New Alcohol Sensitivity in Patients With Post-acute Sequelae of SARS-CoV-2 PASC: A Case Series, 2023, Eastin, Bonila et al.

[Sean]

Worth noting that beverage alcohol contains a lot more compounds than just ethanol and water (up to several hundred, IIRC), and some of those (e.g. ethyl acetate) contribute disproportionately more to the after effects than the ethanol. So it is possible that we are not reacting to the ethanol itself, or at least not just ethanol.

It is well known that some alcoholic drinks cause worse hangovers than others, a classic example being cider. Even vodka (nominally just ethanol and water) contains some additional compounds.

I got a hold of some lab grade ethanol many years ago and tried it, and it definitely has less payback than commercial beverage alcohol.

Any assessment of alcohol intolerance needs to control for the type of alcoholic drink being consumed, as well as the quantity of ethanol.

Also agree that alcohol intolerance is potentially an important clue as to what is going wrong biologically.

(The practical upshot for ME patients being that if you are going to have an alcoholic drink then the least worst one is good quality plain vodka.)

 

[Mij]

Personally with gluten or caffeine I get very predictable results in relation to reintroduction following elimination, but I have never established a clear pattern in relation to alcohol, however as I have never been much of a drinker it easiest for me just to avoid it completely.

I had issues with caffeine before M.E but now it makes it worse. I'm limited to 2 cups a week and I'm o.k if I drink it after 3 p.m. If I drink a cup in the morning is when my heart rate goes up.

It seems to tie in with my experience of feeling better after 5 p.m and worse in the mornings with OI.

 

[Kiwipom]

I'd fully expect alcohol intolerance in long COVID & ME-CFS due to the known effects of alcohol on GABA receptors and its significant vasodilator, potential histaminergic type effects +/- hepatic metabolism.

Alcohol causes an immediate noticeable drop in HRV- this well known to well, fully functioning athletes who use HRV to guide training and recovery, usually for 1-2 days.

Alcohol also disrupts normal sleep patterns, which are probably key in ME-CFS/LC. Although sleep initiation maybe helped after acute alcohol ingestion the sleep structure is disrupted with less deep sleep, probably due to its GABAergic effects. The vasodilation would significantly exacerbate POTS and exacerbate tachycardia. Some alcohols & their additives also exacerbate histamine release, eg red wines.

I stupidly tested this all by drinking a quarter of a glass ie 60-80ml max of a beautiful Waiheke Albarino on NYE arvo to pretend to be 'normal'. It was a terrible idea which I paid for with exacerbation of tachycardia, low HRV and feeling awfully hungover all the next day. I won't share how much I used to be able to drink, but I was usually the 'let's do shots' person.... Lesson learnt. Alcohol is not good for us.