Patients may be advised to avoid the type of drink or ingredient that may be triggering symptoms. The connection between differences in alcohol type and physiological effect is unclear, including whether it is the ethanol content itself or other compounds that are contained within various types of drinks, such as histamines and sulfites. More investigation is needed to understand the differences in response depending on the type of alcoholic beverage consumed, such as beer, hard liquor, or wine 34. While research on post-COVID alcohol intolerance is still limited, anecdotal evidence suggests that it’s a symptom experienced by many people following the virus.
If you’re experiencing post-COVID symptoms that impact your daily life, you don’t have to wait it out. While we’re still learning about how to treat long COVID, there are treatments that can help manage your symptoms and quality of life. Patients undergo a thorough evaluation process that includes a medical history review, physical examination, and laboratory workup.
It’s a hallmark symptom of POTS (postural orthostatic tachycardia syndrome), which about 2% to 14% of people who test positive for COVID end up developing. That’s all to say that an injured liver — or an undiagnosed liver disease, which Rachakonda says is very common because most cases are symptomless — likely won’t process alcohol as it should. It’s possible that people who cannot tolerate alcohol after COVID may have sustained an acute liver injury from their infection or have an undiagnosed liver condition. 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.
COVID can injure the liver in more ways than one, and some experts, like Malcolm, the long COVID doctor, suspects the disease causes “a little bit more injury to the liver than we thought that’s not apparent in standard lab tests.”
While alcohol intolerance and hangovers can often be brushed off as symptoms of drinking, it has greater impacts than we may realize. Other potential mechanisms include disruption of the gut microbiome, which has been reported in long COVID and can also be caused by alcohol. This disruption could affect alcohol absorption and trigger inflammation in the liver, brain and elsewhere. That inflammation, in turn, may be connected to aggravated symptoms and patient discomfort. Current recommendations for the management of alcohol sensitivity include abstinence, avoidance, or the use of antihistamines to see if the severity of the reaction may be reduced 33.
Since this is a case report of just four patients, no causality can be established between long COVID and alcohol sensitivity. Treatment for long COVID, including symptoms like alcohol intolerance, typically involves a multidisciplinary approach aimed at managing specific symptoms and improving overall well-being. However, due to the limited available data on post-COVID-19 alcohol intolerance, it’s unclear whether it’s a temporary or long-term symptom. 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.
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Anecdotal evidence has indicated a potential link between COVID infection and increased alcohol sensitivity. That sensitivity can cause headaches, severe hangover-like symptoms and other effects, including intoxication at low levels of consumption. The patient used to consume several drinks per week and drink socially, but reported that she had not consumed alcohol for the last seven months due to decreased tolerance.
- A subset of PASC has been compared to ME/CFS 12-15 due to the overlap in symptom presentation in patients with these syndromes.
- The duration and frequency of treatment will depend on the extent of your alcohol intolerance symptoms and other long COVID-related complications.
- Alcohol intolerance is not included in the current list of long COVID symptoms on Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) websites.
The Symptoms of Alcohol Intolerance in Long COVID Patients
Even when you’re not alcohol intolerant, the buildup of acetaldehyde in your body makes you sick when you drink too much. In new research published in December, Stanford doctors documented the experiences of four people who experienced long COVID. All of them drank regularly — or often — in social situations, but months or even a year after infection patients reported a shift in alcohol tolerance.
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The 40-year-old woman said drinking even small amounts of alcohol makes her feel as if she has “alcohol poisoning.” The 49-year-old woman told researchers a glass of wine made her feel as if she couldn’t move. The term “long COVID” represents at least four different syndromes, including those that result from organ damage or an ICU stay. Of these syndromes, post-viral fatigue syndrome (PVFS) is the only one that causes alcohol intolerance without organ damage. The good news is that you can avoid alcohol intolerance by avoiding booze altogether. You’ll also want to avoid drinking alcohol when taking certain medications, as some drugs can worsen symptoms of alcohol intolerance.
- Other therapies include lifestyle modifications, such as dietary changes and exercise plans, to improve overall well-being.
- Post-acute sequelae of SARS-CoV-2 (PASC), also known as long COVID or post-acute COVID-19 syndrome, describes new or worsening symptoms that can last for months and even years following acute COVID infection 10.
- However, these medications can cause unpleasant side effects, like headaches, which may be worsened with alcohol use.
- While more research is still needed, at least one peer-reviewed study concluded that long COVID has a causal link to increased alcohol intolerance.
- The study, conducted by researchers at Stanford Health Care and published in the journal Cureus late last year, reports that some people with long COVID experience a dramatically decreased ability to tolerate alcohol, even in small amounts.
Addressing Long COVID Symptoms: A Comprehensive Approach
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. While research on alcohol intolerance post-COVID-19 is limited, numerous anecdotal reports suggest that alcohol intolerance could be a symptom of long COVID for some individuals. Alcohol intolerance can happen even to those who aren’t experiencing long COVID, may disappear or become less severe with time, and can be triggered by specific types of alcohol but not others. Although inconvenient, not being able to drink alcohol isn’t the most earth-shattering of symptoms compared with more serious effects. Other lingering symptoms of COVID can include fatigue, rapid heart rate, depression, anxiety and joint pain.
Some people describe feeling sick after consuming only a small amount of alcohol, while others report experiencing hangover-like symptoms that seem disproportionate to their alcohol intake. There’s growing evidence that it may be a unique symptom of long COVID, particularly the post-viral fatigue syndrome (PVFS) type. While not widely recognized as a symptom of long COVID due to limited research, alcohol intolerance has been reported by some individuals.
This has become a cause of concern for many individuals who are struggling to manage the lasting impacts of COVID-19. The onset of fatigue, muscle aches, muscle twitches, headaches, and problems thinking followed a documented case of COVID-19, and my ongoing symptoms are severe enough to be undeniable. My energy level averages about 50 percent of my prior normal, nine months after the initial infection. But I wonder about the thousands of people who have long COVID that may not even recognize it. 10 to 30 percent of all COVID-19 infections result in fatigue lasting longer than three weeks. There is no test for long COVID, and though it is gaining recognition, few American medical providers know how to screen for it.
However, these cases reported here may reflect a larger population of individuals with PASC who suffer from new-onset alcohol sensitivity following COVID-19. Objective measures, such as blood alcohol levels, in future research on larger cohorts would also provide additional quantitative insight into the degree of alcohol reaction relative to ingested amount. She also reported worsening anxiety and depression in addition to myalgias and arthralgias with numbness in her hands and feet. Prior to the patient’s acute COVID infection, she drank socially without issue, but post-COVID infection, similar amounts of alcohol results in symptoms of flushing and headache.
“One drink is defined as 12 fluid ounces (360 milliliters) of beer that has about 5% alcohol, 5 fluid ounces (150 milliliters) of wine that has about 12% alcohol, or 1½ fluid ounces (45 milliliters) of 80-proof liquor.” The 60-year-old man told researchers that after recovering from acute COVID-19, he now gets headaches when he consumes the same alcohol intolerance after covid amount of alcohol he drank before the infection. When I tested positive, I self-isolated, and he became the single parent of our two school-age children for the following two weeks. We will never know if he got the infection, but our suspicions were raised when he had a night of shaking chills four days after my first symptoms.
