Alcohol Flush Reaction and ALDH2: What Research Says About Cancer Risk

Alcohol Flush Reaction and ALDH2: What Research Says About Cancer Risk

This article is for educational purposes only. It is not a substitute for advice from a licensed physician, board-certified medical geneticist, or board-certified genetic counselor. For any decisions about testing, treatment, or care, consult a qualified clinician. In emergencies, call 911.

Bottom line: Research from the National Cancer Institute and large genetic studies shows that the alcohol flush is a visible sign of an inherited enzyme variant, ALDH2*2 (rs671). The variant lets acetaldehyde, a cancer-causing chemical, build up after drinking. Carriers who keep drinking face a higher risk of esophageal and head and neck cancers, while carriers who do not drink show no such excess. Drinking less, or not at all, is the step the evidence supports.

What you’ll learn

• Why your face turns red after one drink, and which gene is involved
• How common the variant is in North America, based on the NIH All of Us study
• What the cancer research shows, in both relative and absolute terms
• What a 23andMe “likely to flush” result means, and what to do next

What the flush actually is: ALDH2, acetaldehyde, and the rs671 (ALDH2*2) variant

Your body breaks down alcohol in two main steps. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes the pathway clearly.

Step	Enzyme	What happens
1	ADH (alcohol dehydrogenase)	Turns alcohol into acetaldehyde, a highly toxic chemical and known carcinogen
2	ALDH (aldehyde dehydrogenase), mainly ALDH2	Turns acetaldehyde into acetate, a harmless substance
3	Further breakdown	Acetate becomes water and carbon dioxide

Other enzymes, such as CYP2E1 and catalase, can also make acetaldehyde from alcohol. A small amount is processed in the gut itself. That means tissues along the digestive tract are exposed to acetaldehyde directly.

Think of step 2 as a cleanup crew. If the crew is slow, the mess piles up. In people with a less active ALDH2 enzyme, acetaldehyde builds up after drinking. The result is facial flushing and a racing or pounding heart, according to the National Cancer Institute (NCI).

The best-known variant is called rs671. It is also written ALDH2*2, or Glu504Lys or Glu487Lys, depending on how the protein is numbered. All of these names refer to the same change.

How strong is the effect? A review by NIAAA scientists explains it:

• One copy (heterozygous): enzyme activity drops by more than 100-fold. The researchers call this a semi-dominant effect, meaning one copy is enough to change how the body handles alcohol.
• Two copies (homozygous): no ALDH2 activity can be detected. People with two copies usually cannot drink much at all.

ALDH2*2 is a common susceptibility variant. That means it raises risk under certain conditions, mainly drinking. It is not a disease in itself.

A second gene also matters. Large studies in China and Japan looked at ALDH2 together with ADH1B, another alcohol-processing gene. Both genes shape how much people drink and how their bodies respond.

Not every flush is genetic. Some medicines can cause flushing with alcohol; disulfiram, covered later, is one example. Other skin and medical conditions can cause redness too. If flushing is new for you, or does not fit the usual pattern, ask a clinician to check it.

Section recap: The flush happens because ALDH2*2 slows the cleanup of acetaldehyde, a toxic chemical made from alcohol. One copy sharply cuts enzyme activity, and two copies nearly remove it.

Who carries it: East Asian ancestry and the All of Us numbers for North America

Many websites repeat rough guesses about how common the flush is. The strongest North American data now come from the NIH All of Us Research Program.

In 2025, researchers from UC Irvine and UCLA checked the rs671 genotype in 311,290 All of Us participants. Here is what they found:

• 23.5% of Asian-identifying participants carried at least one deficient ALDH2 copy. That is about 24 out of every 100 people.
• Fewer than 2.5% in every other group carried it. That is fewer than 3 out of every 100 people.

Worldwide, NIAAA scientists estimate that at least 540 million people are ALDH2-deficient. That is about 8% of the world population. The Japanese study describes rs671 as an East Asian-specific variant. It is concentrated in people with Chinese, Japanese, Korean, or Taiwanese family roots.

A few points help keep these numbers in perspective:

• Ancestry, not race, is what matters. The variant follows family lines. A person of any background can carry it, though it is rare outside East Asian ancestry.
• Not every flusher is a carrier. As noted above, other causes of flushing exist.
• Not every carrier flushes in an obvious way. Some notice it less, or notice it less over time.

The test company 23andMe also publishes its own ancestry percentages for the variant. Those are company figures, not North American carrier rates. For people living in the US and Canada, the All of Us figure is the most relevant one.

