What Alcohol Does to Your Body, Brain & Health – Part 1

About this Article

In this article, we’re discussing alcohol, one of the most consumed substances on the planet Earth. Both humans and non-human animals consume alcohol either for recreational purposes because they like the feeling that it gives them or for medicinal purposes or for other purposes that we’ll discuss. This article is meant to help people make informed decisions about their alcohol consumption that are in keeping with their mental and physical health goals. We talk about –

• Physiological effects that drinking alcohol has on the brain and body at different levels of consumption and over time have been discussed. We are, of course, going to discuss the effects of alcohol on our biology, ranging from its effects on individual cells, on organs and systems in our brain and body.
• Alcohol metabolism in simple terms and how it effectively acts as a poison, leading to cellular stress and damage.
• How alcohol impacts neuronal function and changes our thinking and behaviour – hallmarks of inebriation, and what being inebriated really does to our thinking and our behaviour and how it does it.
• How alcohol consumption of different amounts impacts inflammation, stress, neurodegeneration, and cancer risk and negatively impacts the gut microbiome, brain thickness, hormone balance, mood and feelings of motivation.
• The biology of hangovers and science-based strategies to mitigate the severity of a hangover is described. We will also talk about what science says about ways to reduce the effects of hangover, either by doing things that are recommended before you drink or while you drink, as well as things to do if you happen to have a hangover.
• What seems to be one of the more common questions out there, which is whether or not low to moderate amounts of drinking are better for our health than zero alcohol consumption at all. Since alcohol is one of the most widely consumed recreational substances, this article ought to be of relevance to everyone. Indeed, even low-to-moderate alcohol consumption negatively impacts the brain and body in direct ways.
• Genetic differences that predispose certain individuals to alcoholism, binge and habit-drinking. And of course, we will talk about severe alcohol intake, and binge drinking.
• Alcohol consumption in young people and how that can be especially detrimental for reasons that I think are going to be quite surprising to most of you.

The first part of this article covers physiological effects, neurodegeneration, alcohol metabolism, inebriation, top-down inhibition, impulsivity, and effects on memory formation. Other aspects will be covered in the next article of this series.

Alcohol Consumption & Neurodegeneration

A commonly asked question is whether or not alcohol causes degeneration of neurons or nerve cells.

It certainly does cause neurodegeneration, in particular of the neocortex, the largest part of the cerebral cortex, which makes up approximately half the volume of the human brain, the outer layers of the brain that house associative memories, that house our ability to think and plan, that house our ability to regulate our more primitive drives according to context, et cetera.

A recent study has established that low to moderate amounts of alcohol consumption can cause brain degeneration. The title of the study is “Associations between alcohol consumption and gray and white matter volumes”. Gray matter are the neurons, the so-called cell bodies that house the genome of the cells, and white matter is the connections, the fibres, the axons of neurons. It is called white matter because that tissue is surrounded by a fatty tissue called myelin, which allows nerve cells to communicate with each other very quickly. This study looked at the brains, both the gray matter and the white matter, of more than 35,000 generally healthy middle-aged and older adults in the United Kingdom who were drinking various amounts of alcohol. What they found was that even for people that were drinking low to moderate amounts of alcohol, one or two drinks per day, there was evidence of thinning of the neocortex, so loss of neurons in the neocortex, and other brain regions.

This study says that if you’re consuming even just seven glasses of wine across the week, it’s likely that there is going to be some degeneration of your brain in response to that alcohol intake.

Alcohol and the Gut

Alcohol has been used for nutritional purposes. There are people that believe that the calories in alcohol are useful. Also, alcohol has been used for medicinal purposes because it does kill bacteria, but it also kills the good bacteria in your gut, and the destruction of that good bacteria in your gut can lead to things like leaky gut syndrome and has all sorts of issues.

Alcohol Metabolism

Because of the structure of alcohol, it is both water-soluble and fat-soluble. What this means is that when you drink alcohol, it can pass into all the cells and tissues of your bod, it has no trouble just passing right into those cells. Unlike a lot of substances and drugs that actually attach to the surface of cells, to receptors, as they’re called, and then trigger a bunch of downstream domino cascades of effects, alcohol has its own direct effects on cells because it can just pass into those cells. The fact that it can pass into so many organs and cells so easily is really what explains its damaging effects.

There are three main types of alcohol. There’s isopropyl, methyl, and ethyl alcohol. Only the last one, ethyl alcohol or ethanol, is fit for human consumption. However, it is toxic. It produces substantial stress and damage to cells. How does it damage cells? There’s a molecule inside of all of us called NAD (Nicotinamide adenine dinucleotide), a coenzyme central to metabolism. NAD is present in all our cells from birth until death. The level of NAD tends to go down across the lifespan. When one ingests ethanol, NAD and related biochemical pathways are involved in converting that ethanol into acetaldehyde. If ethanol is bad, acetaldehyde is particularly bad. Acetaldehyde is poison. It damages and kills cells and it is indiscriminate as to which cells it damages and kills.

