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Long-Term Effects of Excessive Alcohol Drinking

Alcohol, Eyes and Vision

Vitamin B1, B12 and folate deficiency, common in chronic alcoholics, may result in a damage of the optic nerve (optic neuropathy) with reversible vision loss [1].

In individuals with diabetes type 2, chronic heavy drinking is associated with loss of visual acuity [2]. There seems to be no association between alcohol consumption and diabetic retinopathy in individuals with diabetes type 1 or 2 [2,3].

Chronic heavy drinking increases the risk of color blindness [4].

Alcohol and Hearing

Long-term heavy drinking (>4 drinks/day) is associated with hearing loss, especially for high frequencies [5]. According to one study, there is no association between the long-term alcohol consumption and the risk of hearing loss [6]. Long-term high alcohol consumption in combination with low vitamin B12 intake was associated with hearing loss [6].

Children with fetal alcohol syndrome are at increased risk of hearing loss [7].

Alcohol, Bones and Joints


According to one study, there is an association between alcohol drinking and decreased risk of rheumatoid arthritis, osteoarthritis, reactive arthritis and psoriatic arthritis [8]. According to another study, individuals with rheumatoid arthritis (RA) who are regular drinkers tend to have less severe symptoms than nondrinkers [9]. Researchers do not encourage nondrinkers to start drinking to lessen RA symptoms, since more studies are needed to explain this phenomenon.

According to one study, the risk of gout is increased in beer and spirit drinkers, but not in moderate wine drinkers [11]. Lowering alcohol intake and avoiding binge drinking can reduce frequency of painful attacks [10].

According to one study, alcohol consumption is not associated with the risk of systemic lupus erythematosus (SLE) [12], but according to one study, moderate drinking may decrease the risk [13].


Heavy drinking increases the risk of osteoporosis and bone fractures [14,15] and reduces bone growth in adolescents and increases the risk of bone fractures later in life even if they stop drinking [16]. Heavy drinkers, especially those with liver cirrhosis, may have low levels of the active form of vitamin D, which may result in hypocalcemia, which may contribute to osteoporosis and bone fractures [14,15,17]. Stopping drinking may quickly result in normal calcium levels [15].

Moderate drinking is associated with a decreased risk of osteoporosis in women after menopause [15].

Alcohol and Muscles

Chronic heavy drinking results in a decreased synthesis of proteins in the body and thus in a reduced muscle mass and painless muscle weakness [18,20].

Chronic alcoholic myopathy (Greek myo– = muscle; -pathy = disease) is the wasting of skeletal muscles with weakness of shoulder and hip muscles [18]. With alcohol abstinence, the condition may recover within 6-12 months [18].

Alcohol and Asthma

Moderate drinking is associated with the lower risk of new-onset asthma in adults [19].

Ethanol acts as a bronchodilator and may moderately widen the breathing airways in asthmatics [21]. Some asthmatics reported worsening of symptoms after certain alcoholic beverages and improvement after other alcoholic beverages [21].

Sulfites in wines and beers may trigger narrowing of the breathing airways (bronchospasm) in sensitive asthmatics [21,22]. In 2 studies, only few asthmatics with a history of sensitivity to wine (“red wine asthma”), experienced symptoms after consuming high-sulfite wines [22,23], while in another study, 9 of 18 individuals with red wine asthma reacted to high-sulfite wines [24]. This may mean that sulfites alone are not enough to trigger symptoms, but other factors, such as stress, may be necessary.

In asthmatics with ALDH2 deficiency (mainly East Asians), alcohol triggers the release of histamine, which may result in difficult breathing with wheezing [21]. In one study in Japan, treatment with azelastine hydrochloride (antihistamine H1) for 1 week in individuals with alcohol-induced asthma prevented asthmatic symptoms [26].

Alcohol may worsen the side effects of theophylline (a drug that widens breathing airways), such as headache.

Alcohol and Blood Disorders

Chronic heavy drinking can be associated with [28,29]:

  • Increased risk of bleeding, for example, nosebleeds due to impaired or lowered platelets or coagulation factors
  • Increased risk of clotting of the brain arteries (ischemic stroke)

Increased blood triglyceride levels (hypertriglyceridemia) may develop due to drinking 1o or more alcoholic drinks per day, more likely in obese individuals and those who already have increased triglyceride levels [27,30].

Alcohol, Immunity and Infections

Both acute and chronic, and both moderate and heavy drinking can decrease the amount of white blood cells and thus impair immunity and increase the risk of infections, such as tuberculosis and pneumonia [1,31,32,34].

Mechanisms include direct toxic effect of alcohol, increased secretion of a steroid hormone cortisol and, in women, decreased production of estrogen, which may impair the production of white blood cells, which are responsible for destroying microorganisms [1,33].

Alcohol and HIV/AIDS

Alcohol intoxication increases the probability of risky sexual behavior and thus increases the risk of HIV/AIDS [35].

Alcohol consumption increases the risk of staphylococcal pneumonia, hepatitis C and other infections in patients with HIV/AIDS [35].

Alcohol may decrease the effectiveness of drugs to treat HIV/AIDS (antiretrovirals or ARVs) [36]. Alcohol may increase the toxic effects of certain antiretroviral drugs on liver, especially in those who have hepatitis C [37].


Alcohol may promote cancer growth by a direct toxic effect on the cells and by generating free radicals. Alcohol increases the risk of the following cancers: mouth, throat, laringeal (voice box), esophageal, gastric, liver and breast cancer [28]. A combination of smoking and drinking greatly increases the risk of mouth and esophageal cancer [28]. Spirits and white wine (but not red wine or beer) may increase the risk of basal cell carcinoma of the skin [38]. Alcohol is not considered directly carcinogenic, but it lowers the activity of the immune system and cell repair.


Heavy drinking increases the risk of death from ischemic heart disease (heart attack), fire accidents, falls, murders, traffic accidents (pedestrians), drowning, accidental hanging, hypothermia, pneumonia, chronic bronchitis, liver cirrhosis and ruptured esophageal varices [39-p.396].

Disorders Probably NOT Associated with Excessive Drinking

Alcohol consumption does not likely increase the risk of developing kidney stones [41].

Alcohol probably does not cause stomach or duodenal ulcer, but it may worsen symptoms of established ulcers [25,42]. Chronic alcoholics are often infected with the H. pylori bacteria, which may cause peptic ulcer, though [25].

  1. Mroczkowzki MM et al, 2011, Reversible vision loss secondary to malnutrition in a woman with severe anorexia nervosa, purging type, and alcohol abuse
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  38. Fung TT et al, 2002, Intake of alcohol and alcoholic beverages and the risk of basal cell carcinoma of the skin  PubMed
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  41. Diet for Kidney Stone Prevention  National Institute of Diabetes and Digestive and Kidney Diseases
  42. Peptic ulcer disease  Emedicine

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