In early December, we added a survey to the website to ask about your experiences with alcohol and how it might have affected your ME/CFS and/or Long Covid.
Alcohol intolerance can cause an immediate or delayed (20-30 mins) uncomfortable reaction. Common reactions include nasal congestion, skin flushing (redness), headaches, low blood pressure, nausea, and vomiting (source: The ME Association).
ME/CFS Research
The original blog cited two research articles about alcohol intolerance and ME/CFS:
- Woolley, et al. Alcohol use in chronic fatigue syndrome | February 2004.
- Maciuch, et al. Alcohol intolerance and ME/CFS | May 2023.
Long Covid Research
- New Alcohol Sensitivity in Patients With Post-acute Sequelae of SARS-CoV-2 (PASC): A Case Series | 29 December 2023
Abstract
Post-acute sequelae of SARS-CoV-2 (PASC), or long COVID, is characterized by persistent symptoms after acute SARS-CoV-2 infection that can vary from patient to patient. Here, we present a case series of four patients with a history of SARS-CoV-2 infection referred to the Post-Acute COVID-19 Syndrome (PACS) Clinic at Stanford University for evaluation of persistent symptoms, who also experienced new-onset alcohol sensitivity.
Alcohol reactions and sensitivity are not well characterized in the literature as it relates to post-viral illness. While there have been some anecdotal reports of new alcohol sensitivity in PASC patients in the media, there is a paucity of published data in the medical literature about this topic. During their medical consultation, the patients self-reported new changes in their symptoms or behaviors following the use of alcohol. A new onset of alcohol sensitivities should be assessed along with other post-COVID-19 symptoms and may provide novel avenues to explore the pathobiology of illness and potential interventions.
Conclusions
New-onset alcohol reactions and sensitivity can occur after COVID-19 infection in patients with PASC. Clinicians assessing PASC patients should inquire about alcohol consumption and tolerance in their social history, as this information can provide insights into potential triggers for worsening symptoms and help guide lifestyle management strategies.
Further research in the form of larger cohort studies is warranted to better understand the prevalence of this association in PASC patients and the range of alcohol reactions and sensitivities and explore potential associations with specific post-COVID-19 clinical phenotypes and other factors with post-COVID-19 alcohol sensitivity. Furthermore, investigating the underlying biological mechanisms responsible for new-onset alcohol reactions and sensitivity may provide valuable insights into the underlying pathophysiology of post-viral conditions, such as PASC and ME/CFS.
The NICE Guideline
In section 1.2.4 of the NICE Guideline on ME/CFS, it recommends that alcohol intolerance is considered an example of other symptoms:
“Be aware that the following symptoms may also be associated with, but are not exclusive to, ME/CFS: intolerance to alcohol, or to certain foods and chemicals.”
ME Association website survey results
Alcohol Intolerance:
41% said I can only tolerate small occasional amounts of alcohol
7% said I couldn't tolerate any alcohol initially, but now find I can drink
41% said I can’t tolerate any alcohol now
Experience of Alcohol Intolerance:
54% said My ME/CFS or Long Covid symptoms increase in intensity
33% said I feel like I have been poisoned
31% Exacerbated hangover
Symptoms:
39% experience Skin flushing (redness)
56% Headaches
71% Increased fatigue
54% Increased sleep disturbance
34% Increased temperature
More Information
- Website survey: Alcohol intolerance, ME/CFS and Long Covid.
- Medical Matters: Alcohol intolerance.