If you have East Asian ancestry and flush after one drink, this section likely describes you. A primary care clinician can talk through what that means for your health.

Section recap: About 1 in 4 Asian-identifying adults in a large US study carry ALDH2*2, compared with fewer than 3 in 100 in other groups. The variant follows ancestry, and it is rare elsewhere.

Risk magnitude: esophageal and head and neck cancer in carriers who drink

This is the most important part of the story. The flush is not just embarrassing. It signals that your tissues are being exposed to more acetaldehyde.

What the agencies say

The WHO’s International Agency for Research on Cancer (IARC) has ruled on this chemical. Acetaldehyde linked to drinking alcohol is classified as Group 1, carcinogenic to humans. IARC found it causes cancers of the esophagus and of the upper airway and digestive tract.

The NCI fact sheet explains what this means for carriers:

• Most people with the variant drink little, so their risk of alcohol-related cancer is low.
• Carriers who push through the unpleasant effects and drink even moderate amounts face a higher risk.
• That higher risk covers esophageal and head and neck cancers. It is measured against people with the normal enzyme who drink the same amount.
• The extra risk is not seen in carriers who do not drink.

The 2025 US Surgeon General’s Advisory makes the same point. It says many people of East Asian descent carry a flushing variant. It adds that this produces much higher risks for certain alcohol-related cancers.

What the studies found

Study	Who was studied	Key finding
Brooks et al., 2009	Case-control studies in Japan and Taiwan	Heterozygous drinkers had 3.7 to 18.1 times the odds of esophageal squamous cell cancer; most studies found over 10 times in heavy drinkers
Koyanagi et al., 2024	175,672 Japanese adults	Four genes (GCKR, ADH1B, ALDH1A1, ALDH2) were suggested to interact with rs671 in esophageal cancer risk
Millwood et al., 2023	512,724 adults in China, 12 years	Genetically predicted drinking raised death from all causes, alcohol-related cancers, liver disease, and heart disease
Millwood et al., 2019	512,715 adults in China, about 10 years	Genetically predicted drinking raised stroke risk steadily, with no protective dip

An “odds ratio” compares how often a cancer shows up in one group versus another. An odds ratio of 10 means roughly ten times the odds. Brooks and colleagues also estimated that 58% to 69% of the extra risk came from drinking by heterozygotes.

Why the China Kadoorie Biobank results matter

Ordinary drinking studies are hard to read. People who drink differ from non-drinkers in many ways. The China Kadoorie Biobank used genes to get around this problem.

The method is called Mendelian randomization. It uses inherited genes, which are assigned at conception, as a natural experiment. In men, the ALDH2 and ADH1B genotypes predicted a 60-fold gap in average drinking. That ranged from 4 grams to 255 grams of alcohol a week.

The results were consistent:

• All-cause death: hazard ratio (HR) 1.07
• Alcohol-related cancer death: HR 1.12
• Liver disease death: HR 1.31
• Heart and blood vessel disease death: HR 1.15, mainly from stroke (HR 1.18)

A hazard ratio of 1.12 means the rate was about 12% higher. Put simply, where 100 such deaths would be expected, about 112 occurred. There was no genetic sign that moderate drinking protects against death from any cause.

The 2019 study found the same for stroke. Self-reported drinking showed a U-shaped curve, where light drinkers looked healthiest. Genetically predicted drinking showed no such curve. The authors concluded that alcohol steadily raises blood pressure and stroke risk.

Turning relative risk into absolute risk

Relative risk sounds alarming on its own. Absolute risk tells you how many people are actually affected.

Here is a made-up example to show the math only. Suppose a cancer affects 1 in 1,000 people in a group. A tenfold increase would raise that to about 10 in 1,000, or 1 in 100. The relative jump is large. The absolute number is still small, but it is meaningful.

Exact absolute risks for North American carriers are not yet known. Most of the risk numbers come from East Asian studies. Evidence for women is also thin. In the 2023 China study, only about 2% of women were current drinkers.

A useful way to see the scale comes from Brooks and colleagues. They estimated that 53% of esophageal squamous cell cancers in Japanese men might be prevented. That would happen if heterozygous moderate or heavy drinkers drank only lightly. In other words, about half of these cancers in that group were tied to a changeable habit.

A review from Taiwan adds global context. Cancer deaths caused by alcohol rose from 243,000 in 1990 to 337,400 in 2010 worldwide. The review notes East Asians may be more vulnerable to alcohol’s cancer effect because ALDH2*2 is so common.

