How Much Alcohol is Too Much?

In honor of Alcohol Awareness Month, Board Certified Internist and Entrepreneur in Residence Dr. Nancy Simpkins weighs in on an important topic.

From Nancy:
Sixty percent of U.S. women have at least one drink a year. Among women who drink, 13 percent have more than seven drinks per week. For women, this level of drinking is above the recommended limits published in the Dietary Guidelines for Americans, which are issued jointly by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services. The Dietary Guidelines define moderate drinking as no more than one drink a day for women and no more than two drinks a day for men. The Dietary Guidelines also point out that drinking more than one drink per day for women can increase the risk of motor vehicle crashes, injuries, high blood pressure, stroke, violence, suicide and certain types of cancer. Women absorb and metabolize alcohol differently than men. In general, women have less body water than men of a similar body weight, so women achieve higher concentrations of alcohol in the blood after drinking equivalent amounts of alcohol. How Much Alcohol is Too Much? Understanding the rate of metabolism—the speed at which your individual body burns calories from food and drink into energy—is critical to understanding the effects of alcohol. When you are out with your friends, one to two drinks is your limit. Although alcohol content varies from drink to drink, it is still a good rule to follow the two-drink maximum for women. Alcohol itself produces changes in the body (decreased attention, fatigue, impaired function, etc.) even with a single glass of wine. Over that limit, your liver cannot break down the alcohol properly and side effects such as dizziness, nausea and vomiting ensue. How do you know if you have a problem with alcohol? First of all, do you require alcohol to have a good time? Can you experience a night out or dinner without alcohol? Do you need to drink more than once everyday? Does it interfere with work or your profession? If alcohol is a problem for you in any way, speak to your doctor about your options. AA (Alcoholics Anonymous), which is just that—anonymous help, a private addiction counselor or psychologist are just a few starting points. Drinking, even casually on a regular basis, can cause long-term liver damage. The liver is a big organ, which makes it forgiving for an occasional binge, but when it’s more constant, the liver cannot metabolize alcohol without feeling the effects. So if you have screening labs at your doctor’s office and they mention that your liver enzymes are elevated, take it seriously and cut down on your consumption immediately. Do not ignore the early signs of liver disease (elevated blood work) as the next sign can be permanent damage.



Women who abuse or are dependent on alcohol are more vulnerable than men to:

- Liver disease Women are more likely to contract alcoholic liver disease like hepatitis (an inflammation of the liver) and are more likely to die from liver cirrhosis (a chronic disease that progressively destroys the liver’s ability to aid in digestion and detoxification). - Brain damage Women are more likely than men to suffer alcohol-induced brain damage, such as loss of mental function and reduced brain size.


Compared with women who don’t drink or who drink in moderation, women who drink heavily also have an increased risk of:

- Osteoporosis—a thinning of the bones - Falls and hip fractures - Premature menopause - Infertility and miscarriages - High blood pressure and heart disease
A commonly held view is that alcohol is less of a danger than other drugs; this is where people run into trouble. Alcohol is a potent drug that requires a lot of metabolism in the liver to break it down. If you are taking other medications for any reason (oral contraceptive pills, antibiotics, antidepressants, etc.), your liver is already working hard to break down and metabolize the medication. On top of that, you are now asking the liver to work overtime when drinking. So bottom line, have fun but be kind to your liver and it will be kind to you!