You’ve probably heard remarks like, “She could drink me under the table” or “He is a total lightweight.” Those comments, which come with (dubious) connotations of strength and weakness, are rooted in the concept of alcohol tolerance.
Alcohol tolerance refers to the body’s response to alcohol and the effects that alcohol has on them. A person’s tolerance to alcohol can range from high to low, and may also vary over time. There are several reasons why this happens, and thus why it seems like some people can drink endlessly without a buzz, and others feel tipsy on half a glass of wine. Gender, genetics, drinking habits, weights and health all play a role in tolerance.
Multiple factors explain why some people’s bodies appear to handle more alcohol better than others...
Gender And Body Weight
Both gender and weight influence how an individual tolerates alcohol. Men tend to be able to drink more than women before they appear drunk. Larger people may consume more than smaller people without immediate ill effects.
Other Biological Factors
Some think it relates to the enzymes involved in metabolising the alcohol; others think there’s a varied effect on neurotransmission in the brain. In the case of the neurotransmitters, the theory is that the brains of some people with high tolerance simply aren’t receiving signals saying, “Whoa there, you should probably stop drinking.”
As for the role of enzymes, alcohol metabolism is a multi-step process. Much of the alcohol processed in the body is initially metabolised by the enzyme alcohol dehydrogenase to a compound called acetaldehyde. Acetaldehyde is further metabolised by the enzyme aldehyde dehydrogenase. Some people are deficient in aldehyde dehydrogenase, which can lead to a buildup of acetaldehyde in the blood.
This can lead to ‘flushing’ of the skin, and worsening or increased symptoms commonly associated with hangover. Individuals of Asian descent are more likely to have this enzyme deficiency. Beyond that, our brains and bodies tend to adjust pretty quickly to heavy drinking.
The human body has the ability to adapt to increased alcohol use. This can result in more rapid metabolism of alcohol. And that, in turn, means those who drink alcohol more frequently may also appear less intoxicated than others that have consumed a similar amount of alcohol. Higher tolerance is not necessarily a good thing!
The first problem with higher alcohol tolerance is that it can give a false impression of just how drunk someone really is. Although you might think someone seems OK to drive a car or ride a bike because they’re not stumbling or slurring their words ― and they might think so, too ― that is not a sound assumption. The amount of alcohol consumed still matters.
It’s also not safe to assume that someone with high alcohol tolerance, who’s able to drink more without feeling drunk, is not going to see the long-term effects of excessive drinking.
They’re still at risk for complications related to how much alcohol you’ve consumed in a lifetime. These include cirrhosis of the liver, brain disease, neuropathy, pancreatitis, and gastritis or stomach cancer.
Can You Be Allergic To Alcohol?
People report swollen itchy red eyes after one glass of wine, or a cocktail, while others suffer blotchy skin, or even muscle aches. However, an allergy to alcohol doesn't really exist. Allergies are the immune system over-reacting to a harmless substance – leading to hives, swelling, difficulty breathing, a drop in blood pressure and even passing out.
But alcohol molecules are too tiny for the immune system to recognise and trigger an allergic response. Intolerances, on the other hand, could be at play. They are not triggered by an immune response but are usually to do with problems with the digestive system, where the body doesn’t process alcohol the way it should.
Some people lack an enzyme called aldehyde dehydrogenase in the liver, which is involved in the metabolism of alcohol. This leads to a build-up of a toxic substance called acetaldehyde, which causes a host of nasty symptoms including a red, flushed face and neck, and occasionally a rapid heart rate, headache or nausea.
Specific forms of alcohol are notoriously unfriendly for people with allergies. Some types of alcohol, such as wine, can contain sulfites which can worsen allergy symptoms. Sulfites might sound sketchy, but they’re just natural by-products of wine fermentation. However, some people are sensitive to sulfites and experience symptoms like seasonal allergies when consuming them.
In several surveys, people were more likely to report allergy symptoms after drinking wine than after drinking any other alcoholic beverage. In a 2005 survey of nearly 12,000 people who experienced alcohol-induced nasal symptoms, red wine was more likely to cause symptoms than white wine.
Can Alcohol Worsen Food Allergies?
People with serious allergies to certain food like nuts or eggs should limit alcohol intake, as reactions can become dramatically exacerbated after drinking. Although alcohol suppresses the body's ability to fight infection, it also triggers an increase in the release of histamine – the chemical produced by the immune system that floods the body during an allergic reaction.
It's not just food allergies that are worsened by alcohol – studies show that more than a third of those with allergy-driven asthma wheeze, cough and experience more breathlessness after a few glasses of an alcoholic beverage.
An intolerance to the preservatives found in wine, called sulphites, is not uncommon, causing a host of symptoms such as wheezing, itchy eyes and flushed skin, in about one in 100 people.
The key here is quantity, sulphite levels are typically very high in wines. A typical dry white contains up to twice the sulphites (100mg per litre) of an average red.
And dessert wines have even more sulphites. If you opt for organic wine, with say 50mg per litre, reactions are less likely.
Studies show that around seven per cent of adults suffer some intolerance to wine – interestingly, the majority of them are women. And they can develop at any point in life.
But it could well be many other things in wine that spark symptoms – grape proteins or compounds found in plant skins called tannins, enzymes added to help fermentation, or additives. Some people are allergic to the small amount of yeast in wine.
You can undergo a skin test to work out if they have an allergy. This involves placing a drop of the drink on the forearm, placing a pinprick through it and waiting 15 minutes to see if there's a reaction. If a red weal – or hives – appears, it suggests an allergy. Then it is a case of figuring out which ingredient in the drink provokes the reaction.
Don't Keep Up With Alcohol-Tolerant Joneses!
Being able to drink someone under the table is so commonly associated with strength, and there’s such a stigma to being a lightweight. But really, the “lightweights” are better off.
How Can I Help Myself?
Higher histamines in your drinks mean that you're more likely to react to an allergy trigger because you're body is already elevated. A boozy saviour could be gin and vodka, as they have lower levels of histamine, so switching from beer or wine can be a sensible move.
If you are know as a "wino" and can't live without a few glasses here and there, experiment with Organic Wines with no added sulfites. Avoid, Champagnes and red wines which are high in histamines, and sweet white wines that tend to have higher sulfite content.
Avoid Risky Or Hazardous Use Of Alcohol
For men under 65, drinking more than four drinks per day or 14 drinks in a week constitutes risky use. For women, or men over 65, more than three drinks per day or seven drinks in a week is considered risky.
Any amount of alcohol consumption before driving can affect performance behind the wheel. In fact, a recent study showed that having a single drink can significantly affect a person's driving ability.