If these numbers worry you, bring them to your primary care clinician. A genetic counselor can also help you read them in light of your own history.

Section recap: Carriers who drink face several-fold higher odds of esophageal cancer in East Asian studies, and the risk disappears in carriers who do not drink. Genetic studies show no protective effect from moderate drinking.

Testing options: the flush itself, 23andMe Wellness, and clinical genotyping

You may not need a DNA test to know you are likely a carrier. A clear, repeatable flush after a small drink already says a lot.

The two-question flushing check

Brooks and colleagues described a short questionnaire. It asks whether you flush after a glass of beer now, and whether you did in the first year or two after you started drinking.

In Japanese men, it showed:

• 90% sensitivity: of 100 carriers, about 90 were correctly picked up.
• 88% specificity: of 100 non-carriers, about 88 were correctly ruled out, and about 12 were flagged by mistake.

In women, the figures were 88% and 92%. These results come from Japanese populations. They may not apply exactly to other groups.

Your options at a glance

Option	What it is	Main limits
Flushing questionnaire	Two simple questions about your reaction	Tested in Japanese adults; not a lab result
23andMe Alcohol Flush Reaction report	A wellness-category report in the company’s Health + Ancestry Service	Company product; not a diagnosis
Raw DNA data with third-party tools	Uploading consumer DNA files to outside apps	Not clinically validated
Clinical genotyping	A lab test ordered by a clinician	Rarely ordered, because it seldom changes care

What the 23andMe report is, and is not

23andMe lists its Alcohol Flush Reaction report under its wellness topics. It is a Wellness report. It is not one of the company’s Health Predisposition or Carrier Status reports. The company describes ALDH2 variants that make the enzyme less efficient at clearing acetaldehyde.

The variant studied in the research covered here is rs671. Keep in mind that company pages are marketing material. They describe the product, but they are not evidence of health risk.

Clinical tests and hereditary cancer panels

Clinical rs671 testing is uncommon. The advice for carriers, drinking less or not at all, is the same whether you test or not. Hereditary cancer gene panels, such as those from Color or Invitae, focus on other cancer genes. They are not designed to answer the flush question.

Before paying for any test, ask your clinician whether the result would change your care. A board-certified genetic counselor can also help; you can find one through NSGC.org.

Section recap: A consistent flush is strong evidence on its own, and a two-question check performed well in Japanese studies. The 23andMe report is a wellness report, not a diagnosis.

Reading the result: what “likely to flush” does and does not mean

A result that says “likely to flush” points to ALDH2*2. What it means depends on how many copies you have.

One copy (heterozygous)

• Enzyme activity is sharply reduced, by more than 100-fold.
• Many people in this group can still drink, despite the flush.
• That is why this group carries the highest alcohol-related esophageal cancer risk.

Two copies (homozygous)

• No ALDH2 activity can be detected.
• The reaction is usually so strong that people drink very little.
• In All of Us, 24.4% of people with two copies reported drinking in the past year.

The All of Us study shows real drinking habits among carriers. Of people with one deficient copy, 61.2% drank in the past year. Of those drinkers, 30.3% reported binge drinking. Put together, that is about 18 out of every 100 one-copy carriers who binge drank. For two-copy carriers, the figure is about 4 out of every 100.

Why a fading flush is not protection

Some people say the flush fades the more they drink. Brooks and colleagues confirm that some heterozygotes do become tolerant to the flush. Some of them then become habitual heavy drinkers. Sadly, this is the group with the greatest esophageal cancer risk from drinking.

NIAAA makes a related point. Being able to “hold your liquor” is not protection from alcohol problems. It is a reason for caution. Losing the warning sign is like turning off a smoke alarm while the fire keeps burning.

What the result does not tell you

• It is not a diagnosis. It describes how your body handles alcohol.
• It is not a test for alcohol use disorder. It says nothing about whether you drink too much.
• A negative result does not make alcohol safe. The Surgeon General’s advisory links alcohol to at least seven cancer types for everyone.
• No flushing does not mean safe to drink. Alcohol still produces acetaldehyde in every body.

Bring your report to a primary care visit. Your clinician can put it in the context of your health, family history, and drinking pattern.

Section recap: One copy is the higher-risk group because many carriers keep drinking, and a fading flush is not protection. A negative result does not make alcohol safe for anyone.

