What Experts Think Is Happening

Before contracting COVID in March 2020, Rebekah Stein could enjoy a few alcoholic beverages a week. After a mild infection, she thought nothing had changed, so one night she saw her husband holding an attractive glass of whiskey and took a few sips. rice field.

Within a minute, severe chest pains set in, and Stein, 30, felt drunk and had several drinks at once. The next day was even worse, but he was no ordinary hangover. He had arrhythmia, chest pain, cough, sore throat, headache and nasal congestion. It was “basically a relapse of COVID.” long covid Symptoms include shortness of breath, regular fever, general aches and pains, and fatigue.

“I wasn’t connecting the dots when this first happened. I had all the symptoms of COVID, so I woke up and took a COVID test, but when I drank it, my heart rate went up overnight. “My body seems to know pretty quickly that it’s been poisoned,” Stein said.

Nearly three years later, Stein still can’t drink alcohol of any kind. And she’s not alone.

Post-COVID alcohol intolerance hasn’t been studied yet, so no one knows how common it really is, but interviews with doctors, researchers, and people who can no longer drink alcohol suggests that it is yet another mysterious symptom that could be a side effect of a viral infection.

Long COVID, aka Post-COVID status, occurs when health problems persist for weeks, months, or even years after a coronavirus infection. Recognized by the Americans with Disabilities Act in 2021, research suggests that about 30% of adults will experience at least one symptom of her COVID lasting more than three months.

Dr. Stuart Malcolm is a physician and only treats long-term COVID patients RTHM The clinic said many people with prolonged COVID have given up alcohol completely. We presume that you are experiencing this intolerance because you continue to experiment with

A longtime COVID neurologist in Louisiana also wrote about her experience: March 2021 blog post, and reddit thread Since February last year, it has become clear that more and more people are dealing with the same problem.

Alcohol intolerance can occur in people who have not had COVID for a long time, can disappear or become milder over time, and can be caused by certain types of alcohol. , does not occur in other types. Although inconvenient, the inability to drink alcohol is the least shocking symptom compared to the more serious consequences.

Still, professionals, especially those who study or treat people ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) — a complex disease that shares many similarities with the long COVID — isn’t as shocked as we hear about the outbreak.

Alcohol intolerance is actually Key diagnostic features of ME/CFSStudies have found it can appear anywhere in between 65% To 80% of people with illness.

“It comes as no surprise, as we know that ME/CFS patients have all sorts of underlying biological abnormalities, including the immune system, energy metabolism, brain, autonomic nervous system, and gut microbiome. Anthony Komarov, M.D., a professor of medicine at Harvard Medical School who has studied ME/CFS for 35 years, said: “However, it is still unclear what specific abnormalities lead to alcohol intolerance. I don’t understand.”

What is alcohol intolerance?

alcohol intolerance It is a generally inherited metabolic disorder that makes it impossible to process alcohol like other people. Genetic mutations make certain enzymes or proteins less efficient at converting alcohol into non-toxic substances, causing toxins to build up in the blood.

As a result, people’s faces, necks, and chests become flushed (warm, pink or red) immediately after drinking alcohol. You may also experience stuffy nose, nausea, vomiting, increased heart rate, low blood pressure, headaches, diarrhea, and worsening asthma.

This condition doesn’t go away, but it can be dealt with by avoiding alcohol of any kind. People of Asian descent are more likely to carry the genetic mutation and therefore have the condition at a higher rate compared to other racial groups.

Although it may feel that way, alcohol intolerance doesn’t make people get drunk faster or raise their blood alcohol levels. This condition also differs from alcohol allergy, which is an immune response to chemicals, grains, or preservatives in alcohol that can cause rashes, itching, swelling, and stomach cramps.

Both conditions can cause nausea, but alcohol allergies are more painful than usual and can be life-threatening if not treated.

But if it’s related to long-term COVID or another chronic disease, alcohol intolerance is likely to harm the body through another chemical mechanism that doesn’t involve inherited genetic mutations or allergies.

Coronaviruses can also directly affect the enzymes involved in processing alcohol, said Dr. Vikrant Rachakonda, a hepatologist, gastroenterologist and professor of medicine at UC Davis Health.

But it hasn’t been seen yet.

Why are some people alcohol intolerant after COVID?

There are several plausible explanations behind post-COVID alcohol intolerance, but they have not been fully studied. Based on what I’ve learned about research on CFS.

Given how complex COVID is, it’s unlikely that one of these theories alone can fully explain what’s going on.

my liver hurts

The liver processes everything we consume, including alcohol, so if the organ is damaged or weakened in any way, it becomes even more vulnerable to exposure to alcohol and other toxins, Komaroff said. said.

COVID can damage the liver In many ways, some experts, like Malcolm, a longtime COVID doctor, believe the disease is “not obvious by standard laboratory tests, it’s going a little bit more to the liver than we thought.” I suspect that it is causing “damage”.

