Symptoms following alcohol consumption have also been reported in those with Hodgkin’s lymphoma 4, Epstein-Barr infection 5, and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) 6. Patients with post-viral illnesses can experience a myriad of symptoms, such as persistent fatigue, headaches 7, tachycardia/palpitations, sleep disorders, and dyspnea. In a study on patients diagnosed with ME/CFS, a syndrome that can be triggered by viral infections, two-thirds of patients experience increased alcohol sensitivities leading to a reduction in alcohol intake 8. Recent studies have also reported alcohol sensitivity after the onset of their illness in 65-80% of ME/CFS patients 9. Individuals with a lowered tolerance, also known as acute sensitivity, may experience the effects of intoxication even after consuming relatively small amounts of alcohol. New-onset alcohol reactions and sensitivity can occur after COVID-19 infection in patients with PASC.
What are the symptoms of alcohol intolerance?
Prior to her initial COVID infection, she had no issues with alcohol tolerance and could easily tolerate about seven mixed drinks containing hard liquor in one night. A standard drink contains 14 grams of pure alcohol, with one standard drink equivalents including 5 ounces of wine or 12 ounces of beer 21. After COVID infection, however, she reported feeling like she suffers from “alcohol poisoning” after drinking even small amounts of alcohol and feels “terrible” for several days after consumption. Her tolerance has decreased to the point where one beer would result in a severe “hangover,” long covid alcohol intolerance along with exacerbation of PASC symptoms for three days thereafter. Alcohol sensitivity has been observed in a patient with PASC in a case report 20 but has not been widely studied.
Health Challenges
He received four doses of COVID-19 vaccination, two before and two after infection. OI is a condition characterized by an individual’s inability to tolerate an upright posture because of an abnormal response of the body’s autonomic nervous system to gravitational changes, resulting in inadequate blood flow to the heart and brain. This condition is notably common in patients with ME/CFS and is becoming increasingly recognized in patients with long COVID or PASC 13-15. Our understanding of why individuals develop OI after viral illnesses is incomplete, but it is plausible that this could be a key mechanism by which alcohol consumption aggravates symptoms in those recovering from viral infections. Alcohol dilates blood vessels, potentially worsening the drop in blood pressure seen in those with OI. As a diuretic, alcohol may amplify dehydration in OI patients, further diminishing blood flow to the brain when upright and intensifying symptoms 26.
Going “cold turkey” when you have a physical dependence on alcohol can be dangerous. Alcohol consumption may make your symptoms worse, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). “However, we know that long COVID has more than 200+ symptoms and as our knowledge of the condition grows, it is possible that additional symptoms could emerge,” the NIH statement read. The condition doesn’t go away, but people can manage it by avoiding booze of all kinds. People of Asian descent are more likely to have the genetic mutation, so they have the condition at greater rates compared with other racial groups.
- According to Dr. Melnik, alcohol is not a main concern for most patients (“usually they do have bigger fish to fry, so to speak,” she said) and doctors don’t usually ask about it.
- There’s no consensus on whether alcohol affects the antiviral medications used to treat COVID-19.
- Rachakonda said it’s not unreasonable to request a blood test if you’re experiencing alcohol intolerance.
- Still, experts, particularly those who study or treat people with ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) — a complex illness that shares many similarities with long COVID — aren’t too shocked to hear about the occurrence.
Otherwise, Malcolm suggests drinking plenty of water to stay hydrated and possibly pursuing some blood work to better understand what may be causing your symptoms. A low histamine diet could help too, which excludes most fermented products like wine, beer, and cured cheese. Some other foods to consider avoiding include fish, tomatoes, spinach, citrus fruits, eggs, and chocolate. This increased blood flow could also explain the intense body pain some people with long COVID or ME/CFS experience, according to Sarah Annesley, a microbiology senior research fellow at La Trobe University in Australia who studies both conditions. This theory can also help explain why alcohol intolerance may disappear or become less severe over time. As your body clears the virus and begins to recover from the injuries it caused, there’s less chaos triggering your mast cells to release extra histamine.
Are you more likely to develop long COVID if you drink alcohol during an active infection?
You’ll also want to avoid drinking alcohol when taking certain medications, as some drugs can worsen symptoms of alcohol intolerance. Taking antihistamine medication is another no-go because it may hide some symptoms and lead you to drink more. For example, some research suggests that poor sleep can make long COVID worse, and difficulty sleeping is a common side effect of drinking alcohol. Some evidence suggests that post-COVID-19 fatigue syndrome may share characteristics with ME/CFS, a condition where approximately 4 out of 5 people exhibit alcohol intolerance. There are reports that suggest that alcohol tolerance and susceptibility to alcohol-related diseases may differ among racial and ethnic groups 1-3,31,32.
Preventing hangovers can include drinking slowly on a full stomach, drinking in moderation, drinking a glass of water in between drinks, and assessing drinking limits based on gender and weight, according to Harvard Health. The 60-year-old man told researchers that after recovering from acute COVID-19, he now gets headaches when he consumes the same amount of alcohol he drank before the infection. Consult a healthcare professional about whether you can drink alcohol while using these medications. It’s also worth noting that the effects of alcohol — and a hangover — may be particularly unpleasant if you also have COVID-19 symptoms. Alcohol can cause digestive upset, difficulty sleeping, trouble with concentration, and other unpleasant side effects that may worsen your symptoms. MINNEAPOLIS — Long after getting infected with coronavirus, some people are having new reactions to alcohol, according to a recent study.
Several anecdotal reports suggest that alcohol intolerance may be linked to long COVID, specifically the post-viral fatigue syndrome (PVFS) type. Alcohol sensitivity is also emerging as a possible symptom of long COVID, but very little medical research has looked into the phenomenon. The new study is limited, analyzing the cases of four Stanford patients who had long COVID symptoms lasting longer than a month, but offers a serious look at the possible link.
Common antiviral medications used for COVID-19 include remdesivir (Veklury), nirmatrelvir with ritonavir (Paxlovid), and molnupiravir (Lagevrio). There’s no consensus on whether alcohol affects the antiviral medications used to treat COVID-19. If you’re ready to enter treatment and stop drinking, you’ll likely have to wait until your COVID-19 infection is no longer transmissible before you enter a detox program.
An NIH spokesperson said in an email that the topic was not asked about or analyzed in the agency’s own research, published in May 2023. Making matters worse, alcohol not only contains histamine — it’s a byproduct of the fermentation and brewing process — but it also pushes mast cells to release more of it and then blocks an enzyme called the DAO enzyme from breaking histamine down. The liver processes everything we consume, including alcohol, so when the organ is injured or weakened in any way, it becomes vulnerable to further injury when exposed to toxins, like alcohol, Komaroff said. Both conditions can cause nausea, but an alcohol allergy is typically more painful and can be life-threatening if untreated. Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.
