Tag: Alcohol

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Why Your Face Gets Beet Red When You Drink @ClevelandClinic #inflammation

It may come on in those first few sips of alcohol. Or maybe you’re hit with a hot flash whenever you’re a few drinks in. But whenever you drink, you seem to experience a sudden sensation of warmth, and your face, neck and upper chest become covered in red patches and blotchy skin.

Is facial flushing a sign that you can’t handle your alcohol? Or is this a symptom of something more severe? Dermatologist Alok Vij, MD, explains just what causes facial flushing, along with some truth behind some common misconceptions.

What causes your face to turn red when you drink alcohol?

There are a couple of different root causes for facial flushing. More technically termed the “alcohol flush reaction,” this occurs because your body either can’t fully digest the alcohol you’re consuming or because your body is having an inflammatory response to drinking alcohol.

“Your face may flush from alcohol for two reasons: Because of an enzyme deficiency or because of rosacea,” says Dr. Vij. “Both are tied to your ethnicity.”

Enzyme deficiency

Many Asian populations, specifically 35% to 45% of East Asians, have a deficiency in alcohol dehydrogenase, the enzyme that breaks down a specific substance in alcohol called acetaldehyde.

“Alcohol is toxic to cells, and when it gets into the cells of your blood vessels, it makes them dilate,” explains Dr. Vij. “This reddens the skin and can make you feel warm.”

But without enough of this enzyme, you can end up having too much acetaldehyde in your body, and this makes alcohol reach toxic levels much earlier in your cells. This results in your skin becoming flushed.

Rosacea

Fair-skinned people of Northern European backgrounds who flush when they drink may have some degree of rosacea.

“This very common skin condition is marked by vasomotor instability or hyperactivity,” Dr. Vij explains further. “That means lots of things can dilate your blood vessels: alcohol, chocolate, hot beverages and spicy foods — basically, all the good things in life.”

Should I be worried?

You may be asking yourself this question if you’ve ever experienced facial flushing. On the surface, facial flushing might feel cosmetically embarrassing at most and may not come with any other dangerous symptoms. For those with an enzyme deficiency, facial flushing can occasionally be experienced with increased onset of nausea or vomiting because of your body’s inability to fully digest the alcohol you’re consuming.

For the most part, these factors are mostly harmless. But because alcohol is a cellular toxin, anyone who drinks excessively increases their risk for oral cancer and esophageal cancer.

“Alcohol most frequently passes through these sites,” states Dr. Vij. “Toxicity and DNA damage can build up in cells and, eventually, a cancer can form.”

But recent studies report that those who get an alcohol flush because of an enzyme deficiency are also at heightened risk of digestive, liver and respiratory cancers. These populations are more vulnerable to alcohol’s toxicity, as it’s processed and later eliminated in:

  • Your gastrointestinal (GI) tract, especially your stomach, where alcohol is absorbed.
  • Your liver, where alcohol is sent after it’s absorbed by your stomach.
  • Your lungs, where alcohol in your blood is released in your breath.

Is rosacea linked to cancer?

“We don’t think of rosacea as a precancerous disease,” Dr. Vij clarifies. “The biggest problems rosacea causes are a bulbous nose, like W.C. Fields had, and eye inflammation.”

(It was rosacea — not alcoholism — that made the storied comedian’s nose look large, red and bumpy, because of an overgrowth of the sebaceous glands, Dr. Vij adds.)

In addition, rosacea can make your eyes feel itchy, dry and chronically irritated. These eye symptoms can be managed with anti-inflammatory medication.

“We typically prescribe oral antibiotics like doxycycline or minocycline, often at lower doses than are required to kill bacteria,” he continues.

How to prevent facial flushing when drinking

If an alcohol flush makes you feel self-conscious when you drink, certain treatments can help:

  • Topical medications: Medicines like brimonidine (Mirvaso®) can block blood vessels in your skin from dilating.
  • Laser treatments: A series of laser treatments can shrink the superficial blood vessels in your skin. “You usually need three to 10 treatments to get the full effect, but it can last for years, and prevent broken blood vessels in the later stages of rosacea,” notes Dr. Vij.

