Am I intolerant to alcohol, or just bashful?
October 23, 2011 7:10 AM   Subscribe

Drinking usually makes me blush, but I don't have any other symptoms of the alcohol flush reaction. Does the increased cancer risk apply to me?

I'm 20 and female. My (white gentile) mom was an alcoholic. My (Ashkenazi Jewish) dad has never been drunk because he hates the taste and says even half a drink makes him feel unpleasant.

I usually start blushing furiously after a couple of drinks, but occasionally it doesn't happen at all. The flush never spreads past my neck, and usually doesn't even spread to there.

I learned about the alcohol flush reaction today, and I'm worried about the greatly increased esophageal/other head and throat cancer risk if I have it. But other than the blushing, I don't have any symptoms: I never get headaches from drinking, I only ever feel nauseous if I've really overdone it, and my alcohol tolerance is about average for someone of my size and gender. I've never even had a hangover.

The only other symptom I maybe have is being less prone to alcoholism--I enjoy the social aspects of drinking and the taste of good beer, but I can't imagine wanting to get drunk alone. Also, after "learning my limits" one puketastic night, I seem to instinctively know when I've had enough, and the prospect of drinking more actually repulses me. I get tipsy/drunk maybe once every two weekends when I'm at school and never other than that.

My 21st birthday is coming up and I'm wondering if I should skip the festivities and avoid alcohol from now on. My age is why this is anonymous, by the way.
posted by anonymous to Health & Fitness (6 answers total) 5 users marked this as a favorite
Have you considered talking to a doctor. Maybe even getting a referral to a specialist? I don't know that anyone can tell you with any certainty that your sensitivity will naturally lead to cancer. I think if you don't enjoy drinking and, in fact, have a kind of allergy, you can avoid it and explain to any busy-bodies just that.

On the other hand, if you're curious if there is a kind of alcohol which wouldn't cause this, I think you'd need to consult some kind of specialist. I get flushed sometimes drinking some kinds of alcohol. I've never really been able to pinpoint which does it to me.

But, jeez, having a rager on your 21-er is not required. If you want to mark the occasion with alcohol, maybe you can suggest that you and your friends go on a brewery tour and only just sample a few beers. Or, go hiking or something!
posted by amanda at 7:49 AM on October 23, 2011

Flushing can be for a lot of reasons - Rosacea being another one that fits the info you've listed here.
posted by mazienh at 8:04 AM on October 23, 2011 [1 favorite]

The ingredients in beer (barley, hops, yeast) are not uncommon allergens and flushed skin could be a response to any of them. It might be worth it to see an allergist before you self-diagnose and worry about increased cancer risk.
posted by headnsouth at 8:06 AM on October 23, 2011

I am pretty familiar with the alcohol literature and while you are correct that inefficient alcohol dehydrogenase genes typically found in the Asian population are correlated with a higher risk of esophageal cancer, I have not seen studies demonstrating this outside an Asian population.

If you have a high flush response that is correlated with having one of the less efficient variants of the alcohol dehydrogenase gene, but without other feelings of illness after having only a few drinks, and since your mom is white, I'd say you're probably not carrying one of the Asian-like variants. We had a screener for this in the lab which you seem to be familiar with; the other items are nausea and headaches after only one or two drinks, hives after one or two drinks, the flush response, etc. Unless you meet two of those, consistently, after a low dose of alcohol, it's unlikely you're carrying one of the extremely inefficient genes for alcohol dehydrogenase. That means you're probably capable of metabolizing about one drink an hour (1.5 hours if you want to be super conservative and low-ball it), assuming you are average body weight and height.

If you stick to that limit, your body is much more able to deal with the byproducts of alcohol metabolism that are supposedly cancerous. Also, those cancers have been shown in regular and usually heavy drinkers. At your rate of consumption (several drinks a few times a month) and the fact that you are probably not in the highest genetic risk category for these cancers means stopping drinking entirely for the rest of your life is a pretty extreme reaction. Drinking moderately is a good idea for lots of reasons, so don't exceed one drink an hour and about two to three drinks per session, only drink a few times a month, and you are at pretty super low risk of all alcohol-related health complications.
posted by slow graffiti at 8:08 AM on October 23, 2011 [5 favorites]

Related, previously: Flush in the face = Give up the bottle?
posted by chrisamiller at 9:38 AM on October 23, 2011

A close friend of mine is allergic to Tequila. She loves the stuff, but if she drinks it her face turns blotchy red for an hour or so. This isn't your standard blushing, this is what I would call, "holy shit, do you realize your face has red blotches all over it". Drinking vodka or rum doesn't do it to her.

You could have a slight allergic reaction to certain types of alcohol.
posted by darkgroove at 7:28 AM on October 24, 2011

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