When you look up potential asthma triggers, you likely won’t find alcohol on the list. However, many people with asthma report experiencing asthma symptoms after drinking alcohol.

Keep reading to learn more about how alcohol can affect asthma and what you can do about it.

What Is an Asthma Trigger?

An asthma trigger is a substance, an activity, or a condition that can worsen your asthma symptoms. When your asthma suddenly gets worse, it’s called an asthma attack or asthma exacerbation.

Possible asthma triggers include:

• Tobacco smoke
• Dust mites
• Pollen
• Air pollution
• Cockroaches
• Mice
• Animal dander
• Mold
• Cleaning and disinfecting products
• Physical activity
• Infections
• Thunderstorms
• Cold, dry air
• Fragrances
• Strong emotions

Asthma triggers vary from person to person. Some people may recognize just a few things that trigger asthma symptoms, while others experience worse symptoms due to a variety of stimuli. Having several asthma triggers can significantly interfere with your daily life.

Can Alcohol Be an Asthma Trigger?

Alcohol isn’t usually listed as one of the important triggers for asthma. However, people with asthma have reported it. In a 2014 survey of adults with asthma, 18 percent of the participants reported alcohol as an asthma trigger. However, the individuals reported alcohol triggered asthma relatively less frequently than other triggers.

An older survey from 2000 of adults with asthma found that about one-third of people self-reported experiencing an asthmatic response after drinking alcohol.

How Can Alcoholic Drinks Act as an Asthma Trigger?

There isn’t much research on the effect of alcohol on people with asthma. Researchers think that alcohol-induced asthma symptoms may be caused by two chemicals found in some types of alcohol — sulfites and histamine.

Sulfites

Sulfites are commonly found as additives in many different foods and beverages, though they do naturally occur in some foods and drinks. They’re typically used to help preserve foods from going bad. Sulfites have been used in winemaking for hundreds of years. In the U.S., food manufacturers are required to list sulfites on food labels if the product contains detectable levels of sulfites (10 parts per million).

Alcoholic beverages that contain sulfites include:

• Red wine
• White wine
• Rosé
• Hard cider
• Beer

Sulfites can trigger asthma symptoms or allergic reactions in some people — known as sulfite sensitivity. Between 5 percent and 10 percent of people with asthma may experience wheezing, chest tightness, or coughing caused by sulfites. People with poorly controlled asthma may be more sensitive to sulfites.

It’s not clear how sulfites can cause asthma symptoms. Researchers think you may inhale some sulfites when you drink wine or beer, causing your airway to constrict.

Histamine

Histamine is a chemical that helps your immune system regulate inflammation. Histamine naturally forms during the fermentation process of wine and champagne. Although histamine can be found in all wines, amounts are usually lowest in white wine and rosé and highest in red wine and champagne. Additionally, the alcohol in wine can block your body from properly breaking down histamine. This means that your body isn’t able to efficiently get rid of the histamine found in the alcohol.

Histamine from alcoholic drinks, especially red wine, is known to cause asthma symptoms. This could be due to the fact that histamine plays a role in airway constriction, swelling, and mucus production.

Are Any Alcoholic Beverages More Likely To Cause Asthma Symptoms?

Asthma triggers can be different for everyone, but some alcoholic beverages may be more likely than others to cause asthma symptoms. Among the general population, about 10 percent of people have wine hypersensitivity — particularly to red wine — with the most common reactions affecting people’s airways. This makes sense since red wines can contain higher levels of sulfites and histamine.

The 2000 survey mentioned above found that wine was the most common alcoholic drink to which people reported having a reaction. Fewer people in this survey reported an asthmatic response to alcoholic drinks containing spirits. Researchers from this study found that people were more likely to have a wine-induced asthmatic reaction if they:

• Were female
• Used oral corticosteroids
• First showed asthma symptoms at a younger age
• Had ever visited an alternative health provider
• Had sensitivity to other foods and drugs, such as sulfite-containing foods, aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs)

More research about the link between alcohol and asthma is needed to learn which drinks may be more or less likely to trigger asthma symptoms. Your doctor can help you recognize which alcoholic drinks may be triggers for you.

Managing Asthma Triggers

The best way to manage your asthma triggers is to avoid them. Since everyone’s triggers are different, it’s important that you know what your triggers are so you can try to steer clear of them. If you experience an asthma attack while drinking a specific type of alcohol, like wine, you may want to avoid that drink in the future.

If you have a sulfite sensitivity, remember that even though alcohol spirits usually don’t have high sulfite levels, they might be present in the ingredients of a cocktail. If you have a cocktail made with spirits, you should remember to check for sulfite-containing ingredients, such as:

• Fruit juices
• Soft drinks
• Maraschino cherries
• Lemon or lime juice

If you do experience worsening asthma symptoms or an asthma attack, you should follow the steps in your asthma action plan. You can prepare for an asthma emergency by doing the following:

• Learn how to properly use your asthma medications, including inhalers.
• Take all of your asthma treatments exactly as your doctor tells you.
• Get familiar with your asthma action plan.

Alcohol’s Effect on Your Overall Health

Excessive alcohol use can increase your risk of developing other medical problems, such as:

• Cardiovascular (heart) disease
• Hypertension (high blood pressure)
• Liver disease
• Digestion problems
• Increased risk of cancer
• Weakened immune system
• Depression and anxiety

The Centers for Disease Control and Prevention (CDC) recommends that adults of legal drinking age choose to drink in moderation or not at all. The agency recommends that men drink no more than two drinks per day and women consume no more than one. In this context, one drink refers to:

• 12 ounces of beer
• 8 ounces of malt liquor
• 5 ounces of wine
• 1.5 ounces of spirits

Excessive Alcohol Use and Asthma

Some medical conditions caused by excessive alcohol intake may be related to asthma.

For example, certain digestion problems, such as gastroesophageal reflux disease (GERD) — also known as chronic acid reflux — can worsen asthma symptoms and make you more sensitive to triggers.

If your immune system is weaker due to alcohol, you may have an increased risk of infections like the flu or COVID-19. People with asthma may have a higher risk of developing complications from these infections.

Talk to your doctor about how you can drink alcohol safely with your specific asthma triggers and symptoms.

Chat With Others Who Understand

On MyAsthmaTeam — the social network for people with asthma and their loved ones — more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with asthma.

Are any alcoholic drinks an asthma trigger for you? How has it affected your life? Share your experience in the comments below, or start a conversation by posting on your Activities page.