Re: Scientific reason for why we turn red

Hello.
I am 35 year old male and have an 11 year history of alcohol abuse. I admit that I drink but I like to say that I still keep everything in “normal limits”.About a year ago I quit with drinking But, about a month ago I started to feel some stomach pain and I think they could be caused by long history of alcohol drinking.I have heard that alcohol can damage liver but I don’t know anything about its effect on stomach! Please help!

Re: Scientific reason for why we turn red

Probably best to seek medical attention :)

Re: Scientific reason for why we turn red

I did 23andMe this year, and here are my results, concerning ALDH2 deficiency:

General notes:

Sensitivity to alcohol— the alcohol flush reaction—depends almost entirely on a person's genotype at two genes, ALDH2 and ADH1B. 23andMe currently reports your genotype at a SNP in ALDH2. It is possible that those with the AG or GG genotypes at the SNP are more sensitive to alcohol due to their genotype at ADH1B (which 23andMe does not report).

3 options for genes:

AA    No working copies of ALDH2. Extreme flushing reaction to alcohol. Highly unlikely to become dependent on alcohol.

AG    One working copy of ALDH2. Moderate flushing reaction to alcohol. Somewhat less likely than average to become dependent on alcohol.<-- me

GG    Two working copies of ALDH2. Little or no flushing reaction to alcohol.

I suppose I am happy I'm not AA.

Notes from 23AndMe:

Alcohol is a social lubricant for some and an addictive substance for others. But for people with the alcohol flush reaction, alcohol has such an unpleasant, noxious effect that they tend to avoid it altogether. Even a single drink may cause people sensitive to alcohol to become dizzy or nauseous, have headaches, and turn bright red. The alcohol flush reaction is primarily due to variations in two genes that encode proteins responsible for breaking down alcohol in the bloodstream.

The Wrath of Grapes

Alcoholic drinks have been around as long as civilization itself (and possibly longer). Beer and wine have both been described in the written records of ancient Egypt and Mesopotamia. Like many discoveries, the first alcoholic drink was probably an accident, when cereal grains or berries were left out and fermented by yeast in the air. (A similar accident may also have given rise to the other product of the hugely successful human-yeast partnership: leavened bread.)

The first brave soul to try what was essentially spoiled food was a lucky one, as many food-borne microbes, like salmonella or botulism, are very toxic or even fatal. The waste product of brewer's yeast is ethanol—the chemical name for alcohol—moderate amounts of which interact with the brain to produce the pleasant effects of intoxication, like being less shy or more relaxed.

Genetic variation also influences how well you can hold your liquor. Ethanol is poisonous in larger doses, so our bodies have evolved ways to break it down before it has a chance to build up. While your brain is enjoying its temporary loss of inhibition, your liver is doing its best to clear the alcohol out of your system before it kills you.

The liver's ultimate goal is to turn ethanol into harmless acetic acid (i.e. vinegar), which can be easily removed in urine. The problem is that in order to become vinegar, ethanol has to be converted to acetaldehyde, which is as nasty as it sounds. In fact, acetaldehyde is even more toxic than ethanol. Some of the effects of drinking—turning red, increased heart rate—are actually symptoms of acetaldehyde poisoning. Certain versions of genes can cause a logjam in ethanol processing and a buildup of acetaldehyde. If you have these versions, even one drink can result in ill effects, like flushing, dizziness, nausea, and headaches.

The genotypes that result in a buildup of acetaldehyde when drinking alcohol happen to be especially common in Asians compared to Europeans. This is the reason the ill effects are known in some circles as the "Asian flush."

---

12 discoveries from 7000 B.C. to 1994.

