Not drunk but …. deficiency.

 Whenever I went to have a drink with my friends (it doesn’t matter what I drink, be it wine, liquor or beer), my face starts to glow red after a glass or two. It got worst after countless of glasses. People always thought I’m drunk when they see my flushing red face but the fact is that I’m not at all. It actually gets embarrassing, especially if we are at a bar instead of a club.

Then I chanced upon this topic while doing some revision for one of my module in school.

First and foremost, alcohol is metabolized in the liver. The first step in metabolism of alcohol is the oxidation of ethanol to acetaldehyde, catalyzed by alcohol dehydrogenase (an enzyme). Then, the acetaldehyde is further oxidized to acetic acid by aldehyde dehydrogenase (also an enzyme). Finally, it is being converted to carbon dioxide and water through the citric acid cycle.  

Due to a deficiency in aldehyde dehydrogenase, specifically aldehyde dehydrogenase 2 (ALDH2), it inhibits the conversion of acetaldehyde (highly toxic) to acetic acid. Thus, it results in an accumulation of acetaldehyde in blood and tissues of affected person who drink alcoholic beverages. An elevated acetaldehyde levels in the body lead to immediate and unpleasant symptoms including facial flushing, tachycardia, headache, nausea and dizziness.

Apparently this deficiency is almost non-existent in Caucasians and mainly occurs in the Orientals.

Some ways this might be helpful:

  1.   Eating food rich in protein or complex carbohydrates before drinking reduces flushing. This slows down the speed of alcohol getting metabolized and acetaldehyde formation in the blood.
  2.  Taking low dose of H2 receptor antagonist before drinking helps in flushing. However, it’s best to consult with your doctor first.

ALDH2 deficiency is a genetic inherited disease so currently there is no cure. Oh well, I guess we just have to reduce the amount of alcohol intakes then. 


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