Responsible Drinking: Alcohol and the Liver
Your liver is the most important organ when it comes to drinking alcohol. Learn about the relationship between alcohol and the liver, alcohol-related liver diseases, and how to avoid liver damage.
By Emma Zhao on Sep. 13, 2022
The liver is the most important organ in relation to alcohol consumption. In fact, the liver is responsible for digesting the alcohol in your body so that it doesn’t become a toxic substance, which can negatively affect your wellbeing.
The liver is actually the largest organ in the body. and typically contains enzymes that break down harmful chemicals in your body, like ethanol and drugs. Some people may lack these enzymes, which means that they may have an intolerance to alcohol, or an allergy to alcohol.
This is where you may see many issues starting to form as a result of overdrinking. While the liver is an incredibly effective, overconsumption of alcohols can lead to build up in the liver, that can ultimately cause liver damage.
Let’s discuss the incredibly important relationship between the alcohol and your liver, what can cause liver damage, and how you can take care of your liver while still enjoying a glass of wine.
Your Body, Your Liver, and Alcohol
The Liver
The liver is located in the upper right-hand side of your abdomen, on top of the stomach. It weighs about three pounds, and is rich with blood cells, which is supplied by oxygenated blood coming from the heart and nutrient rich blood flowing back up to the heart.
It serves many purposes in the body, and here are just a few:
- Production of some proteins to blood plasma
- Converts excess glucose to glycogen for energy
- Converts ammonia into urea (in urine)
- Regulates blood clotting
- Clearing the blood of drugs, alcohol, or other harmful substances
The Liver and Alcohol
The break down of alcohol occurs in a few steps, and requires two primary enzymes, both of which are located in the liver.
Alcohol dehydrogenase (ADH) is an enzyme that the body produces, which is produced by liver cells, used to convert alcohol into acetaldehyde. This is a highly toxic substance, and is actually associated with most hangover symptoms, including dizziness, headaches, and nausea. In large amounts, acetaldehyde could be dangerous, and even fatal.
Another enzyme, called ALDH2, also known as Aldehyde dehydrogenase, is a mitochondrial enzyme also produced from the liver. ALDH2 breaks down the toxic acetaldehyde into acetic vinegar, which is harmless. In those with alcohol allergies, this enzyme is typically mutated.
Some liver cells typically die when every time alcohol is filtered through the organ. They are typically able to regenerate. However, if alcohol is consumed constantly at a rapid rate, it will be harder for the regenerate its cells, and it may even experienced a reduced ability to regenerate its cells. This can lead to permanent and harmful liver conditions.
Alcohol Can Cause Liver Damage
It’s no doubt that consuming lots of alcohol can cause many health issues, and your liver might experience complications if you’re not careful. Alcohol-related liver diseases (ALD) is caused by drinking alcohol at a rate that is unsustainable for the liver.
The liver needs time and energy to regenerate its cells. This means that if you are constantly consuming alcohol, even if you don’t always become intoxicated, you could be harming your liver.
There are three types of ALDs:
- Alcohol Related Steatohepatitis or fatty liver, where accumulates in your liver and slows down or even prevents the liver from completing normal functions.
- Alcoholic Hepatitis, where inflammation and the death of liver cells causes scarring on the liver, known as fibrosis.
- Alcohol Related Cirrhosis is the most serious ALD, where the entire liver is scarred, hardened, thus causing liver failure.
These can lead to long-term health issues, including high blood pressure, cancers, a weak immune system, memory problems, mental health issues, etc.
Early Detection of Alcohol-Related Liver Issues
While alcohol-related steatohepatitis and alcoholic hepatitis are reversible with abstinence, alcohol-related cirrhosis is usually irreversible and even fatal. Therefore, it’s important to catch the symptoms before they develop into Cirrhosis.
It’s especially important to catch symptoms at their earliest, as ALD symptoms can progress the more severe it gets.
Some early alcohol disease symptoms may include:
- abdominal pain
- poor appetite
- feeling sick or unwell
- digestive issues
As the issues progress, you may start to feel symptoms including;
- jaundice (the yellowing of eyes, and skin)
- swelling of the legs, ankles, and feet
- cold or hot flashes
- weight loss
- memory problems
- tendency to bleed and bruise easily
- increased sensitivity to alcohol
If you’re assessing whether or not you may have an issue, the CDC recommends running through a CAGE test, where you ask yourself:
- Have you thought of cutting down on your alcohol consumption?
- Have you been annoyed when someone points out your alcohol consumption?
- Have you felt guilty about consuming alcohol?
- Do you consume alcohol as an eye-opener (to steady yourself/nerves)?
It’s important to see a doctor if you suspect you may have an ALD. The good news is when you abstain from after early detection of ALD symptoms, the disease is largely reversible.
Treatment for Liver Damage Related to Alcohol
Treatment is mostly dependent on how much the person is willing to receive it, but ultimately it comes down to limiting or completely halting alcohol consumption.
Withdrawal symptoms may make it more difficult to abstain from alcohol, in which case, medical professionals might help reduce alcohol consumption gradually. Usually psychotherapy is an effective way to prevent relapses, but medication like naltrexone may be prescribed to help.
Medication to treat ALD directly is a bit more controversial. Experts believe that these medications don’t actually help all that much. Therefore, medication is usually only prescribed to help symptoms of ALDs.
Diet is also incredibly important to treatment and recovery. Your doctor may recommend a lower salt diet, and you may even be encouraged to consume 3-4 small meals per day. Healthy snacking in between your meals will help you keep your protein and calorie rate consistent.
So how do you drink and avoid liver damage?
The Dietary Guidelines for Americans recommends that if those of legal drinking age choose to consume alcohol, men should consume no more than two standard drinks a day, while women should consume no more than one.
Standard drinks usually mean:
- 12 ounces of beer (5% ABV).
- 8 ounces of malt liquor (7% ABV).
- 5 ounces of wine (12% ABV).
- 1.5 ounces of 80-proof spirits (40% ABV)
For more information on the science behind drinking, check out these articles:
Are sweet alcoholic drinks good for you?
Are Italian wines good for you?
Alcohol Allergies
Global Warming and Wineries