Dopamine | ALDH2 (rs671)

The ALDH2 rs671 Variant and Brain Health: What Your Genotype May Mean for Alcohol Sensitivity, Oxidative Stress, and Cognitive Resilience

ALDH2 encodes aldehyde dehydrogenase 2, an enzyme best known for helping your body break down acetaldehyde - a toxic intermediate that forms when alcohol is metabolized. When ALDH2 activity is reduced, acetaldehyde can build up more quickly after drinking, leading to symptoms like facial flushing, nausea, a rapid heart rate, and general discomfort. For many people, these reactions are not just “annoying side effects.” They can be a biologic signal that acetaldehyde is accumulating faster than your body can clear it.

ALDH2 also has a broader detox role beyond alcohol. Your body naturally produces other reactive aldehydes during everyday metabolism and during periods of higher oxidative stress. ALDH2 helps clear these compounds, including reactive aldehyde byproducts formed when dopamine and norepinephrine are broken down. Because aldehydes can contribute to oxidative stress when they accumulate, ALDH2 is sometimes discussed in the context of brain health and neurotransmitter support - especially in situations that increase oxidative load or alcohol exposure.

How ALDH2 Affects Alcohol Sensitivity and “Alcohol Flush” Symptoms

When you drink alcohol, one of the early breakdown steps produces acetaldehyde. ALDH2 helps convert acetaldehyde into less harmful compounds. If ALDH2 activity is reduced, acetaldehyde may linger longer and reach higher levels. That’s when symptoms like flushing, nausea, rapid heart rate, and discomfort are more likely - particularly with larger amounts or faster drinking.

From a long-term perspective, acetaldehyde exposure is also a key reason ALDH2 genetics matter. Reduced clearance can increase DNA damage signals after drinking, which is one reason many people choose to treat alcohol sensitivity as a “red flag” rather than something to push through.

Why ALDH2 Can Matter for Cognition and Neurotransmitter Balance

ALDH2 isn’t only an “alcohol gene.” It also helps clear reactive aldehydes produced during normal metabolism and oxidative stress. Some of these aldehydes are byproducts tied to dopamine and norepinephrine turnover. If aldehydes accumulate - especially when oxidative load is high - this may indirectly influence dopamine-related brain pathways. In practical terms, the goal for brain and cognitive resilience is often to reduce the situations where reactive aldehydes pile up and to support overall oxidative balance.

Practical Steps for Everyone

Regardless of genotype, there are a few practical strategies that support ALDH2-related pathways. For people with reduced ALDH2 activity (most relevant for AA, and to a lesser degree AG), these steps become even more important because alcohol exposure and oxidative load are the main “inputs” you can control.

• Alcohol exposure: If your result reduces ALDH2 activity, alcohol is the single biggest lever because it directly increases acetaldehyde load.
• Reduce peak exposure: If you drink at all, keep intake slow, pair alcohol with a full meal, alternate with water, and choose smaller total amounts. This does not change your genetics, but it may reduce the intensity of exposure.
• Build an antioxidant, high-polyphenol meal pattern most days: Emphasize deeply colored fruits (such as berries and pomegranate), leafy greens, cruciferous vegetables (like broccoli and Brussels sprouts), legumes, nuts and seeds, extra-virgin olive oil, and omega-3–rich seafood.
• Support steady blood sugar: Include protein and fiber at each meal to avoid large glucose swings, which can increase oxidative stress and worsen “brain fog” for some people.
• Avoid smoking: If you carry the effect allele and still drink, do not smoke. Alcohol plus smoking has been shown to synergistically increase esophageal cancer risk in ALDH2 risk-genotype carriers.

Diet Recommendations for ALDH2 rs671

If your ALDH2 rs671 result reduces enzyme activity (most relevant for AA, and to a lesser degree AG), the safest and most impactful “diet” decision is how you handle alcohol exposure. ALDH2’s job is to clear acetaldehyde; if acetaldehyde is not cleared efficiently, symptoms like flushing, nausea, rapid heart rate, and discomfort can appear - especially with higher intake. Think of these symptoms as a biologic warning that acetaldehyde is accumulating.

For AA (two effect alleles), the most protective approach is to avoid alcohol entirely or treat it as a rare-occasion exposure. For AG (one effect allele), you may tolerate small amounts better than AA, but acetaldehyde clearance is still impaired, so the safest pattern is low frequency and low dose, and avoiding binge drinking. For GG (no effect alleles), ALDH2 activity is typically normal, but alcohol still increases acetaldehyde exposure and risk in a dose-dependent way - so “normal” does not mean neutral.

If you do drink (any genotype), lower your peak acetaldehyde load by drinking slowly, pairing alcohol with a full meal, alternating with water, and choosing smaller total amounts. These steps won’t “fix” ALDH2 genetics, but they can reduce exposure intensity.

