Ever since I was in college, I would get wildly embarrassed anytime just a few sips of alcohol entered my system. That's because every time I drink, my face, neck, chest, and even my legs and arms turn bright red — almost purple, actually. My cheeks and chin get really blotchy, as if I've just broken out in a rash. And my heart starts to furiously beat out of my throat, like I'm about to choke on my own pulse. This does not make for a pleasant happy hour with friends and co-workers.
My friends and I would affectionately refer to this as the "Asian glow," but I always knew deep down inside that there was a scientific explanation for my discomfort with alcohol. I spoke to Dr. Luiza Petre, board-certified cardiologist and weight-loss specialist, who explained the "Asian glow" in great detail.
"Alcohol metabolism is dependent on two enzymes: alcohol dehydrogenase that converts alcohol to acetaldehyde, and acetaldehyde dehydrogenase that further converts acetaldehyde to harmless products," Dr. Petre told me. Here's how this applies to the "Asian glow."
"Eighty percent of Asians have a hyperfunctional alcohol dehydrogenase," Dr. Petre said. That means we metabolise alcohol to acetaldehyde up to 100 times faster than others, but we never really experience the buzz that normally comes with booze. "Additionally, 40 percent have some sort of malfunction of acetaldehyde dehydrogenase that metabolises further down the acetaldehyde," she continued.
This is essentially a "double whammy;" we metabolize alcohol far too quickly into "a toxic stage where it can't easily get out." In other words, that glass of wine is converted to acetaldehyde too fast, and it just gets stuck inside of us — then uncomfortable side effects ensue. Basically, our bodies aren't fully equipped to break down alcohol in a safe and enjoyable way. It's safe to call this an alcohol allergy.
Dr. Petre also said this flushed red look is due to a histamine pathway. "A histamine release is the final byproduct on the battleground between our body and anything considered a threat," she said. "This histamine release increases capillary permeability and acts as a vasodilator, therefore leading to swelling and redness, nasal symptoms, and other GI symptoms including diarrhea, nausea, and vomiting."
Facial redness or flushing is very commonly seen among many Asians and others who have a similar reaction to alcohol. "It is mainly due to its vasodilator properties. One of the alcohol metabolites, the acetaldehyde, stimulates the release of the histamine."
Well, at least now I know. If any of this sounds familiar to you, you probably have the same allergy-like response to alcohol as I do. So what are we supposed to do? Swear off booze forever?
You don't have to. "Pepto-Bismol and Pepcid AC, or any generic Famotidine, are histamine blockers," Dr. Petre pointed out. I learned this in my college years when a friend suggested I take two Pepcid AC's one hour before drinking. I thought she'd lost her damn mind, but when I tried it, I realised that it worked pretty well. It wasn't able to entirely prevent the embarrassing flush, but it at least tamed it.
"Benadryl or anti-histaminic medications that stop the histamine release have been used to mitigate this reaction," she continued. "However, the body still has to handle the excess acetaldehyde, and that has been linked to increased cancer risk." Yes, you read that right. A cancer risk. That's why I rarely touch alcohol these days. If my body isn't equipped to handle it, it probably shouldn't have it.
Taking these anti-histaminic medications are only a band-aid for the actual problem. People like me "are slow acetaldehyde metabolisers," so Dr. Petre says it's best to pace down our drinks "to a maximum of one per every two hours, all the while diluting it with enough hydration."
"Listen to your body," Dr. Petre concluded. "When you turn red, you have to stop drinking."