Does Alcohol Cause Nutrient Depletion?

Sorry to be a buzzkill, but alcohol depletes the body of vital nutrients, especially B vitamins. Most often, the nutrient deficiencies are rooted in malabsorption, malnutrition, and ethanol toxicity. Rapid alcohol exposure causes the cells of the liver to release their vitamin content, but even slow, continual consumption of alcohol contributes to nutrient deficiencies.

Malnutrition

Nutrient depletion is dose-dependent, and could be explained by the fact that those who drink the most alcohol generally consume the fewest nutrients through food. Therefore, malnutrition is a great concern among chronic alcohol use. Research also shows that those who depend on alcohol for calories tend to favor unhealthy food choices, which explains the nutritional deficiencies common in alcoholics and associated with many chronic diseases.

Depletion of B vitamins remains the most common nutrient deficiency among those who drink alcohol. In an animal study where rats could freely partake of a 15% ethanol solution for 28 days, the content of vitamins B1, B2 (riboflavin), B6, and B5 (pantothenic acid) was lower in blood, urine or the liver when the diet was also low in these nutrients. Because many people who regularly drink alcohol also consume a standard diet lacking in many essential nutrients, it is critical that these individuals supplement with nutrients, consume more nutrient-dense foods, and reduce alcohol intake.

Malabsorption

The nutrient deficiencies found among moderate drinkers can often be explained by malabsorption. Alcoholics have difficulty absorbing sodium, fat, thiamin, folic acid, and vitamin B12. Abnormal biliary secretion, pancreatic insufficiency, and the direct effects of alcohol on the GI tract are responsible for malabsorption. However, recent research shows that alcohol also alters the gut microbiota, which leads to liver cirrhosis, liver failure, and hepatocyte damage. Both short term and long term alcohol use has been associated with changes in the gut microbiota, leading to a state of dysbiosis that allows proinflammatory bacteria to grow and results in less short-chain fatty acid production. 

Interestingly, those who consumed excessive alcohol showed gastrointestinal alterations of the small intestine similar to those with untreated celiac disease, another condition for which malnourishment and malabsorption are classical markers and the resulting nutrient deficiencies have been responsible for comorbid conditions.

Neurological Effects

Continuous alcohol consumption is also linked to neurological damage, affecting the brain, mood, and cognition. Many of the resulting conditions are also associated with deficiencies of B vitamins. For example, 25 to 66 percent of chronic alcoholics experience alcoholic neuropathy. Traditionally, this condition has been thought to develop as a result of the nutritional deficiencies common in those who consume alcohol. Alcohol reduces thiamin absorption. The features of alcoholic neuropathy are identical to those of nonalcoholic thiamin deficiency neuropathy.

Chronic alcohol use is also related to increased risk of traumatic brain injury, seizures, stroke, Wernicke’s encephalopathy, Korsakoff’s syndrome, hepatic encephalopathy, central pontine myelinolysis, alcoholic cerebellar degeneration, and alcohol-related dementia. Both Wernicke’s encephalopathy and its progressed form, Korsakoff’s syndrome, are direct results of a thiamin deficiency. Central pontine myelinolysis is an outcome of alcohol-induced electrolyte imbalances.

Alcohol consumption greatly impacts nutritional status and overall health, and should be evaluated in a complete health history. When either managing or preventing the potential health effects of alcohol consumption, it is crucially important to correct B vitamin deficiencies, address dysbiosis and gut damage with probiotics, support the liver, and support the brain and neurological system with nutraceuticals while giving nutritional guidance.