Alcohol: Damaging Effects on the Liver and Blood Cells
Guest: Dr. Sarah Book – Psychiatry & Behavioral Sciences
Host: Dr. Linda Austin – Psychiatry
Dr. Linda Austin: I am Dr. Linda Austin. I am talking today with Dr. Sarah Book, a psychiatrist at the Center for Drug and Alcohol programs.
Dr. Book, you have said that the ill effects of alcohol begin, for women, with more than seven drinks per week and, for men, with more than 14 drinks per week. Let’s talk about those ill effects. First of all, the liver, what happens in the liver?
Dr. Sarah Book: Well, one of the first things is that the liver really likes alcohol. The liver will use alcohol for energy, for its metabolism. Now, the liver also makes fat. The liver makes fat to use for its metabolism, for its energy. But if there is alcohol around, the liver cells would much rather use the alcohol than the fat and so the fat starts accumulating in the liver, and that is what we call a fatty liver.
Dr. Linda Austin: And, then, that leads to cirrhosis?
Dr. Sarah Book: That leads to cirrhosis, when fibers start building up in the liver and the liver actually starts breaking down. So, first the liver starts to become fatty and gets large. And then as the fiber starts coming into the liver, the reverse happens, the liver starts shrinking. That is also when you might see your skin turn yellow and begin to itch, and that is because the liver is not able to do its job.
Dr. Linda Austin: Are there tests a doctor could order to tell if that process has begun?
Dr. Sarah Bookman: Yes, there are actually quite a few tests. Up until just a few years ago, we would run more general liver tests that would tell us about irritation in the liver. Now, more recently, a new test has been developed, called carbohydrate deficient transferrin (CDT). You would order it as a %CDT which is very specific for irritation in the liver caused by alcohol.
Dr. Linda Austin: So, is it fair to say, if you have a loved one and you are worried about them, you might say to them, you know, I know you do not think you have a problem but could you do me a favor, let’s just go to the primary care doctor, let’s just run a test and see, and the test will tell us.
Dr. Sarah Book: That is a great idea. That is right.
Dr. Linda Austin: There are certainly other areas of the body that alcohol can affect. What are some of those areas?
Dr. Sarah Book: Well, alcohol impairs the body’s ability to absorb certain vitamins and because of that, blood vessels do not form properly. And, ultimately, the alcohol is a toxin to the bone marrow. Not only do blood cells not form properly but, because alcohol is a toxin to the bone marrow, the bone is going to make fewer blood cells. And because you are not absorbing as many vitamins, the blood cells that the bone marrow makes are going to be deformed.
Also, alcohol will cause problems in the development of blood vessels themselves and, this is very important, the lining of the esophagus has a protection that alcohol breaks down. So, now you have a very dangerous situation where you have a broken down lining of the esophagus. In the esophagus are tiny arteries that are pretty close to the surface and alcohol has damaged those arteries, the development of the blood vessels is damaged, the blood cells are damaged and there are not of them. So, it does not take very much, now, in this system, to just tick a little piece of that artery and then that individual will start vomiting blood. And, unless they are very close to a medical center, they will most likely die.
Dr. Linda Austin: I know that sounds dramatic. I actually know two individuals, one, the brother of a friend, and another was a patient, who that happened to. The brother of a friend was a 45-year-old dentist. He was watching NFL in the afternoon and he was found dead of that cause. He had evidently started to vomit, to bleed out, and died very suddenly. The second person actually had sustained brain damage as a result of the various consequences of having that happen. And people do not think about that.
Dr. Sarah Book, thank you.
Dr. Sarah Book: Thank you, Linda.
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