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05.12.2004

Losing the wine flush: a cure for the red face

Ruth, like many Asian Americans, has at times been reluctant to drink wine because of her tendency to turn a deep shade of red after even just half a glass of red or white.

The cause of this "wine flush" has to do with how many Asians metabolize alchohol. Alchohol is absorbed through the stomach and small intestine. About 10 percent is eliminated by the kidneys, lungs, and sweat glands, but the rest is dealt with in the liver by two enzymes: alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). I don't know enough about the body's chemistry to know how these two enzymes actually manage to break down the alchohol, but it's enough to know that they do.

It's this second enzyme (ALDH) that is missing (or low) in up to 50 percent of Asian people, and is not present at all in most Native Americans and Inuits. People with less ALDH will often flush and sweat after drinking alcohol, and if their quantities of the enzyme are quite low, they may also become ill after drinking even small amounts of booze.

Recent studies also suggest women have fewer of these enzymes than men.

The wine flush ranges from a light pink to a deep red purple in my experience, and for many it's embarrassing, which is why my ears perked up the other day when an Asian colleague at work claimed to have a cure for it.

He swore that taking a Pepcid AC tablet before or during drinking, significantly reduced or even eliminated his wine flush.

After a few highly scientific tests, we have found that it really does work. How it works is a mystery that won't be solved here. Pepcid AC contains Famotidine. According to DrugDigest.org, "Famotidine is a histamine-2 receptor blocker, or H2-blocker. It works in the stomach on a pump that releases hydrochloric acid when stimulated by histamine. Famotidine prevents histamine from stimulating this pump, thereby reducing the amount of acid that is released into the stomach." What I don't know, is how the level of acid in the stomach correlates to ALDH levels and alchohol metabolism.

I'm going to spare Ruth the embarassment of having before and after pictures posted here, and as a creative person you couldn't have trusted that I didn't photoshop them anyway. So I simply leave it to you to try yourself, or offer to friends. Ruth is glad to know about it, and especially excited at the prospect of not having to be bright red in her wedding dress after a few sips of Champagne at the reception.

Comments (3)

Alder wrote:
11.24.04 at 9:02 AM

This is one of the most popular entries on this web site, and I used to allow people to comment on it, but now it has gotten to be too much.

I am receiving too many questions that should be directed towards doctors rather than me.

I am also starting to receive blatantly commercial posts designed to advertise pills to "cure" this condition.

Enough is enough. I leave you to your own devices on this one.

Good Luck.

Craig wrote:
05.13.07 at 8:02 PM

I don't think it is just Asian-Americans either. I am Caucasian and have a tendency to flush with wine as well. This seems to only happen with some wines, though. I thought it had something to do with sulfites in the wine, but it may actually be the aldehyde dehydrogenase. I am glad to know your tip about using Pepcid. It seems like I have run across something like this before.... Thanks!

JC wrote:
03.24.09 at 3:46 PM

The New York Times (3/21, Bakalar) reported that, according to a study published in the journal PLoS Medicine, facial flushing while drinking alcohol "may indicate an increased risk for a deadly throat cancer," squamous cell esophageal cancer. Researchers from the National Institute on Alcohol Abuse and Alcoholism said that the "flushing response, which may be accompanied by nausea and a rapid heartbeat, is caused mainly by an inherited deficiency in an enzyme called ALDH2, a trait shared by more than a third of people of East Asian ancestry -- Japanese, Chinese, or Koreans," and may be triggered by "as little as half a bottle of beer." The deficiency itself "results in problems in metabolizing alcohol, leading to an accumulation in the body of a toxin called acetaldehyde." People who are ALDH2-deficient who consume "two beers a day" may have "six to 10 times the risk of developing esophageal cancer as" those "not deficient in the enzyme." This type of cancer kills 83% of those diagnosed within 5 years.

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.1000050

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