Even the tiniest amount of alcohol can bring on severe facial flushing, rapid heart rate, nausea and throbbing headaches in millions of people as a result of a genetic deficiency.
But now there may be new hope for those who ‘can’t hold their drink’ due to a fault in a gene – ALDH2 – that normally helps the body process alcohol.
A Danish biotech firm, Alcolase, is developing a supplement that is swallowed just before drinking alcohol which, it claims, will break booze down in the stomach before it gets a chance to enter the bloodstream, triggering unpleasant effects.
The supplement, which comes as a gel in a capsule, or a liquid that you drink, contains enzymes that instantly convert alcohol into harmless by-products that are flushed out as waste.
As well as helping those with alcohol intolerance, the supplement is likely to stop people getting drunk – or even enjoying any of the buzz they normally get from alcohol – as it’s dispatched from the body before it can reach the brain, potentially suggesting another future use in helping reduce alcohol consumption in problem drinkers.
Still in the development stage, the Alcolase supplement is currently aimed at people who have the genetic variant but want to be able to consume alcohol socially without standing out from the crowd by ordering soft drinks.
When we drink alcohol, the liver then converts the ethanol it contains into another chemical, called acetaldehyde.
In most people this toxic substance is quickly cleared from the body by an enzyme called ALDH2 – unless they drink too much, leading to effects such as severe facial flushing, headaches, racing heart and nausea.
Danish firm Alcolase is developing a supplement that is swallowed just before drinking alcohol which, it claims, will break booze down in the stomach before it enters the bloodstream
Andrew Misell, a spokesman for the charity Alcohol Change UK, says that for those lacking in the right gene to break down alcohol rapidly, it gets converted into toxins that have been shown to increase the risk of certain cancers
But millions of people have a genetic variant of the ALDH2 gene which makes this enzyme almost completely ineffective. It’s particularly common in people of East Asian origin, including those from China, Korea and Japan, where roughly one in three people are affected. Among Western populations it’s under 5 per cent.
One theory is that some people evolved to carry this genetic deficiency as a built-in warning that alcohol is a poison – though why this evolved in some populations and not others is not clear.
This genetic intolerance to alcohol is different from the allergic reactions that people can experience to other ingredients.
Some studies, for example, suggest up to one in ten are hypersensitive to sulphites, which are used as preservatives in wine. These can trigger symptoms such as wheezing, coughing and chest tightness within minutes.
But there can sometimes be a heavy price to pay for those with a genetic intolerance who endure debilitating symptoms in order to continue enjoying alcohol.
Adults with a defective ALDH2 gene were more than three times more likely to develop cancer of the oesophagus (food pipe) than those who didn’t have the gene fault, according to a 2021 study by researchers at Chonnam National University in South Korea, published in the journal BMC Cancer.
This is thought to be due to the cumulative toxic effects of acetaldehyde on the oesophagus. A separate 2021 study, at Seoul National University Hospital in South Korea, found that light to moderate drinkers who carried the genetic fault were 20 per cent more likely to develop stomach cancer.
Among heavy drinkers with the genetic deficiency, the risk more than doubled.
‘Alcohol is a toxin for all of us,’ explains Andrew Misell, a spokesman for the charity Alcohol Change UK.
‘But most people are able to produce the enzymes needed to break it down fairly rapidly.
‘For those lacking the right gene, it gets converted into toxins that have been shown to increase the risk of certain cancers.’
He points out there are various products available online or over-the-counter claiming to help with the breakdown of toxic acetaldehyde, but none has been proven to do so in clinical trials.
The Alcolase supplement, which has yet to be tested on humans, works by absorbing alcohol as it enters the stomach.
The delicate man-made enzymes it contains are protected against the harsh, acidic environment of the stomach by a tough outer layer of fats. However, this shell allows ethanol to pass through it, so that once it comes into contact with alcohol the enzymes can get to work on breaking it down quickly.
The company hopes to start testing the supplement in the next few months.
Dr Peter Rice, a consultant psychiatrist and chair of the Institute of Alcohol Studies, said it could potentially help those who, despite carrying the genetic fault, still want to consume alcohol to ‘fit in’.
He told Good Health: ‘In my experience, the anxiety people have of being the odd one out is usually self-generated.
‘Once they quit alcohol, they realise that peer pressure is nowhere near as powerful as they thought it would be.’
