Why can't I drink?

May 25, 2007 7:40 AM

Are there any solutions to alcohol intolerance? And does alcohol intolerance developed later in life (late twenties/early thirties) indicate other possible health problems?

Since I turned 27, the smallest amount of alcohol (1/2 a shot, 1/4 a beer) gives me a terrible hangover - intestinal distress, sweats, occasionally vomiting. Two aspects of this intolerance are 1. immediacy (it happens within 2 hours of ingestion) and 2. severity (it feels like I spent the whole night drinking). Why does my body react like this? I used to be able to drink six jack and cokes a night with only a headache the next morning.


Weirdly enough, when I lived in Paris (two years ago), I could drink a bottle of red wine a night and not feel any negative effects. But since returning to the states, I've been unable to indulge in even one drink with friends. This is hindering my social life and my emotional state -- sometimes a person needs a drink!

Do these side effects indicate alcohol intolerance, or is something else going on?

A friend of mine told me my reaction might be an indication of type 2 diabetes, but I have no other diabetic symptoms.

Other aspects of health: I take paxil (20mg/day), xanax (sometimes), and ortho tricyclen. I smoke (my one indulgence). I exercise regularly and alternate yearly with a vegan/vegetarian diet. I weigh 145. And I'm white -- I add this final indication because I've read about alcohol intolerance in people of Asian heritage, and my symptoms are similar, but not exactly the same - no red flush, for example.

Any suggestions or answers would be much appreciated. I want to have wine at night with my friends!

posted by seeka to health & fitness (16 comments total)

I'm about to turn 27 and I've found I get worse hangovers from less alcohol now as well. Spoken with friends who feel the same. I'm not sure if it's just age or what.

(One more health aspect that sticks out: being on birth control as well as smoking greatly increases your risk for dangerous blood clots than can travel to your lungs and kill you, or other heart disease.) Back on topic.
posted by gramcracker at 8:06 AM on May 25, 2007

I've heard recovering alcoholics talk about this. It could be an indication of liver problems. I suggest you get yourself to a doc, pronto.
posted by milarepa at 8:19 AM on May 25, 2007

Did you used to take the antidepressants when you were able to drink in Paris?
Because antidepressants, especially Paxil and Prozac, completely jacked with my alcohol tolerance.
posted by mckenney at 8:21 AM on May 25, 2007

Totally not answering your question, but my step-father has never been drunk a day in his life because he falls asleep before he can even finish a beer. His life seems to have turned out ok.

If you don't have any other indications of anything being 'wrong' with you, I wouldn't worry about it. IANAD.
posted by matty at 8:23 AM on May 25, 2007

Get thee to a doctor. Alcohol intolerance can be a symptom of something bad going on with your liver, like, oh, Hepatitis C, for example.
posted by Andrhia at 8:29 AM on May 25, 2007

You say shots and beer make you feel awful, but red wine 2 years ago was fine. Can you still drink red wine? It is possible that you have something along the lines of a food allergy. Some people are allergic to various grains.
posted by yohko at 8:48 AM on May 25, 2007

I have exactly the same symptoms that you do, and I'm in (nearly) perfect health -- no history of alcoholism, no hep c, no anti-depressants, nada.

And my symptoms began at exactly the same age -- 27. They've continued into my forties unabated. Like you, I was a blue-ribbon imbiber through my mid-twenties, then bam. Out of contention.

Also like you, a quarter of a beer will leave me with a hangover the following day, and two pints of beer with mild hangover symptoms for a week. (Yes, a week. You read that right).

While I agree that a doctor visit is a necessary step for you, you might find that this syndrome is a fait accompli. In my case, it's genetic -- both of my parents are unable to drink (one, due to congenital migraines, the other, due to intestinal irritation).

If, after a full checkup, you've ruled out medical problems, experiment with different varieties of alcohol to see if you can lessen the hangover.

In my case, I've found that distilled, clear booze -- such as gin, vodka, and clear tequila -- diminish (though fail to extinguish) the hangover.

My favorite drink (which I indulge in only several times a year) is a dry martini made with Tanqueray. Good, clear, distilled booze, in other words. I drink one or two early in the day, and enhance the buzz with my favorite green combustible. Then, I take a vitamin B pill at bedtime.

If I'm lucky, I'll suffer through a two-day hangover -- including precisely the symptoms you relate, like sweats and nausea, but no vomiting -- before returning to my usual self.