Prevention: drinking less or not at all, and what not to do

For carriers, prevention is simple to state. The extra cancer risk is not seen in carriers who do not drink. Drinking less, or not at all, is the evidence-based way to remove it.

What US and Canadian guidance says

United States

• The Surgeon General’s 2025 advisory calls alcohol a leading preventable cause of cancer. It contributes to nearly 100,000 cancer cases and about 20,000 cancer deaths in the US each year.
• The advisory ranks alcohol third among preventable causes of cancer, after tobacco and obesity.
• The current Dietary Guidelines for Americans, 2025-2030, advise: “Consume less alcohol for better overall health”. They give no number of daily drinks.
• The Dietary Guidelines add that people who cannot control their drinking, or who take interacting medicines, should avoid alcohol completely.

Canada

Canada’s Guidance on Alcohol and Health (2023) lays out a risk continuum by weekly drinks:

Standard drinks per week	What the guidance says
0	Benefits, including better health and better sleep
2 or fewer	Likely to avoid alcohol-related consequences
3 to 6	Risk of several cancers, including breast and colon cancer, rises
7 or more	Risk of heart disease or stroke rises significantly

The guidance also says more than 2 standard drinks on one occasion raises harm. Its core message: “No matter where you are on the continuum, for your health, less alcohol is better.”

These general limits were not written for ALDH2 carriers in particular. Researchers have proposed setting separate drinking guidelines for ALDH2-deficient people. They also say such strategies still need testing.

What not to do

• Do not mask the flush. Antihistamines, “flush-blocking” products, and supplements may hide the redness. They do not stop acetaldehyde from building up. The cancer risk stays the same.
• Do not try to build tolerance. A flush that fades is not protection.
• Do not add tobacco. NCI reports that alcohol and tobacco together have multiplied harms for mouth and throat cancers. The combined harm is greater than the two added together. Quitting smoking helps on its own.

Hiding the flush is like taping over a warning light on a car dashboard. The light goes dark, but the problem is still there.

Screening and symptoms

Researchers have proposed using ALDH2 status to find high-risk people for targeted screening. This is a proposed strategy, not an established one. The authors say it still needs evaluation.

Do not wait on symptoms, though. Tell a clinician promptly about trouble swallowing or other lasting throat or chest symptoms.

Getting help to cut back

Cutting back can be hard, especially when work dinners and social drinking are routine. Help is available:

• NIAAA’s Rethinking Drinking site has tools to review your drinking and plan a change.
• In the US, SAMHSA’s National Helpline is 1-800-662-HELP (4357). You can also text your zip code to 435748.
• In Canada, provincial and territorial health services offer alcohol-use support.
• Your primary care clinician can discuss options, including treatment for alcohol use disorder.

Section recap: The carrier-specific risk goes away when carriers do not drink, so drinking less or not at all is the core step. Do not mask the flush, do not try to build tolerance, and avoid tobacco.

Treatment landscape: no approved therapy for ALDH2 deficiency

As of October 2026, no therapy has been identified as approved by the FDA or Health Canada to treat ALDH2 deficiency itself. There is no pill that fixes the enzyme.

Research on ALDH2 activators

Scientists have studied compounds that boost ALDH2. In 2008, a team reported a small molecule called Alda-1.

• In rats, Alda-1 given before a heart attack reduced heart damage by 60%.
• In lab dishes, Alda-1 was an especially effective activator of the weak ALDH2*2 enzyme.

These are early animal and lab results. Alda-1 is a research tool, not an available treatment. Whether ALDH2 activators will ever become therapies is still unknown.

What disulfiram teaches about the flush

Disulfiram shows why the flush matters. It is a prescription medicine used to treat chronic alcoholism, according to MedlinePlus. It works as an alcohol deterrent by blocking aldehyde dehydrogenase.

With even a small amount of alcohol, disulfiram causes flushing, headache, nausea, vomiting, chest pain, and trouble breathing. These effects start about 10 minutes after drinking and last an hour or more. MedlinePlus stresses that it must never be given without the patient’s full knowledge.

In other words, medicine uses this very reaction on purpose to discourage drinking. The flush is a warning signal from your body. It is not a flaw to suppress.

Any medicine choice, including disulfiram, belongs in a conversation with a prescribing clinician.

Section recap: No FDA- or Health Canada-approved therapy for ALDH2 deficiency has been identified, and ALDH2 activators remain research only. Disulfiram creates a flush-like reaction on purpose, which shows the flush is a warning sign.

