Beer Allergy

There are many types of alcoholic beverages and beer is probably one of the oldest. It is produced through the process of brewing and is primarily made from wheat or barley. Some people have high tolerance to beer while others develop an allergic reactions to it; although rarely happens. Allergy to beer has something to do with a particular ingredients, which vary among different brands of beer. Water is the main ingredient of beer but there are other components too such as brewer’s yeast, malt barley, hops, preservatives and flavoring. (1, 2, and 3)

(There are millions of beer drinkers all around the world and some of them develop a mild to moderate sensitivity reactions.)

 

Image Source | (Redness of the skin and formation of rashes are the common symptoms of beer allergy.)

What are the symptoms of being allergic to beer?

• Flushing of the skin
• Frequent sneezing, stuffy or runny nose
• Hives
• Hoarseness of voice and noticeably wheezing sound
• Nausea with or without vomiting
• Chest tightness
• Abdominal pain and diarrhea
• Low blood pressure

The severity of symptoms varies. If the symptoms are mild such as redness of the skin, you may have sensitivity to beer. On the other hand, if the symptoms are severe, then you have a true beer allergy. Alarming symptoms include chest pain and tightness, hives, and wheezing sound. If you notice these symptoms, you should immediately bring the person to the emergency department as the condition could be potentially life-threatening. (2, 3, 4, and 5)

Presence of allergen in beer

• Proteins derived from barley – According to the research published by Journal of Allergy and Clinical Immunology in 2001, one of the reasons for beer allergy is the protein derived from barley, one of the common ingredients of beer. People develop hives and angioedema (rash-like hives) and swelling beneath the skin, particularly around the lips and eyes. The swelling can affect the throat, which increases the possibility of airway blockage leading to difficulty in breathing and wheezing sounds. It is a life-threatening situation and the patient should be immediately brought to the hospital.
• Allergic reaction to sorghum – Some beers are brewed with sorghum, which is a gluten-free alternative to wheat or barley. So, if you asked for a gluten-free beer, expect that it contains sorghum. If you are hypersensitive to sorghum, then you will surely develop beer allergy. Symptoms include swelling and redness of the skin and fever, which could persist for more than two hours.
• Contact allergy – It is rare to cause an itchy skin rash when the beer gets in contact with the skin. The skin’s reaction to beer is likely due to malt and brewer’s yeast. It is an extremely rare reaction but could take place in some individuals.
• Beer-induced anaphylaxis – An anaphylactic reaction may also take place after drinking beer. This is most likely to happen in people with severe sensitivity to beer components. Symptoms of beer-induced anaphylaxis include extremely low blood pressure, difficulty of breathing secondary to inflammation of the mouth and throat restricting the flow of air, and problems with swallowing.
• Sulphites or Sulphur Dioxide – Home brewed beers may have sulfur dioxide/sodium metabisulphite; a chemical used to clean equipment for brewing. The problem is with home-brewed beer, the sulphites or sulphur dioxide content is higher than the usual thereby increasing the possibility of unwanted reactions in people with known allergy to beer.
• Additives – Allergic reactions such as urticaria and asthmatic can be triggered if the beer contains additives like sodium benzoate and tartrazine.
• Fruit extracts – The fruit extracts of beers and other alcoholic beverages are usually destroyed during the making process. However, some residues may be left behind which may trigger an allergic reaction.
• Hops – It is the ingredient that gives beer its bitter taste and unfortunately, some people are sensitive to hops. It causes them to experience unusual reactions such as redness and rashes on the skin, runny nose, swelling of the eyelids, and asthma attack.
• Fining agents – A fining agent is a substance mixed into the beer during production. It is removed through the process of filtration or sedimentation. Some of the commonly used fining agents include casein, egg whites, and isinglass, which is a derivative of fish. Isinglass is made from the swim bladders of sturgeon fish; a commonly used fining agent in beers and wines. People who are sensitive to these agents may experience a severe allergic reaction such as hives, asthma, and anaphylactic shock. Beer makers claim that the allergen level in their beers is too low to cause an allergic reaction. However, people with severe allergy to beer may experience allergic reactions even with just a minute quantity of allergens. (4, 5, 6, and 7)

Beer allergy – sensitivity vs true allergy

Those who are allergic to beer treats it as a threat and as the body’s mechanism to threat, it will produce an antibody called immunoglobulin E, the one responsible for causing an allergic reaction. How will you be able to know if you have a true allergy? Those with a true allergy to beer may react to even just a small amount of beer intake. Even just one sip of beer may cause you to feel the following symptoms:

• Severe redness and rashes
• Difficulty in breathing
• Stomach cramps
• Collapse, in rare instances

What you need to keep in mind is that beer allergy may increase the symptoms of other conditions, specifically urticaria, asthma, and allergic rhinitis. (6, 8, 9, and 10)

Diagnosing beer allergy

To confirm the diagnosis of beer allergy, the doctor will conduct a series of test and will investigate your past medical history and the nature of symptoms you experience while drinking beer. Physical examination and laboratory procedures have to be conducted to find out other existing medical conditions that might trigger allergic reactions. A part of the diagnostic procedure includes the following:

• Skin test – This is to test a specific component of beer you are allergic into. A skin prick test is performed wherein a small amount of the substance found in beer is injected into the skin to elicit a skin reaction. You have an allergic reaction if the injection site becomes red and bumpy.
• Blood test – A blood work is done to measure the level of immunoglobulin E. a high level of immunoglobulin E shows that your body has developed an allergic reaction to beer. (2, 4, 5, and 6)

(An adrenaline autoinjector is injected into the thigh in case of severe allergic reaction.)

How do you treat alcohol allergy?

Once you confirmed that you indeed have a beer allergy, the next important step is to make sure you manage your allergy wisely. There are things you can do to significantly reduce the possibility of allergy. These are the following:

1. Avoid allergens – the best way to avoid beer allergy is to stay away from beer or any types of beverages that contain alcohol. If you are allergic to a particular ingredient of beer, make sure you carefully read the label of alcoholic beverage before even considering drinking.
2. Take anti-allergy medicine – If you happen to drink beer that contains ingredients you are allergic with, the best remedy is to immediately take anti-allergy medications such as over the counter anti-histamine. For severe allergic reaction, you should bring the patient to the nearest hospital.
3. Wear a medical ID/tag such as a necklace or bracelet – If you have a severe allergy to beer, it is best to wear a medical ID so as to alert others about your condition. In case of an emergency, they know how to handle your situation.
4. Have an emergency auto-injector – An emergency device in the form of auto-injector should be always carried by people with severe allergy to beer and other substances. The auto-injector comes with a needle that provides a single dose of epinephrine. In case of severe allergic reaction, you can easily inject epinephrine on your thigh. (2, 5, 8, 9, and 10)