But because these medications and laser treatments are considered cosmetic, they aren’t typically covered by insurance.

Are some types of alcohol more likely to cause flushing?

So, if your face flushes, are specific kinds of alcohol to blame? And can you avoid some but not others as an at-home treatment approach to facial flushing?

“It’s really patient-specific. Some people with rosacea flush more with red wine; others flush more with hard liquor,” says Dr. Vij.

If you have rosacea and keep track of what happens when you drink, you may be able to find your triggers. But if facial flushing is an issue for you at all, avoiding alcohol in all its forms might be the next best and most equitable solution.

“If flushing bothers you, and you know alcohol is a trigger, the easiest and most cost-effective solution is to avoid it,” suggests Dr. Vij.

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Alcohol has risks. We must all aim to minimise those risks. @DrPaddy_Barrett preventative cardiologist @HealthBlackrock

Let’s start with some simple facts.
Alcohol is a toxin.
Alcohol is a factor in1:
30% of suicides
40% of fatal burn injuries
50% of fatal drownings
50% of homicides
65% of fatal falls
29% of fatal road traffic accidents
Globally, alcohol is responsible for 3 million deaths per year; in the United States, it is the third leading cause of preventable death2 3.
It is hard to see the upside when you see these figures.
So let’s go a little deeper.
First off, I drink alcohol. Not a lot. But I do drink.
So any comments made here are not some puritanical position on alcohol but reflections on the data that exist in the literature.
Multiple studies have demonstrated that excess alcohol consumption, usually defined as consuming greater than 2 to 4 drinks per day, is associated with worse outcomes and a greater likelihood of dying when compared to someone who drinks less than 2 to 4 drinks per day4.

Alcohol Dosing and Total Mortality in Men and Women: An Updated Meta-analysis of 34 Prospective Studies. Arch Intern Med.2006

In the study shown above, females start to accrue an increased risk at greater than two drinks per day on average and males at greater than four drinks per day.

These findings shouldn’t come as a surprise to anyone.

Surprisingly, on average, individuals who consume less than two drinks per day appear to have better outcomes than those who do not drink at all. This is where things start to get a little counterintuitive, and the story of alcohol being beneficial for you starts to appear.

This relationship is known as a ‘U’ shaped curve where those in the middle have the best outcomes, and those on the edges have worse outcomes. A kind of ‘Goldilocks’ relationship; “Not too hot. Not too cold. Just right.”

How might we explain this?

Enter the darling of the 1990s, Resveratrol. This compound in red wine spawned the mantra that red wine was ‘good for your heart’. This was based on research that suggested that it might reduce cholesterol levels, among other things.

But to consume the levels of Resveratrol tested in some of the animal studies that demonstrated benefit, you would have to drink 40 litres of wine…… Per day.

Not exactly a feasible strategy. Even with the best will in the world.

Let’s look at a more plausible explanation.

Data on alcohol consumption and outcomes are almost always based on observational data, not randomised controlled trials. This means that other factors or ‘confounders’ may explain the difference between the groups, not the alcohol consumption alone.

When you look at the trials that suggest a benefit of modest alcohol consumption, you will often find that this group tend to exercise more, smoke less, be in a higher socioeconomic bracket etc. This is referred to as a ‘healthy user bias’ and is likely to explain the difference between the groups.

Most trials try to correct or adjust for these confounders, but in truth, it is very hard to do. A recent publication looked at this problem and attempted to (as much as possible) correct for these ‘healthy user’ bias factors and then compare outcomes between alcohol consumption groups. The results were a little more in line with what we might expect.

Those in the lowest alcohol consumption category had the best lifestyle factors overall. When these healthy factors were corrected for, any benefit seen with modest alcohol consumption disappeared. What remained was a linear relationship between alcohol consumption and coronary artery disease5. Much more what you might expect.

Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022

Research like this and other studies is where the more recent media reports of ‘any’ alcohol being bad for you have come.

So, alcohol is a toxin. But, as Paracelsus notes:

“The dose makes the poison.”

Even water consumed to excess can be lethal.

We know that excess alcohol consumption is harmful. But I don’t think there was any great uncertainty around that point.