You might combine the aforementioned green combustible with a pill, such as percocet, a combination which -- um, so I'm told -- produces an alcohol-like effect.

Apart from occasional martinis, and the regretful mornings that follow them, I've concluded that drinking is out of the picture for me in this lifetime. Meet up with me in the next lifetime, in which I'll be the stumble-drunk alky in the local dive who wakes up with a smile on his face and perkiness in his step the following morning.
posted by Gordion Knott at 9:03 AM on May 25, 2007

Ethanol consumption by rats is inversely related to hepatic alcohol dehydrogenase activity

Age-dependent changes in in vivo ethanol metabolism and in the activity of hepatic enzymes involved in ethanol oxidation and microsomal functions

Effects of prolonged alcohol administration.
posted by meehawl at 9:13 AM on May 25, 2007

no real answer here but I'll nth the change in my ability to drink in my mid/late 20s. Use to drink a tremendous amount of anything I could get my hands on with little day-after repercussion. At age 25 or so a totally reasonable amount (in my mind) of alcohol consumption would cause catastrophic results the next day.
posted by Soulbee at 9:23 AM on May 25, 2007

Effects of alcohol seem to differ widely from person-to-person. I'm healthy, but I find it pretty impossible to get drunk in a fun way. If I drink moderately, I don't feel much of anything except fuzzy-headed (I don't feel uninhibited or wild). If I drink a lot, I feel sleepy. I've pretty much always been this way, and I'm in my 40s.

(I started a thread about this once, but it was never resolved: I sometimes get an excruciating pain in my jaw when I drink. It's really easy to avoid, because I can feel just the beginning of it before it comes on full-steam, and if I stop drinking at that point, I'm fine. But if I foolishly continue -- even having a couple more gulps -- it's excruciating. I've talk to doctors and dentists about this, but no one has been able to give me a definitive answer. I can happen with alcohol in any form. It's intermittent. If I drink 10 nights in a row, it will probably happen twice.)
posted by grumblebee at 9:27 AM on May 25, 2007

Tolerance increase usually occurs prior to the decrease. Did you notice your tolerance go higher before dropping to it's current low? I will say, based on my experience and what you've shared, a bottle of red wine per day will build your tolerance pretty quickly and shorted the period of time it takes to start dropping. Based on my limited medical experience but from what doctors have shared with me, it could be indicative of precirrhotic scarring. Again, I am NOT a doctor so only he/she can test you for this but it should be taken into consideration. Any drastic drop in tolerance is cause for concern and should be investigated by your doctor. The other exacerbating factor is your Paxil intake. As mentioned upthread, this will greatly enhance the effects of alcohol and should be ruled in or out as a factor for your tolerance drop.
posted by KevinSkomsvold at 10:37 AM on May 25, 2007

That's odd. Paxil decreases alcohol tolerance in some folks, but not to the degree you mention in my experience.

Alcohol and xanax should never be combined - it's a dangerous, synergistic combination, which means the effects can be multiplicative. I can see that making you sicker than you expected to feel, but not within 2 hours of ingesting 3 oz of beer.

I think I might get to a doc and have my liver checked out if this were going on. That said, my guess is that these symptoms will turn out to be psychologic in origin. But don't take my word for it; see your own doc and get it checked out.
posted by ikkyu2 at 11:08 AM on May 25, 2007

Any other foods give you problems? Could it be some form of IBS/IBD?
posted by chrisamiller at 11:11 AM on May 25, 2007

Correction to my earlier comment: I meant to refer to Xanax rather than Paxil. KevinSkomsvold regrets the error.
posted by KevinSkomsvold at 11:27 AM on May 25, 2007

too much alcohol in your youth (a bottle of red wine a day is an unhealthily large amount) but mainly now you are getting older; yep, even 27 is older.
posted by londongeezer at 2:39 PM on May 25, 2007

I don't know if this is rocket science but you're combining Paxil (which doctors obsessively warned me should NEVER be combined with alcohol) AND xanax (which doctors obsessively warn me should NEVER be combined with alcohol) AND alcohol (which doctors obsessively warn me should NEVER be combined with paxil and/or xanax). Maybe, and this is just a wild guess, doctors suggest not making any one of those combinations (much less all) because, erm, how do I put this - because they believe doing so might perhaps make you feel ill?
posted by bunnycup at 2:46 PM on May 25, 2007