ALDH2 + ADH1B — "Asian flush" amplified
Both the ALDH2 deficient variant and the ADH1B fast variant detected.
You have DNA changes in both of the genes that handle alcohol, hitting the classic "Asian flush" combination.
A combination strongly associated with the "Asian flush" reaction to alcohol. ADH1B fast metabolism produces acetaldehyde quickly; ALDH2 deficiency means it can't be cleared fast enough. The result is flushing, nausea, and a substantially increased risk of upper aerodigestive cancers with continued alcohol exposure.
This combination causes the well-known "Asian flush" reaction. Your body turns alcohol into a toxic by-product faster than usual, then struggles to clear it away — leaving you flushed and queasy. If you drink heavily over time, the build-up substantially raises the risk of cancers of the throat, mouth, and oesophagus.
What this means
Alcohol is metabolised in two steps: ADH1B converts ethanol to acetaldehyde (toxic), and ALDH2 clears acetaldehyde. The ADH1B fast variant accelerates the first step; the ALDH2 deficient variant bottlenecks the second. The combination produces a particularly strong flush response and pushes lifetime risk of oesophageal and head-and-neck cancers substantially higher in heavy drinkers — moderation matters more here than in the average drinker.
Your body breaks alcohol down in two steps. First, one enzyme turns alcohol into a toxic chemical called acetaldehyde. Then a second enzyme clears the acetaldehyde away. You have a DNA change that speeds up the first step and another that slows down the second — so the toxic chemical piles up faster than your body can deal with it. That causes the flush, the nausea, and over time substantially raises the chance of cancers in the mouth, throat, and oesophagus if you drink heavily. Cutting back matters more for you than for the average drinker.
Caveats
- For people who don't drink alcohol, this has no clinical impact.
- The cancer risk increase is conditional on alcohol consumption — abstinence neutralises most of it.
- These variants are most common in East Asian populations.
References
- Brooks et al. — The Alcohol Flushing Response: An Unrecognized Risk Factor for Esophageal Cancer from Alcohol Consumption (PLoS Medicine, 2009)
- Yokoyama et al. — Alcohol and aldehyde dehydrogenase gene polymorphisms and oropharyngolaryngeal, esophageal and stomach cancers in Japanese alcoholics (Carcinogenesis, 2001)