Family and privacy: telling relatives, GINA, and the life-insurance gap

How the variant runs in families

ALDH2*2 is inherited from your parents. Each child of a parent with one copy has about a 50% chance of inheriting it. That is about 1 in 2 children. Your parents, brothers, sisters, and cousins may share it too.

Because the flush is easy to see, relatives often already know. Here, “cascade” sharing means passing on what the flush means, rather than urging everyone to test.

Bringing it up without blame

Talking with a parent who flushes and drinks can feel awkward. These approaches may help:

• Share the research, not a judgment. For example, explain that research links the flush to a slow enzyme that clears a cancer-causing chemical.
• Start with yourself. Explain why you decided to cut back.
• Offer a resource. Point to the NCI fact sheet or NIAAA’s Rethinking Drinking.
• Suggest a doctor visit. A primary care clinician can talk through the risk privately.

Legal protections in the US and Canada

Area	US: GINA (2008)	Canada: Genetic Non-Discrimination Act (2017)
Health insurance	Protected	Covered under the broad rule below
Employment	Protected	Covered under the broad rule below
Life, disability, long-term care insurance	Not covered by GINA; some states add protections	Covered under the broad rule below
Main rule	Bans genetic discrimination in health insurance and employment	No one may require a genetic test, or test results, as a condition for goods, services, or contracts

The Canadian law defines a “genetic test” as a test of DNA, RNA, or chromosomes for purposes such as predicting disease. The Supreme Court of Canada upheld the Act on July 10, 2020, with a dissent.

Before you apply for life, disability, or long-term care insurance in the US, think about how your result might be used. A genetic counselor can explain the rules where you live.

Section recap: Each child of a one-copy parent has about a 1 in 2 chance of inheriting ALDH2*2. GINA protects health insurance and jobs but not life, disability, or long-term care insurance, while Canada’s law is broader.

FAQ

Q1. Does flushing mean a person will get cancer?

No, flushing does not mean you will get cancer. It means your body clears acetaldehyde slowly. The extra cancer risk appears in carriers who drink and is not seen in carriers who do not drink. Talk with your primary care clinician about your own risk.

Q2. Will children inherit the variant?

Each child of a parent with one copy has about a 50% chance of inheriting it. If both parents carry it, the chance is higher. The flush itself is often the first clue in a family. A genetic counselor can explain your family’s odds.

Q3. Can a result affect health or life insurance?

In the US, GINA protects you in health insurance. It does not cover life, disability, or long-term care insurance, though some states add protections. In Canada, the Genetic Non-Discrimination Act bans requiring genetic test results for contracts or services.

Q4. Can an employer find out or use the result?

In the US, GINA protects against genetic discrimination in employment. In Canada, no one may require you to share genetic test results as a condition of a contract or agreement. If you have concerns, ask a lawyer or a genetic counselor about your situation.

Q5. Is a second opinion worth getting?

A second opinion can help if a result confuses you, or if you have symptoms such as trouble swallowing. You can ask your primary care clinician for a referral. You can also find a board-certified genetic counselor through NSGC.

Summary

• The alcohol flush comes from ALDH2*2 (rs671), which slows the cleanup of acetaldehyde.
• IARC classifies acetaldehyde from alcohol as Group 1, carcinogenic to humans.
• About 24 out of 100 Asian-identifying All of Us participants carry the variant.
• Carriers who drink face higher esophageal and head and neck cancer risk; carriers who do not drink show no excess.
• Genetic studies show no protective effect from moderate drinking.
• Masking the flush or building tolerance does not lower risk.
• No FDA- or Health Canada-approved therapy for ALDH2 deficiency has been identified.
• Drinking less, or not at all, is the step the evidence supports.

This article is for educational purposes only. It is not a substitute for advice from a licensed physician, board-certified medical geneticist, or board-certified genetic counselor. For any decisions about testing, treatment, or care, consult a qualified clinician. In emergencies, call 911.

