, but sometimes they don’t work as they should.

If they don’t, you may experience what’s called a “red wine headache” and other symptoms. These include itchy or flushed skin, red eyes, facial swelling, runny nose, and congestion.

While red wine is particularly high in histamine, all alcoholic beverages contain high levels of histamine.

Antihistamines such as Allegra (fexofenadine) and Zyrtec (cetirizine) can help relieve symptoms of histamine intolerance. However, the best treatment is to avoid histamines in the foods we eat, including alcohol.


If you experience headaches, flushing, itching, or congestion after drinking red wine, it may be because you have a histamine intolerance.

sulfite allergy

A group of sulfur-containing compounds called sulfites occur naturally in wine and beer. They help inhibit the growth of harmful bacteria. Some vintners add more sulfites to wine because they act as preservatives.

While most people can tolerate sulfites in food, some people are particularly sensitive to sulfites and may experience asthma attacks.In rare cases, exposure to sulfites is known to cause a potentially life-threatening systemic allergy called allergic reaction.

As a result, U.S. labeling laws require any food product with a sulfite concentration greater than 10 parts per million (ppm) to include the words “contains sulfites” on its label.

There are no sulfite-free wines. While the law says that organic wines cannot add sulfites to their products, some wines contain enough natural sulfites to trigger a reaction in sensitive people.

If you are extremely sensitive to sulfites or are at risk of an allergic reaction, you will need to bring your EpiPen to inject yourself epinephrine (Epinephrine) in an emergency.


The naturally occurring sulfites in wine and beer can cause asthma symptoms in people who are sensitive to sulfites. In rare cases, the reaction can be severe and cause an allergic reaction.

What to do in an allergic reaction emergency

yeast allergy

The type of yeast used to ferment many alcoholic beverages is called brewer’s yeast. It is the same yeast used to make bread.

Allergy to brewer’s yeast is well documented in the medical literature. They are most likely to occur in people who are allergic to mold. Brewer’s yeast is used in all fermented alcoholic beverages. This includes beer, wine, hard cider and sake. People with yeast allergies should avoid these.

Distilled liquor is not made with brewer’s yeast. Distilled beverages typically remove any naturally occurring yeast or yeast by-products from the liquid. Therefore, distilled spirits are generally safe for people with yeast allergies.


People allergic to mold or yeast may develop an allergic reaction to the brewer’s yeast used to make fermented beverages such as beer, wine, and hard cider.

grape allergy

Grape allergy is rare, but has been reported in some medical journals. In addition to wine, people with grape allergies may want to avoid Armagnac, Cognac, ouzo, absinthe, port, and champagne. Most wine coolers and packaged martinis should also be off the list.

Possible substitutes for wine and wine spirits include Japanese plum wine, which has an enticing sweetness. Apple Brandy Calvados is another option.


People with a grape allergy need to avoid grape-based wines and distilled spirits, including cognac, ouzo, and absinthe.

Corn allergy and intolerance

It is not known whether distilled spirits made from corn are safe for people with corn allergies. So far, there is little solid evidence for this.

The European Food Safety Authority says distilled alcohol derived from corn is “likely safe” for people with corn allergies. This is because the distillation process removes most of the zein that could cause a reaction.

Even so, if you have a severe corn allergy, you may want to avoid corn-based spirits, especially bourbon. Gin, whisky, brandy, and some vodkas may also use corn as an ingredient or flavoring, so be sure to check the label.

Beer and wine are considered safe.

There is little evidence that distilled spirits made from corn, including bourbon, pose a risk to people with corn allergy or intolerance.


While an allergy to alcohol is rare, an allergy or intolerance to the ingredients used to make wine, beer, or distilled spirits is possible.

These include grains such as wheat, barley, and rye used in brewing beer, which can affect people with celiac disease, non-celiac gluten sensitivity, and wheat allergies. Red wine contains high levels of histamine, which may cause headaches, congestion, and itching in people with histamine intolerance.

People who are allergic to sulfites may need to avoid red wine. Likewise, those with mold or yeast allergies may want to avoid fermented beverages made with brewer’s yeast, including beer and wine.

Although rare, people with a grape allergy should avoid wine and grape-based wines, including brandy. Even less common are allergies or intolerances to corn wines such as bourbon.

VigorTip words

If you are allergic to any type of food, it is important to be careful about the alcoholic beverages you drink. It helps to read product labels, although many of the ingredients used in the fermentation or distillation process may not be included.

When in doubt, ask your allergist about the types of alcoholic beverages you can or cannot drink.

Frequently Asked Questions

  • What is the main difference between alcohol allergy and alcohol intolerance?

    Alcohol intolerance is an inherited metabolic disorder that does not allow the body to process alcohol properly, while alcohol allergy is an immune response to a component in alcohol.

  • Is there a cure for alcohol allergy or intolerance?

    No, there is no cure for alcohol allergy or intolerance, but symptoms can be managed.

  • How Is Alcohol Allergy Diagnosed?

    Your healthcare provider may perform an ethanol patch test, in which a drop of alcohol (ethanol) is placed on a piece of gauze and taped to the skin. If you have a skin reaction such as a rash, itching, or swelling, you may be allergic to alcohol, whether you drink alcohol or be exposed to it.

  • Can I still drink if I have an alcohol intolerance?

    Not recommended. People with alcohol intolerance are at greater risk for head and neck cancer, liver disease and Alzheimer’s disease if they drink alcohol.

Why do I feel pain after drinking alcohol?