Hereditary Angioedema and Alcohol: Is Drinking Safe?

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How Alcohol Affects HAE

While alcohol isn’t considered a typical HAE trigger, it may contribute to swelling in some people, says Julia Montejo, MD, an allergist and immunologist at Parkview Health in Fort Wayne, Indiana. Alcohol is a vasodilator, meaning it widens blood vessels, she says, adding that this vasodilating effect may contribute to fluid leakage and swelling.

Even so, it’s a different mechanism from the one that causes HAE attacks. HAE is a rare genetic condition, and its attacks are driven by excess bradykinin.

 In the most common types of HAE, a protein called C1 inhibitor, which normally controls bradykinin production, is missing or doesn’t work properly.

 Excess bradykinin allows fluid to leak into surrounding tissue, causing swelling in different parts of the body, such as the face, hands, feet, abdomen, or throat.

Swelling after drinking doesn’t necessarily mean that alcohol triggered an HAE attack. Researchers haven’t determined whether alcohol activates the bradykinin pathway or why some people report HAE attacks after drinking.

Bielory suggests paying attention to whether avoiding alcohol changes how often attacks occur. If they become less frequent when you stop drinking, that may indicate that alcohol is one of your personal triggers.



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