Why Gogglebox’s Mary can’t stomach a drink
After an indulgent festive season, many of us will have a dry month. But for those like writer Mary Killen, it’s a health complaint that wrecks your tolerance for alcohol
Writer Mary Killen used to unwind with a few glasses of wine ‘five or more days a week without any effect’. it was one of the joys of her life. But all that abruptly changed three years ago following a five- day bout of campylobacter food poisoning, brought on, she suspects, by eating ‘grubby’ vegetables from the garden.
Mary, the author of the Spectator’s agony aunt column and a stalwart of Channel 4’s Gogglebox, needed a course of antibiotics, so severe were the symptoms of vomiting and diarrhoea.
‘immediately afterwards, i found i couldn’t face alcohol,’ says Mary, who lives in Marlborough, Wiltshire, with her husband Giles.
‘i remember going to a house party on the isle of Mull a short time later. All sorts of wonderful wines were being served and i couldn’t touch any of them. it made me recoil — reminding me of when i was pregnant with our two daughters, both of whom are now i n their 20s. it has completely lost its appeal. i don’t even like the smell of it.’
Mother- of-five Lucille Whiting had a similar experience. Never a big drinker, Lucille used to enjoy unwinding with her husband every few weeks by watching a film and sharing a bottle of wine.
But following a bout of Covid in April, Lucille, 39, a jewellery designer from Suffolk, doesn’t just recoil from alcohol, she finds it also makes her ‘horribly sick’.
She made the discovery after trying a glass of wine in August, following her recovery from the virus.
‘We had a couple of glasses on a Friday night and i ended up being sick for most of the weekend,’ says Lucille. ‘i had pain in my sides, towards my back; severe nausea and vomiting; and chills. i had to sit under a blanket, frozen.’
Neither Mary nor Lucille can now drink anything harder than lemonade.
So why should an i l l ness prompt someone to go off alcohol? there are various theories, say experts.
‘One wild theory — and i stress it is a wild theory — is that serious infection may affect the microbiome or genetic material of gut bacteria,’ says rajiv Jalan, a professor of hepatology at University College London.
‘the gut is innovative because it has lots of nerves and links with the brain. So if the gut bacteria are altered — as can happen after an infection or a course of antibiotics — it may have an impact on the desire for drinking alcohol.’
This chimes with Mary’s experience, as the only other time she has gone off alcohol (aside from during pregnancy) was in 1999 after a bout of Legionnaires’- related pneumonia ( caused by t he Legionella bacterium) and a course of antibiotics.
it took her ten years to feel like drinking again. ‘i don’t know if it was physiological or psychological, but i couldn’t face it,’ she says.
Some people find they suddenly go off alcohol even without falling ill, says Professor David Lloyd, a consultant liver and laparoscopic surgeon at University hospitals of Leicester NhS trust.
An intolerance to alcohol can happen due to a lack of enzymes, i ncluding aldehyde dehydrogenase, needed to break down acetaldehyde, the toxic compound produced when alcohol is processed by the liver.
‘if these enzymes don’t function properly, or if there is a deficiency, then you can get a reaction — or rather an overreaction — of the liver,’ says Professor Lloyd.
Symptoms include flushing of the skin and a runny nose (as a result of alcohol dilating the tiny blood vessels in the body), as well as a fast heart rate.
Some may also feel nauseous or actually be sick when they drink, as the toxins will build up in the liver rather than be broken down.
‘Anyone can have this genetic defect, though it seems to be more common in certain ethnic groups,’ says Professor Lloyd. ‘For example, the Chinese and Vietnamese populations tend to have low levels of the liver enzyme that converts alcohol to acetaldehyde.’
reactions may vary according to the type of alcohol, too, but the reason isn’t clear. For some people, red wine may provoke a response rather than beer, for instance.
Once this develops, the only reliable way to avoid symptoms is to refrain from drinking alcohol, although some people may be able to tolerate drinks with low alcohol content, such as spritzers. Professor Lloyd says it is also possible to develop an alcohol allergy, which occurs when the immune system overreacts to ingredients in it, such as barley in whisky or sulphites (preservatives used in wine-making).
this can cause itchy eyes or even the severe reaction anaphylaxis, which can l ead to breathing difficulties. Some may experience vomiting, caused by the body trying to get rid of the substance it perceives as a threat. Although most common among people with existing allergies and asthma, Professor Lloyd says it could strike anyone at any stage of life.
‘there are reports of people becoming allergic to alcohol after illness or randomly,’ he says. ‘there is a blood test called ige (referring to i mmunoglobulin e, t he antibodies produced during an allergic reaction), which can help i dentify this allergy. Your GP can refer you to an allergy clinic.’
Age can be a factor, too, as liver function tends to decrease with age, says Professor Jalan. ‘ the capacity of the body to detoxify the liver of alcohol seems to reduce with age, and that may well have an impact on the way people feel about drinking when they are older.’
Someone who l oses a l arge amount of weight may also notice their tolerance to alcohol reduces, says Dr Shireen emadossadaty, a GP based i n London. ‘ that’s because as weight changes, the amount of tissue through which alcohol can diffuse through the body also changes.’ Women have reported that the menopause has put them off alcohol, too, possibly as a consequence of hormonal changes in the body.
Lucille has been told by her GP that Covid may have made her intolerant to alcohol. indeed, much remains unknown about the residual effects of Covid.
Mary, meanwhile, is happy to stick to alcohol-free drinks, although quietly wonders if she will get a taste for alcohol again, as happened after her pneumonia.
‘i save about three hours a day,’ she says. ‘Drinking takes up a lot of time—especially when socialising, although obviously we can’t do that at the moment.
‘i wake up with a clearer head. i enjoy reading more or listening to online lectures in the evenings rather than drinking.
‘Last time, my intolerance lasted ten years. Will it end sooner this time? Who knows?’
Lucille says she won’t try alcohol again after the intensity of the last reactions. ‘i have no desire to feel that awful again,’ she says.
‘i’ve got a family and a business to run. i’m just going to have to manage without the occasional drink — i’d much rather feel well.’