The key takeaway is that modest alcohol consumption is unlikely to be ‘beneficial’ to you. As much as you loved the idea that red wine was good for your heart, we can say with reasonable confidence that this is not the case.

The real question we need to answer is whether consuming modest amounts of alcohol is considerably worse for you when it comes to heart disease and death from any cause.

Based on the literature to date, it seems that the incremental risk for modest amounts of weekly alcohol consumption is likely to be small. But that doesn’t mean there are no downsides.

Sleep

One of the main reasons I significantly reduced my alcohol consumption was its effect on my sleep. If I drink more than one drink, I find that the quality of my sleep gets worse. I am much more likely to wake in the middle of the night and feel the effects the following day. But that’s just my personal experience.

Although alcohol is likely to make you fall asleep faster, it impacts your sleep quality6. Additionally, alcohol also reduces the percentage of REM sleep a person gets overnight7.

A workaround for me is to consume any alcohol during the daytime, so my sleep is unlikely to be affected, and if I am going to have a drink, I make sure it is worthwhile. I.e. I am with friends, or it is a high-quality drink. No more drinks on airplanes for me. Mainly because you lose about 30% of your sense of smell and taste in a pressurised cabin and therefore you are less likely to enjoy your drink8. Why do you think they serve you tomato juice and the fact that you think it’s tolerable?!

Humans have been consuming alcohol as far back as the ancient Egyptians, and some evidence suggests the Chinese were consuming alcohol as far back as 7000 B.C. So I don’t see alcohol disappearing any time soon.

The question we all need to ask is:

How much are we realistically drinking on a daily or weekly basis &

Is it likely to be doing us harm?

Only you can answer that question.

The only way to be certain you are doing no harm is to eliminate alcohol entirely. But life is full of risks, some of which we can control, some we cannot.

And some risks are worth taking.

Want to eliminate all road traffic accidents worldwide?

Simple.

Ban cars.

But at what cost?

The risks of driving are a risk most of us are willing to take.

Alcohol has risks.

We must all aim to minimise those risks.

Whatever that means for you, only you can decide.

1

https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-The-Consequences.aspx

2

Mokdad, A.H.; Marks, J.S.; Stroup, D.F.; and Gerberding, J.L. Actual causes of death in the United States, 2000. JAMA 291(10):1238–1245, 2004. Erratum in JAMA 293(3):298, 2005.

3

Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Annual Average for United States 2011–2015 Alcohol-Attributable Deaths Due to Excessive Alcohol Use, All Ages.

4

Alcohol Dosing and Total Mortality in Men and Women: An Updated Meta-analysis of 34 Prospective Studies. Arch Intern Med.2006;166(22):2437–2445. doi:10.1001/archinte.166.22.2437

5

Biddinger KJ, Emdin CA, Haas ME, et al. Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022;5(3):e223849. doi:10.1001/jamanetworkopen.2022.3849

6

Britton, A., Fat, L.N. & Neligan, A. The association between alcohol consumption and sleep disorders among older people in the general population. Sci Rep 10, 5275 (2020). https://doi.org/10.1038/s41598-020-62227-0

7

Ebrahim IO, Shapiro CM, Williams AJ, Fenwick PB. Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res. 2013 Apr;37(4):539-49. doi: 10.1111/acer.12006.

8

Burdack-Freitag, Andrea & Bullinger, Dino & Mayer, Florian & Breuer, Klaus. (2010). Odor and taste perception at normal and low atmospheric pressure in a simulated aircraft cabin. Journal für Verbraucherschutz und Lebensmittelsicherheit. 6. 95-109. 10.1007/s00003-010-0630-y.

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A dearth of information investigating alcohol use in women exists: Source:National Library of Medicine (USgov)

The relationship between alcohol consumption and menstrual cycle: a review of the literature:

Abstract

Alcohol use affects men and women differently, with women being more affected by the health effects of alcohol use (NIAAA, 2011). Yet, a dearth of information investigating the alcohol use in women exists (SAMSHA, 2011). In particular, one dispositional factor hypothesized to contribute to alcohol consumption in women is the menstrual cycle. However, only 13 empirical papers have considered the menstrual cycle as related to alcohol consumption in women. These studies fall out with somewhat mixed findings suggesting that the premenstrual week is associated with increased, decreased, or no change in alcohol consumption, likely due to methodological differences in menstrual cycle determination and measures of alcohol consumption. These methodological differences and possible other contributing factors are discussed here with recommendations for future research in this area. Understanding the contribution of the menstrual cycle to alcohol consumption is one step in addressing an important women’s health concern.