That means a damaged liver, or, according to Ratchakonda, an undiagnosed liver disease that is so common as it is mostly asymptomatic, is likely not handling alcohol properly. People who become intolerant to alcohol after COVID may have acute liver injury from the infection or have an undiagnosed liver condition.

Ratchakonda said it’s not unreasonable to request a blood test if you’re experiencing alcohol intolerance. Checking liver enzymes, kidney function and electrolytes can help rule out other causes. It’s helpful.

mast cell activation

Mast cells are a type of immune cell that trigger an allergic reaction when they detect allergens like peanut proteins. They do this by releasing a chemical called histamine, which works to get rid of the allergen by causing itching, sneezing, nausea, shortness of breath, and more. “)

According to research, A long COVID will exacerbate this process Activates mast cells and encourages them to release excess histamine into the body (ME/CFS does this too). Mast cell activation syndromeis a recurring anaphylactoid-like episode of hives, hypotension, severe diarrhea, and dyspnea. (Anaphylaxis is a potentially life-threatening allergic reaction.)

To make matters worse, not only does alcohol contain histamine (histamine is a by-product of the fermentation and brewing process), it also pushes mast cells to release more histamine, which is broken down by enzymes called DAO enzymes. prevent you from doing it.

“It’s kind of a triple whammy,” Malcolm said. All that extra histamine could explain why some people feel terrible after drinking alcohol post-COVID.

This theory also helps explain why alcohol intolerance fades or becomes less severe over time. and less chaos that triggers mast cells to release excess histamine.

That may have happened to 26-year-old Selina Quinlan. When she contracted her COVID in February 2021, she experienced a loss of her sense of taste and smell for several weeks, including a strange aversion to foods such as onions and guacamole. But after a night out with her friends and a solo wine night at her house with just a few glasses of wine, Quinlan says her body is functioning like she’s had at least eight. , she told BuzzFeed News.

“For the rest of that spring and summer, I had a really, really hard time just having one drink. Quinlan said. “It was so strange.”

Her friend who gave her COVID in the first place also experienced the same symptoms.

After 3 months, her alcohol intolerance was completely gone.

blood flow problems

Many long-term COVID patients (similar to those with ME/CFS) experience problems with the autonomic nervous system, which plays a key role in constricting and dilating blood vessels, but researchers still don’t fully understand why. I have not.

If someone has COVID or ME/CFS for a long time, the blood vessels cannot properly respond to signals from the brain to tighten and relax. This is why many people with long-term COVID-19 feel light-headed or faint after standing because their blood vessels do not constrict sufficiently and blood pressure drops. This is a characteristic symptom of POTS (Postural Orthostatic Tachycardia Syndrome). Between 2% and 14% of people who test positive for COVID eventually develop symptoms.

Now let’s think about alcohol. alcohol dilates blood vessels In addition, it further lowers blood pressure. “If you already have a loose hose that doesn’t respond to the signal to tighten it, and you loosen it with alcohol, it will exacerbate symptoms like fatigue, increased heart rate and cognitive impairment,” Malcolm said.

According to Sarah Ansley, a senior researcher in microbiology at La Trobe University in Australia who has studied both conditions, this increased blood flow may be associated with some people who have had a long history of COVID or ME/CFS. It may also explain the severe body pain in

Julie Harmon knows this feeling all too well. About a month after she contracted the novel coronavirus in December 2020, she began feeling tingling, numbness, tingling and pain all over her body. It wasn’t until the summer that Harmon, 39, realized she was intolerant to alcohol. Thirty minutes after she drank a beer, her face was flushed and her hands hurt so badly that she could not hold her books, her phone, or “live a normal day-to-day life.” Harmon told BuzzFeed News.

“My first few drinks were like, ‘Well, this is my long COVID pain.’ “So I finally realized that even a few alcoholic drinks were making my symptoms so much worse.” Harmon began avoiding alcohol completely.

What to do if you’re experiencing alcohol intolerance after COVID

Alcohol intolerance is arguably not the worst of COVID or long-term COVID symptoms, but it can rob you of the “happiness” of happy hour and affect your social life in general ( where alcohol is involved).

The good news is that you can avoid alcohol intolerance by avoiding alcohol altogether. Avoiding alcohol when taking certain medicationsbecause some drugs can exacerbate the symptoms of alcohol intolerance. This is one prohibited item.

Otherwise, Malcolm suggests drinking plenty of water to stay hydrated and possibly doing blood tests to better understand what’s causing your symptoms. Low histamine diet is effective Most fermented products such as wine, beer, and cured cheese are also excluded. Other foods to avoid include fish, tomatoes, spinach, citrus fruits, eggs, and chocolate.

But giving up alcohol is really the best thing, Malcolm said.

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