To support cognition and oxidative balance - especially for AA/AG - build meals around a high-antioxidant, high-polyphenol pattern most days: deeply colored fruits (berries, pomegranate), leafy greens, cruciferous vegetables (broccoli, Brussels sprouts), legumes, nuts and seeds, extra-virgin olive oil, and omega-3–rich seafood. This pattern supports oxidative-stress balance, which matters because reactive aldehydes can increase when oxidative load is high. Also prioritize steady blood sugar with protein and fiber at meals to reduce large glucose swings that can increase oxidative stress and contribute to “brain fog” for some people.

Supplement Recommendations for ALDH2 rs671

Start with the most important principle: no supplement reliably “cancels out” acetaldehyde risk in ALDH2-deficient drinkers. If you are AA (or AG and symptomatic), the safest strategy remains avoiding alcohol, because acetaldehyde exposure is the core issue. Supplements may be used for general support of cognitive resilience and oxidative-stress balance, but they should not be treated as protection against acetaldehyde-related harm.

For many people, a practical foundation includes omega-3s (EPA/DHA) to support neuroinflammation balance and neuronal membrane support, plus magnesium glycinate or magnesium taurinate in the evening to support relaxation and sleep quality. Sleep is a downstream driver of cognitive performance and stress physiology, so supporting sleep can be a meaningful part of brain-health strategy.

If your diet is inconsistent, a basic B-complex (or at least B6, folate, and B12) can support neurotransmitter metabolism, methylation balance, and energy pathways. This can be a useful context when you’re thinking about dopamine and norepinephrine turnover and overall brain energetics.

If you carry the effect allele and want more targeted antioxidant-capacity support, N-acetylcysteine (NAC) is commonly used as a glutathione precursor (often 600 mg once daily, sometimes up to 600 mg twice daily for short periods). Evidence for NAC as an “alcohol fix” is mixed and it should not be treated as protection against acetaldehyde-related harm, but mechanistically it is often used to support glutathione-dependent antioxidant defenses. Vitamin C (for example, 250–500 mg/day) and a food-first polyphenol approach (berries, cocoa, green tea) are also commonly used to support redox balance without overcomplicating the stack.

If you’re considering “alcohol support” products marketed around acetaldehyde, be cautious. Some contain L-cysteine and vitamins and may have small studies on symptom outcomes, but they are not a substitute for reducing alcohol exposure - especially in AA/AG. As always, check medication interactions (especially with blood thinners, blood pressure medications, antidepressants, and liver-active drugs) and talk with a clinician if you are pregnant, have asthma, have ulcers or GERD, or have liver disease.

Lifestyle Recommendations for ALDH2 rs671

For ALDH2 rs671, lifestyle is largely about lowering the situations where reactive aldehydes pile up: alcohol exposure, smoking exposure, poor sleep, chronic stress, and high inflammatory load. If you are AA, treat flushing and discomfort as a “stop signal” and consider adopting a default identity of “non-drinker” for both brain health and long-term risk reduction. For AG, the same approach applies, though some people choose a lower-dose, lower-frequency pattern if they drink at all. For GG, you still benefit from keeping alcohol modest because acetaldehyde is a harmful metabolite and alcohol-related risk rises with dose.

To reduce oxidative load and support resilience, aim for 150+ minutes per week of aerobic activity plus two days per week of resistance training. Add a simple daily “circulation break,” such as a 10–15 minute brisk walk after meals, which can support metabolic and brain benefits. Support sleep like it’s a cognitive supplement: keep consistent sleep and wake times, get morning light exposure, maintain a cool and dark bedroom, and choose a caffeine cut-off that protects deep sleep.

Stress management matters because chronic stress can raise oxidative burden and increase catecholamine turnover. Consider a daily 10-minute downshift practice such as paced breathing, mindfulness, or a walk without your phone. Finally, if you’re AA/AG and you drink, take esophageal health seriously: avoid smoking (synergy risk), avoid frequent binge patterns, and consider discussing your personal risk profile with your clinician - especially if you have reflux or GERD symptoms, family history concerns, or persistent throat or chest discomfort.

Genetic Interpretations for rs671 (ALDH2)

When to Talk to Your Healthcare Provider

Consider speaking with a healthcare provider if you have strong alcohol-related symptoms (especially flushing, nausea, rapid heart rate, or significant discomfort), if you have reflux or GERD symptoms, if you smoke and drink, or if you have persistent throat or chest discomfort. A clinician can help you interpret your genetic result in the context of your overall health and personal risk profile, and can help you make a plan that fits your goals.

PlexusDx does not provide medical advice. This information is educational and intended to help you understand how ALDH2 genetics may relate to alcohol sensitivity, oxidative balance, and brain-health pathways. Always consult your healthcare provider before making changes to your diet, supplement routine, or exercise plan, or if you have concerns about your health.

If this genetic variant is present in your PlexusDx results, the following tests and reports are commonly used to explore it further:

🧬 Genetic Tests:

• Functional Health Genetic Test

🧪 Blood Tests:

• Women's Health and Wellness Blood Test
• Men's Health and Wellness Blood Test

📄 Genetic Report:

• Cognition and Brain Health Genetic Report