Keywords: Alcohol consumption, Menstrual cycle, Women, Women’s health

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9 Ways Alcohol Affects Your Health @ClevelandClinic

February 15, 2024

What Does Alcohol Do to Your Body? 9 Ways Alcohol Affects Your Health

Alcohol affects your whole body, from your liver and immune system to your brain and mental health

You probably already know that excessive drinking can affect you in more ways than one.

There are the empty calories that can lead to weight gain. There’s the potential for injury and regrettable choices. And don’t forget about the hangovers of course.

Heavy drinking can also lead to a host of health concerns, like brain damage, heart disease, cirrhosis of the liver and even certain kinds of cancer.

And that’s on top of the toll that alcohol use can take on relationships, not to mention the potential for financial strain and legal troubles.

But even moderate alcohol use changes the way your body functions.

We talked with hepatologist Shreya Sengupta, MD, about how alcohol use affects your body and your emotional health.

“Some people think of the effects of alcohol as only something to be worried about if you’re living with alcohol use disorder, which was formerly called alcoholism,” Dr. Sengupta says.

“But when you consider how alcohol is metabolized and used by your body, we can start to see that even moderate and social drinking affects our health to some degree.”

Dr. Sengupta shares some of the not-so-obvious effects that alcohol has on your body.

Liver

Your liver detoxifies and removes alcohol from your blood through a process known as oxidation. When your liver finishes that process, alcohol gets turned into water and carbon dioxide.

But when you ingest too much alcohol for your liver to process in a timely manner, a buildup of toxic substances begins to take a toll on your liver.

If alcohol continues to accumulate in your system, it can destroy cells and, eventually, damage your organs.

“When your liver is overwhelmed by oxidizing alcohol, it generates molecules that inhibit fat oxidation,” Dr. Sengupta explains. “The fats build up. Over time, it can lead to a condition known as steatotic liver disease.”

Steatotic liver disease used to go by the name fatty liver disease.

Steatotic liver disease develops in about 90% of people who drink more than 1.5 to 2 ounces of alcohol per day. That’s about one shot glass worth.

With continued alcohol use, steatotic liver disease can lead to liver fibrosis. Eventually, you can develop permanent and irreversible scarring in your liver, which is called cirrhosis.

“The good news is that earlier stages of steatotic liver disease are usually completely reversible in about four to six weeks if you abstain from drinking alcohol,” Dr. Sengupta assures.

Cirrhosis, on the other hand, is irreversible and can lead to liver failure and liver cancer, even if you abstain from alcohol.

Metabolism

You probably are keenly aware of the so-called “beer belly.” That’s shorthand for a round midsection that some people associate with drinking too much beer.

In reality, there’s no evidence that drinking beer (or your alcoholic beverages of choice) actually contributes to belly fat.

But there’s plenty of research to back up the notion that alcohol does lead to weight gain in general. Even for people who aren’t particularly heavy drinkers.

“Drinking gives your body work to do that keeps it from going about its other processes,” Dr. Sengupta notes. “Alcohol distracts your system from its regularly scheduled duties, including things like metabolizing carbohydrates and fats.”

Once you take a drink, your body makes metabolizing alcohol a priority — above processing anything else.

That’s because your body already has processes in place that allow it to store excess proteins, carbohydrates and fats. But there isn’t a storage tank for alcohol. So, your system prioritizes getting rid of alcohol before it can turn its attention to its other work.

That allows excess calories from the foods you eat to sit around, leading to weight gain.

Gut health

Your gut microbiome is a hotbed of bacteria that help keep your digestive system happy and healthy. The trillions of microbes in your colon and large and small intestines are critical to proper digestion. They also help fend off inflammation and support healthy metabolism.

When you drink too much alcohol, it can throw off the balance of good and bad bacteria in your gut.

