Alcohol flush reaction, AFR ( also knows as Asian flush, Asian red or Asian glow ), is a condition in which the face and/or body experiences flushes or blotches, due to an accumulation of acetaldehyde. It is associated with the erythema ( reddening caused by dilation of capillaries ) of the face, neck, shoulder and in some cases, the entire body after consumption of alcohol.
Research has shown that alcohol flush reaction is indicative of ALDH2 deficiency. The inability to process acetaldehyde in an efficient way leaves it to accumulate in the system. Over extended periods, acetaldehyde can cause damage to kidney, liver and other tissues. Research shows that an ALDH2-deficient drinker who drinks 2 beer per day has 6 – 10 times the risk of developing esophageal cancel as a drinker not deficient in the enzyme.
AFR is estimated to be as much as 50% of the Asian population. It is not known why such a high percentage of Asians posses the genetic makeup which linked to acetaldehyde dehydrogenase-2 ( ALDH2 ), which breaks down acetaldehyde, a product of the metabolism of alcohol. Native Americans are highly susceptible to this condition as well.
C2H6O (ethanol) → C2H4O (acetaldehyde) → C2H4O2 (acetic acid) → Acetyl-CoA → 3H2O + 2CO2 + Energy
Once alcohol enters the bloodstream, ADH ( alcohol dehydrogenase ) turns ethanol into acetaldehyde. The gene coding for enzyme ADH is 1.1.1.1 on chromosome 4, locus 4q21-q23.
Then ALDH2 converts the acetaldehyde into acetic acid. The gene coding for enzyme ALDH2 is 1.2.1.3 on chromosome 12, locus q24.2. Acetaldehyde is a highly unstable compound and quickly forms free radical structures which are highly toxic if not quenched by antioxidants such as ascorbic acid and Vitamin B1.
Conversion of acetic acid to acetyl-CoA is assisted by ACSS2. The gene coding for ACSS2 is 6.2.1.1 on chromosome 20 locus q11.22.
Finally, acetyl-CoA enters citric acid cycle , and formed CO2, H2O and energy.
When the body is slow in converting the acetaldehyde into acetic acid, the acetaldehyde caused nausea, headache, drowsiness, light-headedness, drop of blood pressure, blotched skin, facial swelling, fatigue, racing pulse, vomiting and even stomach bleeding.
Treating AFR
Anecdotal evidence suggests that ingestion of low doses of heartburn medicine, containing ranitidine or famotidine, may be able to relieve the body of symptoms if taken 30 – 60 minutes before drinking. Although ranitidine has been proven to significantly increase blood alcohol content.
Experts suggest that consuming certain food before drinking may help. Some say that food that contain starches may coat the stomach, thus reducing the ingestion of alcohol. Some suggest that sugary foods may help reduce the effects of AFR.
However, there is currently no permanent cure for AFR. The fact remains that alcoholism rate are lower among Asians groups, possible due to the adverse reaction of AFR.
While it may be embarrassing and uncomfortable, our body discomfort towards alcohol should be treated as a sign that something is not right within our body. It’s important to follow our body’s response to reduce or avoid harm or damages to our body.
