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ALDH2 and Alcohol Processing: What Your Genotype Means for Health and Wellness

When you drink alcohol your body converts it into acetaldehyde, a toxic compound that can cause flushing, nausea, and heart palpitations if it accumulates. The ALDH2 gene makes an enzyme responsible for turning acetaldehyde into a harmless substance. Variations in ALDH2 change how well that enzyme works and can affect how your body responds to alcohol and certain foods. Below is a clear explanation of what different genotypes mean and practical steps you can take to support safe alcohol and acetaldehyde handling.

How ALDH2 affects your body

  • Normal ALDH2 activity helps convert acetaldehyde to acetate so it is safely cleared.
  • Reduced ALDH2 activity causes acetaldehyde to build up, producing the alcohol flush reaction and other symptoms.
  • Chronic acetaldehyde exposure is associated with increased irritation and potential health risks, so reducing exposure and supporting detoxification matters.

Practical recommendations

These steps are general, patient friendly, and meant to help you manage acetaldehyde exposure. They do not replace medical advice. PlexusDx does not provide medical advice. Always consult with your healthcare provider before making changes to medications, diet, supplements, or lifestyle.

  • Limit or avoid alcohol. For people with reduced ALDH2 activity, even small amounts of alcohol can cause symptoms and increase exposure to acetaldehyde.
  • Be cautious with acetaldehyde-rich foods and beverages. Examples include fermented foods, some aged cheeses, certain processed foods, and some coffee preparations.
  • Stay well hydrated. Water helps support liver and kidney function and assists in clearing metabolic byproducts.
  • Support liver health through a balanced diet rich in vegetables, lean protein, whole grains, and healthy fats. Avoid excess sugar and processed foods.
  • Consider supplements that support antioxidant and detox pathways. Common options include glutathione precursors like N-acetylcysteine and other antioxidants. Discuss any supplement with your healthcare provider, especially if you take prescription medicines.
  • Monitor symptoms. If you experience intense flushing, severe nausea, fainting, or irregular heartbeat after drinking or eating certain foods, seek medical advice.

Diet and supplement ideas

  • Eat regular meals that include protein and fiber to slow alcohol absorption when alcohol is consumed.
  • Focus on foods rich in sulfur amino acids and antioxidants that support detox: cruciferous vegetables, garlic, onions, eggs, legumes, berries, and leafy greens.
  • Consider foods that support glutathione production: lean protein, Brussels sprouts, spinach, and avocados.
  • Supplements to discuss with your clinician: N-acetylcysteine (glutathione precursor), alpha lipoic acid, milk thistle (silymarin), and vitamin C. These may support antioxidant defenses but do not replace avoiding exposures.

Lifestyle and monitoring

  • Limit exposure to environmental aldehydes such as tobacco smoke and heavy air pollution.
  • Get regular health screenings and discuss any family history of alcohol-related cancers or liver disease with your healthcare provider.
  • If you are taking medications, confirm with your clinician that they are safe with any supplements you consider. Some supplements interact with drugs or affect liver enzyme activity.
  • Consider keeping a symptom diary to track what triggers flushing or other reactions. Include foods, beverages, and amounts to share with your clinician.

Genetic interpretations

2 effect alleles (AA) — Severely reduced ALDH2 activity

If your genotype is AA for rs671 you carry two copies of the effect allele. This causes severely reduced ALDH2 enzyme activity and a marked inability to convert acetaldehyde to harmless acetate. When you consume alcohol acetaldehyde accumulates rapidly and you are likely to have a pronounced alcohol flush reaction. Symptoms can include intense facial redness, a sensation of warmth, nausea, and rapid heartbeat.

Recommendations

  • Avoid alcohol entirely. Even small amounts can cause uncomfortable and potentially harmful acetaldehyde exposure.
  • Be cautious with foods and beverages that may contain acetaldehyde, including some fermented products, aged cheeses, certain processed foods, and types of coffee.
  • Prioritize hydration and a nutrient rich diet that supports liver detoxification and antioxidant status.
  • Discuss targeted support with your healthcare provider. Supplements like N-acetylcysteine may help glutathione production but are not a substitute for avoiding alcohol.
  • If you experience severe reactions or persistent symptoms, seek medical evaluation.
1 effect allele (AG) — Partial ALDH2 activity

If your genotype is AG for rs671 you carry one copy of the effect allele. This leads to partially reduced ALDH2 enzyme activity. Your body still removes acetaldehyde but less efficiently than someone with fully active ALDH2. After drinking alcohol you may experience a moderate alcohol flush response such as facial redness, warmth, nausea, or a faster heart rate.

Recommendations

  • Limit alcohol intake. Moderation reduces acetaldehyde buildup and symptom risk.
  • Avoid binge drinking and avoid mixing alcohol with other substances that affect the heart or liver.
  • Be mindful of acetaldehyde containing foods including some fermented items, aged cheeses, and certain processed products. Track triggers in a food and symptom diary.
  • Support detox pathways through hydration, balanced nutrition, and avoiding tobacco smoke and other environmental aldehydes.
  • Talk with your clinician about supplements that support antioxidant capacity if you consider them.
0 effect alleles (GG) — Typical ALDH2 activity

If your genotype is GG for rs671 you carry two copies of the non-effect allele, which is associated with normal ALDH2 enzyme function. Your body converts acetaldehyde to acetate efficiently, so you are less likely to develop the alcohol flush reaction. This genotype means standard alcohol metabolism through ALDH2, but normal cautions about alcohol use and health still apply.

Recommendations

  • Follow standard public health guidance for alcohol use. If you choose to drink, do so in moderation and avoid binge drinking.
  • Maintain a balanced diet and healthy lifestyle to support liver health and overall resilience.
  • Be aware that other genes and factors influence alcohol tolerance and long term risk. If you have a family history of alcohol related illness discuss your personal risk with your healthcare provider.

When to talk with a healthcare provider

  • If you experience severe flushing, chest discomfort, fainting, or prolonged symptoms after alcohol or certain foods.
  • If you are considering supplements to support detoxification or antioxidants. Some supplements can interact with medications.
  • If you have a family history of liver disease, alcohol use disorder, or upper digestive tract cancers and want personalized risk management.

PlexusDx provides genetic information to help you understand predispositions and support informed conversations with your clinician. This information is educational only and does not replace medical advice. Always consult with your healthcare provider before making changes to diet, supplements, medications, or lifestyle based on genetic results.