The body deals with that problem by using another component of the NAD biochemical pathway to convert acetaldehyde into acetate. Acetate is actually something that the body can use as fuel. The process of going from ethanol to acetaldehyde to acetate does involve the production of a toxic molecule. If one’s body can’t do this conversion of ethanol to acetaldehyde to acetate fast enough, acetaldehyde will build up in body and cause more damage. So, it’s important that your body is able to do this conversion very quickly. And the place where this conversion is within the liver. The cells within the liver are very good at this conversion process, but they are cells and they are exposed to the acetaldehyde in the conversion process, therefore cells within the liver are badly affected in the alcohol metabolism events.

Empty Calories

The key thing to understand here is that when you ingest alcohol, you are, yes, ingesting a poison (ethanol), and that poison is converted into an even worse poison (acetaldehyde) in your body, and some percentage of that worse poison is converted into a form of calories that you can use to generate energy (ATP – Adenosine triphosphate). ATP is an organic compound that provides energy to drive many processes in living cells, such as muscle contraction, nerve impulse propagation, condensate dissolution, and chemical synthesis.

And the reason why alcohol is empty calories is because that entire process is very metabolically costly, but there’s no real nutritive value of the calories that it creates. You can use it for immediate energy, but it can’t be stored in any kind of meaningful or beneficial way. It doesn’t provide any vitamins, it doesn’t provide any amino acids, it doesn’t provide any fatty acids, it’s truly empty calories.

Inebriation

Now, the important thing to understand is that it is the poison, the acetaldehyde itself, that leads to the effect of being inebriated or drunk. Being drunk is actually a poison-induced disruption of neural circuits.

People who are regular drinkers or who have a genetic predisposition to alcoholism, when they drink, they tend to feel very energized and very good for longer periods of time. They typically experience an increase in alertness and mood when they drink, whereas occasional drinkers will have a briefer, meaning less long-lasting period of feeling good when they drink and then more quickly transition into a state in which they’re tired or they start losing motor skills, they start slurring their speech.

Alcohol is consumed into the gut, right? It goes into the stomach, the liver immediately starts this conversion of ethanol to acetaldehyde to acetate, and some amount of acetaldehyde and acetate make it into the brain. It crosses the blood-brain barrier. The brain has a fence around it that we call the blood-brain barrier or the BBB. Most things, thankfully, can’t pass across the blood-brain barrier, but alcohol, because it’s water- and fat-soluble, just cruises right across this fence and into the milieu, the environment of the brain, which is made up of a couple of different major cell types, neurons, nerve cells, and so-called glial cells, which are in between the nerve cells.

What happens when alcohol gets into the brain? It makes us feel tipsy or drunk and, in some people, makes people feel really especially energized and happy? Well, alcohol is indiscriminate in terms of which brain areas it goes to. It doesn’t bind to particular receptors, but it does seem to have a propensity or an affinity for particular brain areas that are involved in certain kinds of thinking and behaviour. So, one of the first things that happens is that there’s a slight, at least after the first drink or second drink, there’s a slight suppression in the activity of neurons in the prefrontal cortex. This is an area of your neocortex that’s involved in thinking and planning and, perhaps above all, in suppression of impulsive behaviour.

Top-Down Inhibition, Impulsivity

You go to a party and they’re serving alcohol. People are consuming drinks, what you’ll notice is that a few minutes into that party, the volume of people’s voices will increase. That’s because people are simply not paying attention to their voice modulation, and as other people start speaking more loudly, other people also start speaking more loudly. Then you step outside for a moment and you go, “Oh, my goodness, I was shouting.” You come home, the next day, you’ve got a sore throat.

It might be that you picked up some sort of bug, some virus or something, but oftentimes it’s just the fact that you’ve been shouting all night just to be heard because as the prefrontal cortex shuts down, people stop modulating their level of speech quite as much. You will notice that people start gesticulating more, people will start standing up and sitting down more, they’ll start walking around more, if there’s music on, people might spontaneously start dancing.

All of this is because these areas of the prefrontal cortex normally are providing what’s called top-down inhibition. They are releasing a neurotransmitter called GABA onto various parts of the brain that are involved in impulsive motor behaviour and thought patterns, and as you shut down the prefrontal cortex, that GABAergic suppression of impulses starts to be released. So, people will say things that they want to say without so much forethought about what they’re saying, or they might do things that they want to do without really thinking it through quite as much or they might not even remember thinking it through at all.

Memory Formation

Alcohol has a very strong effect in suppressing the neural networks that are involved in memory formation and storage. This is why oftentimes we forget the events of a night out if we’ve been drinking. One of the more important things to know about the effects of alcohol in the brain is that areas of the brain that are involved in flexible behaviour, sort of considering different options, like I could do A or I could do B, I could say this to them or I could say that, I could say it in that way or I could say it in this way, this might be a little more tactful, those brain areas basically shut down entirely and people just tend to say what they want to say.

This completes the first part of the article. Please also read the 2nd part with more details here.

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References

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