7000 B.C.
Inhabitants of the neolithic village of Jiahu in Henan province in China make a fermented beverage of rice, honey, and fruit (hawthorn fruit and/or grape). Chemical analyses of ancient organics absorbed into pottery jars reveal their recipe in the 21st century. (sources)

2100 B.C.
The Sumerians use alcohol as a form of medicine and record its use on a cuneiform tablet of pharmacopeia. (sources)

1000 B.C.
Archaeological evidence shows that fermented cacao beverages were being made in Mesoamerica before 1000 B.C. (sources)

800 A.D.
The process of distillation is invented by the Arabian alchemist Jabir (or Geber) ibn Hayyan. He may also have named the distillate alcohol, which derives from the Arabic root, al-kuhul. Al-kuhul originally referred to powdered antimony (kohl) used as an eye cosmetic but with time it came to mean the "essence," and eventually, the essence of wine—its spirit, or alcohol. (sources)

1947
Disulfiram, a drug that inhibits aldehyde dehydrogenase was discovered by accident at the Royal Danish School of Pharmacy in Copenhagen, Denmark, by Danish researchers Eric Jacobsen and Jens Hald. The two were studying compounds to be used for treating parasitic stomach infections. Both men took a small dose of disulfiram to check for possible side effects. At a cocktail party several days later, they both became very ill after having a drink. They concluded that the disulfiram had interacted with the alcohol to trigger the illness. (sources)

1951
Disulfiram is approved by the FDA as a drug to treat alcohol abuse. Its brand name is Antabuse. It discourages a drinker's desire for alcohol by causing extremely unpleasant symptoms (including facial flushing) when a drink is taken. (sources)

1971
Researchers show that disulfiram inhibits the function of aldehyde dehydrogenase. (sources)

1972
To find if the lower incidence of alcoholism in Asians vs. Europeans is due to cultural or biological factors, Wolff conducts an experiment looking at the physiological reactions to alcohol in both adults and infants from both ethnic groups. He finds that many Asians exhibit a pronounced facial flushing when given alcohol. He concludes that since infants showed the same variation in alcohol response as adults, cultural factors and drinking habits could not be at work. The cause must be genetic. (sources)

1979
The absence of the enzyme coded by ALDH2, which is a common occurrence in people of Asian ancestry, is hypothesized to cause alcohol intolerance. (sources)

1980
Experiments show that livers from Japanese autopsies typically show two forms of aldehyde dehydrogenase enzyme. This finding provides evidence for how genetic differences might lead to phenotypic differences in alcohol sensitivity. (sources)

1991
Researchers publish a study of ALDH2 genotypes in Chinese, showing that alcoholics are less likely to have the slow version of acetaldehyde dehydrogenase. This observation lends support to the hypothesis that the same mechanism that leads to the alcohol flush reaction—a buildup of acetaldehyde due to a slow enzyme—protects against alcoholism. (sources)

1994
A group of biochemists show that the two versions of the ALDH2 gene commonly seen in Asians encode two versions of the aldehyde dehydrogenase protein with strikingly different biochemical properties. This evidence connects genetic differences to phenotypic differences by providing a biochemical mechanism. (sources)

Re: Scientific reason for why we turn red

More from 23andMe:

Alcohol Consumption, Smoking and Risk of Esophageal Cancer
Intended for research and educational purposes. Not for diagnostic use.

Your Genetic Data

Your result - Reduced ability to break down acetaldehyde, a toxic byproduct of alcohol and cigarette smoke. As a result, you are likely to have increased odds of esophageal cancer, especially if you drink or smoke.

Technical Report - Detected the following mutations: ALDH2*2

Other Name(s)ALDH2*2   
DNA Change: G to A   
Genotype: AG (variant present)

Only a medical professional can determine the right medication for a particular patient. This information should not be used to independently establish or adjust an existing regimen.

The Genetics of Alcohol Consumption, Smoking and Risk of Esophageal Cancer
Acetaldehyde is a highly toxic substance known to cause cancer. It occurs naturally in a variety of food and beverages, is found in cigarette smoke, and is a breakdown product of alcohol.

The body normally converts acetaldehyde into a harmless substance called acetate. But many people with East Asian ancestry have a mutation in the aldehyde dehydrogenase gene (ALDH2) that prevents this reaction, leading to a build-up of acetaldehyde and the "alcohol flush" often seen in this population. The mutation, called ALDH2*2, has not been found in people who trace their ancestors back to Europe or Africa.

On its own, the increase in saliva acetaldehyde caused by the ALDH2*2 mutation about doubles the odds of esophageal cancer. Alcohol and cigarette smoke also each raise the odds of the disease by about two times. But when a person with the ALDH2*2 mutation drinks and/or smokes, these risk factors work together to dramatically increase risk. The magnitude of the combined effect varies from study to study, but the basic finding that these three risk factors synergistically increase the risk of esophageal cancer is definitive.

