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Understanding ALDH2 and Alcohol Detoxification

Alcohol detoxification is the set of processes your body uses to break down and eliminate alcohol. The liver is the primary site for this work. When alcohol is consumed it is first converted to acetaldehyde, a toxic molecule that can cause flushing, nausea, rapid heart rate, and other unpleasant effects. The ALDH2 gene encodes an enzyme that converts acetaldehyde into acetate, a harmless compound the body can eliminate. Variants in ALDH2 influence how effectively this step occurs and can affect how your body responds to alcohol.

Why this matters

Differences in ALDH2 enzyme activity change how quickly acetaldehyde is cleared. Higher acetaldehyde levels are linked to stronger immediate reactions to alcohol, worse hangovers, and longer exposure to a toxic intermediate. Knowing your ALDH2 genotype can help you make informed choices about drinking, nutrition, and lifestyle to support liver health and reduce acetaldehyde exposure.

Genetic interpretations

Two effect alleles (AA) — significantly reduced ALDH2 activity

If your genotype is AA at rs671 you carry two copies of the effect allele. This results in very low or nearly absent ALDH2 enzyme activity. After drinking alcohol acetaldehyde cannot be efficiently converted to acetate and will accumulate. Common consequences include facial flushing, nausea, rapid intoxication, heart palpitations, and intense hangovers. Because acetaldehyde is toxic, repeated exposure increases short-term discomfort and may raise risk from environmental aldehyde exposure as well.

  • Alcohol recommendation: Avoid or strictly limit alcohol. Even small amounts can cause strong reactions and prolonged acetaldehyde exposure.
  • Diet: Emphasize antioxidant-rich fruits and vegetables (berries, leafy greens, cruciferous vegetables), which can help reduce oxidative stress from acetaldehyde.
  • Supplements to discuss with your healthcare provider: Vitamin B3 (niacin or nicotinamide), Magnesium, and Vitamin B12 to support general metabolic and detox pathways.
  • Lifestyle: Avoid tobacco and other sources of aldehydes such as heavy air pollution and occupational solvents. Prioritize sleep, hydration, and meals with protein and healthy fats to slow alcohol absorption if consumed.
  • Monitoring: Talk with your clinician about liver health testing if you have any alcohol use or symptoms after exposure.
One effect allele (AG) — reduced ALDH2 activity

If your genotype is AG at rs671 you carry one copy of the effect allele. This typically reduces ALDH2 activity by roughly 50 to 70 percent. When you drink alcohol acetaldehyde clearance is slower than average and can accumulate to levels that cause flushing, nausea, faster intoxication, and stronger hangovers. Many people with this genotype naturally drink less due to these unpleasant effects, but support for detoxification is still valuable.

  • Alcohol recommendation: Practice mindful drinking and consider limiting amounts. Pay attention to how small amounts make you feel and avoid situations where rapid consumption is likely.
  • Diet: Prioritize antioxidant foods such as citrus, berries, dark leafy greens, nuts, and colorful vegetables. Include foods that support liver function like onions, garlic, and cruciferous vegetables.
  • Supplements to discuss with your healthcare provider: Vitamin B3, Magnesium, and Vitamin B12 may support metabolic pathways involved in detoxification.
  • Lifestyle: Avoid smoking and inhaled pollutants, since these can add to aldehyde exposure. Maintain regular exercise, adequate sleep, and hydration to support liver function.
  • Monitoring: If you experience strong reactions or have patterns of alcohol use, review them with your healthcare provider and consider liver function testing as appropriate.
No effect alleles (GG) — typical ALDH2 activity

If your genotype is GG at rs671 you carry two copies of the non-effect allele. Your ALDH2 enzyme activity is expected to be within the typical range and acetaldehyde is usually converted to acetate efficiently. This helps prevent the strong immediate reactions some other genotypes experience.

  • Alcohol recommendation: Even with normal ALDH2 activity, keep alcohol intake within public health guidelines and avoid binge drinking. Regular heavy drinking can harm the liver independent of ALDH2 genotype.
  • Diet: Continue eating antioxidant-rich foods and maintain balanced nutrition to support liver and overall health.
  • Supplements to discuss with your healthcare provider: Vitamin B3, Magnesium, and Vitamin B12 can be considered to support metabolism, especially if dietary intake is low.
  • Lifestyle: Limit exposure to other aldehyde sources, practice safe drinking habits, and keep a healthy weight to reduce fatty liver risk.
  • Monitoring: Routine clinical care and liver health checks as advised by your healthcare provider if you consume alcohol regularly or have risk factors for liver disease.

Practical strategies to support alcohol detoxification

Regardless of genotype, lifestyle and dietary choices influence how your body handles alcohol and acetaldehyde. Below are practical steps to support your liver and reduce toxic exposure.

Diet recommendations

  • Eat antioxidant-rich produce daily: berries, citrus, leafy greens, beets, and cruciferous vegetables help reduce oxidative stress.
  • Include sulfur-containing foods such as garlic, onions, and cruciferous vegetables to support liver phase II detoxification.
  • Maintain stable blood sugar by including protein and healthy fats at meals to slow alcohol absorption and reduce cravings.
  • Stay well hydrated and limit processed foods, added sugars, and excessive saturated fats that can compromise liver health.

Supplements to consider discussing with your clinician

  • Vitamin B3 (niacin or nicotinamide): supports metabolic reactions; dosing and form should be discussed with your provider.
  • Magnesium: supports many enzymatic processes and overall metabolic health.
  • Vitamin B12: important for energy metabolism and may be low in some diets.
  • General liver support supplements: discuss the evidence, interactions, and safety with your clinician before starting anything new.

Lifestyle and environmental tips

  • Avoid smoking and secondhand smoke, which add aldehyde exposure.
  • Limit time in heavily polluted environments and use appropriate protective measures at work if exposed to solvents.
  • Practice mindful drinking, avoid binge episodes, and choose alcohol-free days each week.
  • Keep a healthy weight through diet and regular exercise to reduce fatty liver risk.

When to talk to your healthcare provider

  • If you experience frequent flushing, nausea, rapid heartbeat, or other strong reactions when drinking alcohol.
  • If you are considering supplements or have health conditions or medications that could interact with them.
  • If you have concerns about liver health, long-term alcohol use, or occupational exposures to aldehydes. Your provider can recommend appropriate blood tests and monitoring.

Important disclaimer

PlexusDx provides educational information about genetic predispositions only and does not provide medical advice. This content is not a substitute for professional medical care. Always consult your healthcare provider before making changes to your diet, supplements, medications, or lifestyle based on genetic results.