Doc’s Corner

How Alcohol Affects Your Body

Alcohol consumption is widely considered to enhance our social well-being. The reported health effects of drinking alcohol are varied, with clear deleterious effects of heavy drinking on the brain, liver and other organ systems and some suggestion of benefit at low levels of consumption. According to Topiwala, Valkanova, et al BMJ 2017, and now multiple additional recent studies have called into question earlier (older, less well controlled) studies suggesting any benefit over abstinence. More recent studies have tended to reveal that “all cause morbidity and mortality” is not enhanced by any level of alcohol consumption. As life span increases, preserving quality of life will depend on maintaining cognitive function, which declines with age. Alcohol drinking may be a modifiable risk factor for cognitive impairment, if primary prevention efforts begin in early adulthood or sooner.

In light of these recent findings, justifying drinking habits that are regarded as normal or even as beneficial may no longer be rational. This being said, it seems prudent to consider some ways alcohol effects our body. Many of the physiological effects noted with moderate to heavy consumption take place with light consumption but to a far less extent and often are “subclinical”, without any discernible awareness.

Did you know that as early as thirty seconds after your first sip, alcohol races into your brain. It slows down the chemicals and pathways that your brain cells use to send messages. Depending on the amount, and varying greatly among individuals, it potentially alters mood, slows reflexes, and throws off balance. It also becomes difficult to think straight, which you may not recall later, because you’ll struggle to store things in long-term memory. If you drink heavily for a long time, booze can affect how your brain looks and works. Its cells start to change and even get smaller. Too much alcohol can actually shrink your brain (atrophy of the hippocampus). The result can have big effects on the ability to think, learn, and remember things. It can also make it harder to keep a steady body temperature and control movements. Alcohol’s slow-down effect on the brain can make you drowsy, so you may doze off more easily. But you may not sleep well. The body processes alcohol throughout the night. Once the effects wear off, it leaves you tossing and turning. You don’t get that good REM sleep your body needs to feel restored and nightmares and vivid dreams are more likely. You’ll also probably wake up more often for trips to the bathroom.

When enough acid and alcohol build up, nausea results and you may throw up. Years of heavy drinking can cause painful ulcers in your stomach. High levels of stomach juices mean you may not feel hungry. That’s one reason long-term drinkers often don’t get all the nutrients they need. The small intestine and colon get irritated, too. Alcohol throws off the normal speed that food moves through them. That’s why hard drinking can lead to diarrhea, which can turn into a long-term problem. It also makes heartburn more likely – it relaxes the muscle that keeps acid out of the esophagus contributing to acid reflux or GERD.

The brain gives off a hormone that keeps the kidneys from making too much urine. When alcohol is present the brain tends to hold off. That means more urination, which can contribute to dehydration. When you drink heavily for years, that extra workload and the toxic effects of alcohol can wear the kidneys down. The liver breaks down almost all the alcohol you drink. In the process, it handles a lot of toxins. Over time, heavy drinking makes the organ fatty and lets thicker, fibrous tissue build up. That limits blood flow, so liver cells don’t get what they need to survive. As they die off, the liver gets scars and stops working as well, a disease called cirrhosis.

Normally, the pancreas makes insulin and other chemicals that help the intestines break down food. But alcohol impairs the process. The chemicals stay inside the pancreas. Along with toxins from alcohol, they cause inflammation in the organ, which can lead to serious damage. After years, it may no longer be able to make the insulin needed, which can lead to diabetes or pancreatitis. It also makes pancreatic cancer more likely.

Ever experience a hangover? That cotton-mouthed, bleary-eyed morning-after is no accident. Alcohol dehydrates and makes blood vessels in your body and brain expand. That can result in headache. The stomach wants to get rid of the toxins and acid that booze churns up, which results in nausea and vomiting. When the liver is busy processing alcohol, it does not release enough sugar into your blood, bringing on weakness and the shakes. One night of binge drinking can jumble the electrical signals that keep the heart’s rhythm steady. That could precipitate an acute arrhythmia. If you do it for years, those changes may become permanent. And, alcohol can literally “wear the heart out” resulting in cardiomyopathy. Over time, it causes heart muscles to droop and stretch, like an old rubber band. It can’t pump blood as well, and that impacts every part of the body. Alcohol widens blood vessels, making more blood flow to the skin. That may make you blush and feel warm and toasty. But not for long. The heat from that extra blood passes right out of the body, causing temperature to drop. On the other hand, long-term, heavy drinking boosts the blood pressure. It makes the body release stress hormones that narrow blood vessels, so the heart has to pump harder to push blood through.

You might not link a cold with a night of drinking, but there might be a connection. Alcohol puts the brakes on the immune system. The body can’t make the numbers of white blood cells it needs to fight germs. The sugars in alcohol tend to enhance inflammation. So for 24 hours after drinking, you’re more likely to get sick. Long-term, heavy drinkers are much more likely to get illnesses like pneumonia and tuberculosis.

Our hormones manage everything from sex drive to how fast food is digested. Hormonal balance is essential for excellent health. But alcohol can throw that out of whack. In women, menstrual cycles can become thrown off and even cause problems with pregnancy . In men, it can mean trouble getting an erection, a lower sperm count, shrinking testicles, and breast growth. Along with hormonal imbalance, calcium levels are affected by alcohol that can contribute to thinner and more fragile bones, osteoporosis.

Building muscle strength is an important goal at Elite Fitness Plus. Heavy alcohol drinking can limit blood flow to muscles and get in the way of the proteins needed to build them. Over time with heavy drinking, muscle mass becomes lower resulting in reduced strength. It has the potential to undo what has taken considerable effort to create.

Since most of us are likely to continue light or “social drinking” (defined as 1 drink for women, 2 for men) it is important to remember that alcohol affects each of us differently. You don’t have to get wasted to pay a price the next morning. Just a couple of drinks can trigger a headache and other hangover symptoms for some people. Having water or a nonalcoholic drink between each beer or hard drink can help keep you hydrated and cut down on the overall amount of alcohol you drink. Red wine contains tannins, compounds that are known to trigger headaches in some people. Malt liquors, like whiskey, also tend to cause more severe hangovers. If you’re worried about how you’ll feel in the morning, the gentlest choices are beer and clear liquors, such as vodka and gin. It’s the amount of alcohol you drink (not the order of your drinks) that matters most. Standard drinks — a 12-ounce glass of beer, a 5-ounce glass of wine, or a 1.5-ounce “shot” of liquor — have about the same amount of alcohol. Although any food can slow down how fast your body absorbs alcohol, fat does it best. Food has to be in your stomach before alcohol to have any significant impact. Caffeine can narrow your blood vessels and may make your hangover worse. After a night of drunkenness, it’s best to sip water and sports drinks to counter dehydration and replace lost electrolytes — especially if you threw up.

In summary,  alcohol consumption is potentially a significant risk factor that merits strategic consideration for those that value optimal health. As always, I welcome your questions and comments.

Paul R. Block, MD, FACP, FCCP

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