References

1. National Cancer Institute (NIH). Alcohol and Cancer Risk (fact sheet, reviewed May 2, 2025). https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet
2. Forman D, Yang M, Chien R, et al. ALDH2 Deficiency and Alcohol Intake in the United States: Opportunity for Precision Cancer Prevention. Cancer Epidemiol Biomarkers Prev. 2025;34(5):744-753. https://pubmed.ncbi.nlm.nih.gov/40063522/
3. Millwood IY, Im PK, Bennett D, et al.; China Kadoorie Biobank Collaborative Group. Alcohol intake and cause-specific mortality: conventional and genetic evidence in a prospective cohort study of 512 000 adults in China. Lancet Public Health. 2023;8(12):e956-e967. https://pubmed.ncbi.nlm.nih.gov/38000378/
4. Koyanagi YN, Nakatochi M, Namba S, et al. Genetic architecture of alcohol consumption identified by a genotype-stratified GWAS and impact on esophageal cancer risk in Japanese people. Sci Adv. 2024;10(4):eade2780. https://pubmed.ncbi.nlm.nih.gov/38277453/
5. Brooks PJ, Enoch MA, Goldman D, Li TK, Yokoyama A. The alcohol flushing response: an unrecognized risk factor for esophageal cancer from alcohol consumption. PLoS Med. 2009;6(3):e50. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000050
6. Millwood IY, Walters RG, Mei XW, et al.; China Kadoorie Biobank Collaborative Group. Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500 000 men and women in China. Lancet. 2019;393(10183):1831-1842. https://pubmed.ncbi.nlm.nih.gov/30955975/
7. IARC Working Group. IARC Monographs Vol. 100E: Personal Habits and Indoor Combustions (2012). https://publications.iarc.who.int/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Personal-Habits-And-Indoor-Combustions-2012
8. Office of the US Surgeon General (HHS). Alcohol and Cancer Risk: The U.S. Surgeon General’s Advisory (January 2025). https://www.hhs.gov/surgeongeneral/reports-and-publications/alcohol-cancer/index.html ; USDA/HHS. Dietary Guidelines for Americans, 2025-2030. https://cdn.realfood.gov/DGA.pdf
9. Canadian Centre on Substance Use and Addiction. Canada’s Guidance on Alcohol and Health: Final Report (2023). https://www.ccsa.ca/en/guidance-tools-resources/substances/alcohol/canadas-guidance-alcohol-and-health
10. National Institute on Alcohol Abuse and Alcoholism (NIH). Alcohol Metabolism. https://www.niaaa.nih.gov/publications/alcohol-metabolism ; Rethinking Drinking. https://rethinkingdrinking.niaaa.nih.gov/
11. National Human Genome Research Institute (NIH). Genetic Discrimination. https://www.genome.gov/about-genomics/policy-issues/Genetic-Discrimination ; Genetic Non-Discrimination Act, S.C. 2017, c. 3. https://laws-lois.justice.gc.ca/eng/acts/g-2.5/page-1.html ; Supreme Court of Canada. Reference re Genetic Non-Discrimination Act, 2020 SCC 17. https://scc-csc.ca/judgments-jugements/cb/2020/38478/
12. Chang JS, Hsiao JR, Chen CH. ALDH2 polymorphism and alcohol-related cancers in Asians: a public health perspective. J Biomed Sci. 2017;24:19. https://pubmed.ncbi.nlm.nih.gov/28253921/
13. Chen CH, Budas GR, Churchill EN, et al. Activation of aldehyde dehydrogenase-2 reduces ischemic damage to the heart. Science. 2008;321(5895):1493-5. https://pubmed.ncbi.nlm.nih.gov/18787169/ ; MedlinePlus (NLM). Disulfiram. https://medlineplus.gov/druginfo/meds/a682602.html
14. 23andMe. Let’s talk about Alcohol Flush Reaction & Genetics (company page). https://www.23andme.org/en-ca/topics/wellness/alcohol-flush-reaction/

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Last updated: 2026-10-22

Author: Yu Mizuno (Editor-in-Chief, non-physician), GeneLumen editorial team. This article aggregates 14 sources from peer-reviewed medical literature and public health agencies (tier 1=10 / tier 2=3, plus one company product page), including the National Cancer Institute, NIAAA, NHGRI and MedlinePlus (NIH), the US Surgeon General’s Advisory and Dietary Guidelines for Americans, the WHO International Agency for Research on Cancer, the Canadian Centre on Substance Use and Addiction, Canadian federal law and Supreme Court of Canada records, and PubMed-indexed cohort studies and reviews.

This article is for educational purposes only and is not a substitute for medical advice from a licensed physician, board-certified medical geneticist, or board-certified genetic counselor. In emergencies, call 911 (US/Canada) or 119 (Japan).

Related: Metabolic and Hematologic Genetic Diseases

🇯🇵 For readers in Japan — a separate Japanese edition written for Japan’s healthcare system (not a translation): https://genelumen.com/ja/ja-metabolic-hematologic-genetic/alcohol-flush-aldh2-genetics-ja