In one of the largest studies done to date (Cui, 2009), researchers found that in ALDH2*2 carriers who smoke, the odds of esophageal cancer were between 5.65 and 23.08 higher than non-carriers who did not smoke or drink. The wide range in risk has to do with the presence or absence of another genetic risk factor prevalent in East Asians that is not covered in this report.

I am AG (heterozygous). Someone who is AA would see this:

Unable to break down acetaldehyde, a toxic byproduct of alcohol and cigarette smoke. As a result, you are likely to have greatly increased odds of esophageal cancer, especially if you drink or smoke, although too few individuals with your genotype who also drank were studied to constitute a meaningful sample size.

And GG:

Normal ability to break down acetaldehyde, a toxic byproduct of alcohol and cigarette smoke. No increase in odds of esophageal cancer due to genotype, but alcohol consumption and smoking are still risk factors.

Re: Scientific reason for why we turn red

All who experience the flush, please review the early posts - you are at risk of developing a very serious and deadly cancer. Please read the medical research. This is a genetic disorder that has been passed down for 1000's of years. I have no 'history' of Asian ancestry, however, if you look to the halpogroups that populated the world and how they traveled across time, you will see that it is entirely possible to have northern European ancestors who evolved from Asian ancestors 40,000 years ago. The American Indians were recently linked (via mitochondrial DNA) to Asian ancestors who traveled across the Bearing Straits in Alaska and populated the North and South American continents. We are all a 'hybrid' human being of some sort. The only way to truly know is to have the genetic testing done. As far as I can trace I'm of "German" ancestry - and we can look back on one branch of our tree to the 1400's. I turn bright red, throb, get the fast heart rate. Two years ago I was diagnosed with Esophogitis - which made no sense to me at all as I can't eat spicy food (they burn my mouth), I eat fairly bland. I have only consumed alcohol casually, but now that I know what I know - there is no magic medicine to cure what has mutated in the DNA. Please read more at aldh.org

Re: Scientific reason for why we turn red

If you are experiencing chronic liver disease that is due to alcohol or viruses. You better consult your doctor and ask for serious medical advice.

Re: Scientific reason for why we turn red

Business Venture Opportunity-
I'm a biochemist that has been working for over 3 years to discover a viable business opportunity to create a cure for this affliction.  Unfortunately for all of you out there, it doesn't seem like Convivia will ever be an option in a country such as ours with such strict regulations (as well as Japan and China) because the mechanism of action of 4-methylpyrazole, originally used to treat methanol poisoning, is just too dangerous to be taken regularly or sold over the counter. I am also well aware of the misinformation coming from Cheerz and NoRedFaceFormula, which seem to have little to no effect in treating alcohol flush reaction. Finally, Pepcid AC, which seems to be the general go-to cure for most people, most likely blocks the histamine (redness) response but does nothing to reduce acetaldehyde levels, resulting in a greatly increased risk of cancer and liver cirrhosis.
I believe that I have found a potential cure, based both on anecdotal evidence from this forum and personal research, that will prove to cure both the symptoms of Asian glow. I have developed a formulation, based largely on H2 antagonists (blockers) as well as antioxidants which target and neutralize acetaldehyde while protecting the stomach.
I am currently working with the former CFO of Pfizer, Canada, as well as an American teacher in Japan to develop this business, but require someone with an entrepreneurial spirit and experience in the pharmaceutical industry, preferably regulatory experience. Anyone with a PHD or MS in biochemistry or a related field should also contact me at chrisumbach@gmail.com

PS: ECheng - I contacted you via email several times regarding this venture. If you want an effective and harmless cure for this ailment, please help me to recruit for this new venture.

Re: Scientific reason for why we turn red

Hey Chris, I was wondering where you got the information that Convivia is not viable. I believe they passed Phase 1 and Phase 2 of their clinical trials and my understanding was that they wanted to test the market in Taiwan, hence why it is currently not going through Phase 3 in the states. I don't have a pharmaceutical background but I didn't think we could allow patient trials for stage 1 and stage 2 if there is known harm to patients using the medication.

