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Alcohol intolerance
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'''Alcohol intolerance''' may occur in [[ME/CFS]]. It usually develops after the onset of the illness, where the patient was previously able to tolerate alcohol.<ref name=":2" /><ref name="Chu2019" /><ref name="Woolley2004" /><ref name=":4" /> It may form part of a wider range of allergies and sensitivities that can develop during the course of the illness.{{Citation needed}} Recovery from CFS/ME is often accompanied by the return of alcohol tolerance.<ref name=":2">{{Cite web | url = https://www.prohealth.com/library/alcohol-intolerance-in-cfs-gives-us-a-clue-as-to-the-mechanisms-of-fatigue-37284 | title = Alcohol intolerance in CFS - gives us a clue as to the mechanisms of fatigue | last = Myhill | first = Sarah | author-link = Sarah Myhill | date = 2015-09-21 | website = Prohealth|language=en-US|archive-url=|archive-date=|url-status= | access-date = 2019-07-09}}</ref> A 2019 study with [[Stanford ME/CFS Initiative]] reported that 66% of subjects meeting the 1994 [[Fukuda criteria|Fukuda CFS criteria]] were less able to tolerate alcohol compared to their pre-illness state.<ref name="Chu2019">{{Cite journal | last = Chu | first = Lily | author-link = Lily Chu | last2 = Valencia | first2 = Ian J. | author-link2 = Ian Valencia | last3 = Garvert | first3 = Donn W. | author-link3 = Donn Garvert | last4 = Montoya | first4 = Jose G. | author-link4 = Jose Montoya | date = 2019-02-05 | title = Onset Patterns and Course of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | url =https://www.frontiersin.org/article/10.3389/fped.2019.00012/full | journal = Frontiers in Pediatrics | volume = 7 | issue = | pages = |doi=10.3389/fped.2019.00012|issn=2296-2360|quote=|via=}}</ref> This finding replicates those in a 2004 study of patients fulfilling UK criteria for chronic fatigue syndrome referred to a specialist clinic: two-thirds reduced alcohol intake. The most common reasons were increased tiredness after drinking (67%), increased nausea (33%), exacerbated hangovers (23%) and sleep disturbance (24%).<ref name="Woolley2004">{{Cite journal | last = Woolley | first = James | author-link = | last2 = Allen | first2 = Roz | author-link2 = | last3 = Wessely | first3 = Simon | author-link3 = Simon Wessely | date = Feb 2004 | title = Alcohol use in chronic fatigue syndrome | url =https://linkinghub.elsevier.com/retrieve/pii/S0022399903000771 | journal = Journal of Psychosomatic Research|language=en | volume = 56 | issue = 2 | pages = 203–206|doi=10.1016/S0022-3999(03)00077-1|quote=|via=}}</ref> ==Prevalence== *1995, [[Katrina Berne]], PhD, reported an estimated prevalence of 45-75% for alcohol intolerance (although she notes that this symptom may be underreported and therefore more prevalent than indicated).<ref>{{Cite book | last = Berne | first = Katrina | author-link = Katrina Berne | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition= 2nd |url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ | publisher = Hunter House | page =58 |isbn= 978-0897931915}}</ref> *2001, In a Belgian study, 59.5% of patients meeting the [[Fukuda criteria]] and 63.7% of patients meeting the [[Holmes criteria]], in a cohort of 2073 [[Chronic fatigue syndrome|CFS]] patients, reported alcohol intolerance.<ref name=":4">{{Cite journal | last = De Becker | first = Pascale | author-link = Pascale De Becker | last2 = McGregor | first2 = Neil | author-link2 = Neil McGregor | last3 = De Meirleir | first3 = Kenny | author-link3 = Kenny De Meirleir | date = December 2001 | title = A definition‐based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome | url =https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2796.2001.00890.x?sid=nlm%3Apubmed | journal = Journal of Internal Medicine | volume = 250 | issue = 3 | pages = 234–240|doi=10.1046/j.1365-2796.2001.00890.x|quote=|via=}}</ref> *A 2019 study with [[Stanford ME/CFS Initiative]] reported that 66% of subjects meeting the Fukuda 1994 CFS criteria were less able to tolerate alcohol compared to their pre-illness state.<ref name="Chu2019" /> ==Symptom recognition== ==Research studies== * 2004, Alcohol use in chronic fatigue syndrome<ref name="Woolley2004" /> ==Possible causes== *[[Channelopathy]] has been proposed as a mechanism of the illness which would explain intolerance to alcohol and other drugs.<ref>Verrillo - Channelopathies</ref> *Gut fermentation problems<ref>Verrillo - Gut fermentation and small intestine bacterial overgrowth (SIBO)</ref><ref name=":2" /> *Alcohol is a depressant of the [[central nervous system]], which tends to be hyper-reactive in people with ME/CFS<ref name=":0">Verrillo - Foods to Avoid</ref> *Alcohol is toxic for the liver, and many people with ME/CFS have suboptimal liver function<ref name=":0" /> *Alcohol can interfere with the [[methylation cycle]]<ref name=":0" /> *Alcohol is a vasodilator - this will exacerbate [[vascular symptoms]] such as [[neurally mediated hypotension]] or [[Postural orthostatic tachycardia syndrome|POTS]]<ref name=":0" /> ==Potential treatments== If a patient presents with alcohol intolerance, alcohol should be avoided, including that in mouthwashes and herbal tinctures.{{Citation needed}} ==See also== ==Learn more== * [https://www.prohealth.com/library/alcohol-intolerance-in-cfs-gives-us-a-clue-as-to-the-mechanisms-of-fatigue-37284 Alcohol intolerance in CFS – gives us a clue as to the mechanisms of fatigue] by [[Sarah Myhill]] for [[ProHealth]] ==References== {{reflist}} [[Category:Signs and symptoms]] [[Category:Sensitivity signs and symptoms]]
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