“Alcohol can kill the good bacteria that live in your gut, allowing bad bacteria to grow unchecked,” Dr. Sengupta explains. “That can lead to problems with digestion, inflammation and even organ damage.”

Having a glass of wine with dinner or a beer at a party here and there isn’t going to destroy your gut. But even low amounts of daily drinking and prolonged and heavy use of alcohol can lead to significant problems for your digestive system.

Heart health

Too much alcohol is bad for your heart. Alcohol can cause:

  • Increased heart rate.
  • Spikes in blood pressure.
  • Irregular heartbeats (arrhythmia).
  • A weakening in your heart (cardiomyopathy).

Warnings from the World Heart Federation go so far as to state that no amount of alcohol is safe for your ticker.

But wait, you may be thinking, what about those headlines that claim red wine is supposed to be good for my heart?

There are a few studies that associate red wine with improved heart health in lab tests. But no research proves that red wine causes any improvements in heart health in people.

“The reality is that alcohol causes more health troubles than it could ever help,” Dr. Sengupta reinforces. “And that goes for your heart, as well as the rest of your body.”

Pancreas

Your pancreas helps your body digest food and manage your blood sugar. Drinking alcohol changes how your pancreas works.

“Your pancreas secretes fluids. Alcohol use can thicken those fluids, which can clog the ducts that those fluids flow out of,” Dr. Sengupta explains.

Like a clog in a drain, those thickened fluids can jam up your ducts. That can lead to pancreatitis, which is inflammation of the pancreas.

Pancreatitis can be a short-term (acute) condition that clears up in a few days. But prolonged alcohol abuse can lead to chronic (long-term) pancreatitis, which can be severe.

Cancer risk

The U.S. Centers for Disease Control and Prevention (CDC) has a clear warning regarding the connection between drinking and cancer: “The less alcohol you drink, the lower your risk for cancer.”

Why?

Your body breaks alcohol down into a chemical called acetaldehyde, which damages your DNA. Damaged DNA can cause a cell to grow out of control, which results in cancerous tumors.

Alcohol use has been shown to raise your risk for several kinds of cancer. That includes cancers of the:

  • Mouth.
  • Esophagus.
  • Throat.
  • Liver.
  • Breast.
  • Colon and rectum.

Immune system

If you drink every day, or almost every day, you might notice that you catch colds, flu or other illnesses more frequently than people who don’t drink. That’s because alcohol can weaken your immune system and make your body more susceptible to infection.

“We see lower levels of a specific kind of white blood cells called lymphocytes in people who drink heavily for long periods of time,” Dr. Sengupta reports. “That can leave them more vulnerable to infectious diseases.”

Brain

The morning after a night of over-imbibing can cause some temporary effects on your brain. Things like trouble concentration, slow reflexes and sensitivity to bright lights and loud sounds are standard signs of a hangover, and evidence of alcohol’s effects on your brain.

Long-term alcohol use can change your brain’s wiring in much more significant ways. Ways that your standard hangover cures won’t even begin to touch.

“Excessive alcohol consumption can cause nerve damage and irreversible forms of dementia,” Dr. Sengupta warns.

Mental health

Alcohol is a depressant. And prolonged alcohol use can lead to mental health conditions like anxiety and depression. Chronic misuse can also lead to paranoia and hallucinations.

Even drinking a little too much (binge drinking) on occasion can set off a chain reaction that affects your well-being. Lowered inhibitions can lead to poor choices with lasting repercussions — like the end of a relationship, an accident or legal woes. Each of those consequences can cause turmoil that can negatively affect your long-term emotional health.

“Alcohol tends to cause more problems than it solves for a lot of people,” Dr. Sengupta emphasizes. “If drinking is affecting your health, your relationships, your work, your finances, it’s time to make some serious changes.”

Ready to stop drinking and improve your health? These tips may help.

If you need more guidance to quit drinking, the Substance Abuse and Mental Health Services Administration (SAMHSA) offers a hotline, 24/7, 365 days a year. Call 1.800.662.HELP (4357).

Alcoholics Anonymous is available almost everywhere and provides a place to openly and nonjudgmentally discuss alcohol issues with others who have alcohol use disorder.