As for the compound you are working on, I am glad you are taking matters into your own hands and I wish you the best of luck. However, if you are working on an H2 drug, or one that is modeled off of H2 antagonists, how is that different than Pepcid AC? Isn't it doing the same thing in treating the neutralization of acids in the stomach? I didn't think it could neutralize and break down Acetaldehyde which is the dangerous part and the cause of the flushing.

Additionally, if you are focusing your efforts on the stomach, how will this new compound address 2nd-pass alcohol metabolism that is done in the liver?

59 (edited by Dalmore 2012-04-19 14:51:02)

Re: Scientific reason for why we turn red

MTER wrote:

Additionally, if you are focusing your efforts on the stomach, how will this new compound address 2nd-pass alcohol metabolism that is done in the liver?

Good post MTER however, my understanding on Conviva is (correct me if I'm wrong), it neutralizes acetaldehyde in bloodstream.  Alda-1 on the other hand, helps the metabolic function of liver of those with ALDH2 deficiency so that it can process acetaldehyde normally.

Re: Scientific reason for why we turn red

Dalmore, Convivia and Alda-1 are similar. Convivia is essentially the missing enzyme in ALDH-2 deficient people that allow them to break down alcohol into acetate instead of letting it remain as acetaldehyde. Alda-1 is, however, "fixing" the malformed gene so that our body can naturally produce was Convivia substitutes.

So yes, it is working slightly different in the way it introduces the enzyme into our body. However, Alda-1 seems a lot further from ever becoming available than Convivia since Convivia is already approved in an intravenous form. In a way, I'm a little nervous about Alda-1 and being a human beta since it is essentially altering my body to produce a chemical versus just taking the chemical when I need it. I don't think Alda-1 has been used on humans at all...am I missing something?

Re: Scientific reason for why we turn red

MTER wrote:

In a way, I'm a little nervous about Alda-1 and being a human beta since it is essentially altering my body to produce a chemical versus just taking the chemical when I need it. I don't think Alda-1 has been used on humans at all...am I missing something?

From what I've read, Alda-1 has not been tested on human (Re: Alda-1 thread on this forum).  I would put it little differently about its function.  Per article online, it is to support the inadequate liver function of those with ALDH2 deficiency gene to be able to function normally via artificial buttressing of cellular structure that is necessary to metabolize acetaldehyde. 

The article also mentions the benefit of this cellular level activity which can allow the effectiveness of heart medications for those with heart problem.  The impression I've got from the article/s is that Alda-1 has a greater use than just alcohol related issues which can make its future brighter than Convivia.

Re: Scientific reason for why we turn red

From what I understand Pepcid alone will only reduce facial redness and nothing else. The h2 Blockers slow down the rate at which the alcohol is converted to Acetaldehyde which is why.

Re: Scientific reason for why we turn red

You'd think that after all those years of evolution, we'd have changed enough to get rid of this thing. I've been trying antacids lately and they are okay, but inconvenient when there are impromptu drinks with friends or co workers. I went to a meeting with a client a few weeks ago and it was just supposed to be coffee, but the client's wife ordered wine and then my client suggested I have one. I should have gone to the bathroom and popped an antacid, but didn't and I went red...ahhh!

I don't know about getting the genetic test done. I mean, it seems like I already have it, so what's point?

Re: Scientific reason for why we turn red

Thank you to everyone who has posted all of the great information in this forum.  I have learned so much, but the more I read also, the more confused I am whether what I am experiencing is "Asian Blush", or Rosacea, or allergy...etc

Occasionally, when I drink, not every time, I start to feel my face and ears get very warm.  I will get red blotches.  Not a full face flush, but red jagged edged blotches on my face and very prevalently on my chest.  Sometimes my shoulders.  Sometimes it happens with wine, sometimes not.  Sometimes beer, sometimes not. Sometimes hard liquor, again sometimes not.  The blotches don't last the entire time I am drinking either.  They will often go away after 10-30 minutes. I don't get a headache, or itching, or nausea. Just warm red blotches that eventually subside.

These same blotches often appear when I am emotional, hot, excited...etc  They often appear when I first go out in the sun.  They eventually fade.

I am of Hispanic and European ancestry.  I am not aware of an Asian ancestry, but then again, I haven't traced my family back that far.  This does not happen to either of my parents nor does it happen to my sisters.

My main concern is the increased risk of cancer.  Do my symptoms sound like I might have "Asian Blush"?

Thanks for your help!