Alcohol consumption and brain damage

[Seggybop]

People often comment on how drinking ethanol kills brain cells. I'm curious as to the exact details of this. How much research has been done on it? Is this something that only takes place as a result of heavy drinking, or is there some damage from any amount of consumption? Is this damage reparable?

[The Duchess of Zeon]

There's no evidence of permanent loss in mild to moderate drinkers, but in heavy drinkers to full alcoholics, the loss can be as high as 20% of frontal association cortex neurons in terms of loss of density, when adjusted for all other possible factors, including thiamine deficiency.

As a general rule, if you've had more than six drinks (beers, glasses of wine, or shots of hard liquor) in any combination thereof in a day, then you're putting your health in extreme risk. The same is probably true if you drink more than two drinks a day on a daily basis for a sustained period of time. If you're a frequently but not daily drinker, indulging in more than three at a time is inadvised.

That's the gist of it, essentially.

2 glasses of wine a day is probably fine if you never exceed that, for instance, and the health benefits probably outweight the risks. As you increase beyond that level on a regular basis, however, you can gain nothing except becoming a shit-faced idiot whose is literally destroying your own brain for no gain whatsoever.

Yeah, you can have repeated massive piss-ups in which you slam twenty shots of rum in a night and still graduate from Berkeley with a doctorate in Physics with honours, no doubt. But there's also more than 250,000 hibakusha still alive in Japan; does that mean it's smart to stand near an atomic detonation? I don't think so.

[Dark Hellion]

How does tolerance affect damage? I have to drink far more than many of my peers in order to feel the effects of liquor, is the damage the same per drink or per raise in Blood Alcohol Level?

[kinnison]

How does tolerance affect damage? I have to drink far more than many of my peers in order to feel the effects of liquor, is the damage the same per drink or per raise in Blood Alcohol Level?

I would guess that the damage is less per alcohol unit for someone who drinks a lot, simply because liver metabolism alters to adapt to it. There is a limit to this however; hence cirrhosis. I am also in no doubt that the adaptability of the liver varies from person to person.

As well as this, it is also a known fact that alcoholics (to take an extreme example) are very often malnourished both because they eat less and worse food and because the detoxification of alcohol requires extra nutrients, notably thiamine (vitamin B1).

If you are determined to drink a lot, then the harm might be lessened by taking a decent multivitamin with high B complex content and possibly by various detox agents such as milk thistle. Google that or silymarin.

[Shrykull]

I thought the damage comes from your neurons being deprived of oxygen as the alcohol inferes with it.

[His Divine Shadow]

Some research has gone against the old idea of alcohol actually killing brain cells from what I recall. IIRC the gist of it was that alcohol interfered with the connecting tissue, which would then repair, but scarring would result.

From what I gathered the effect wouldn't be noticeable for any but the most heavy consumers over a long time, i.e. alcoholics. The build up of scarring in the brains pathways could lead to long-term damage and personality changes I think it was.

I really need to find that article again, it was an interesting read. I think it was in the swedish magazine "Illustrerad Vetenskap" or "Illustrated Science" when translated.

[Broomstick]

As a general rule, if you've had more than six drinks (beers, glasses of wine, or shots of hard liquor) in any combination thereof in a day, then you're putting your health in extreme risk. The same is probably true if you drink more than two drinks a day on a daily basis for a sustained period of time. If you're a frequently but not daily drinker, indulging in more than three at a time is inadvised.

Remember, this scales up and down based on body size. Also, for the same weight, men process alcohol slightly more efficiently than women.

Right now, the rule of thumb in the medical world is 2 drinks or less per day for men, 1 drink or less per day for women on a sustained basis is moderate drinking. If you drink less often then that goes up to 2-3 for men, 1-2 for women but that's usually assuming something like 3 "episodes" of alcohol indulgence per week.

Yes, in the past people drank considerably more. It also used to be the custom to, for example, dilute wine with water and beer was often brewed for a shorter period of time, resulting in a lower percentage of alcohol in at least some instances (though by no means all).

How does tolerance affect damage? I have to drink far more than many of my peers in order to feel the effects of liquor, is the damage the same per drink or per raise in Blood Alcohol Level?

Level of intoxication is not a reliable indicator of other possible damage being done. However, tolerance can be a sign of heavy usage - if you have always had high tolerance that might be just your particular biochemistry at work, but if your tolerance has gone up that might not be a good sign.

There are a lot of variables, including genetics, co-morbid conditions, and so forth.

I am also in no doubt that the adaptability of the liver varies from person to person.

And from ethnic group to ethnic group. Certain groups of people either lack or are relatively deficient in some of the chemical machinery required to process and detoxify alcohol. Native Americans, for instance, and many Japanese (though not all) are at an inherited biochemical disadvantage. They not only tend to suffer more damage, they often require less to become seriously intoxicated than, say, those of Northern Europen or Eastern European descent. This is in addition to a wide variation within ethnic groups. The current thinking is that groups that have had alcohol beverages for some time have undergone selective pressures to improve their processing of it. In other words, 10,000 years ago Europeans might have had the same problems with alcohol that we see in some tribal groups only recently introduced to it, but the difference is that we couldn't see the elimination of those who couldn't handle it from the population.

[Dark Hellion]

I always had high tolerance, and I have gotten my alcohol habit under control since I turned 21, so don't worry.

[Broomstick]

I wasn't too concerned - it's also normal for people to go through a period in early adulthood where they drink more than before or after those years. Most folks enter and emerge from that without ill effect.

I have found, though, that between age and a sharp reduction in drinking (it's incompatible with some of my hobbies) my tolerance has dropped below what it originally was when I was young and had my first alcohol. Well, that would make some sense - as you age, efficiency sinks for all parts of the body. It's not noticable day-to-day, but after 20 years or so yeah, you notice even if no one else does.

[Superman]

You might find this interesting. These are brain PET metabolic images in a normal control subject and an alcoholic subject tested 2 weeks after the last use of alcohol. What you're seeing is decreased cortical metabolic activity in the alcoholic person.

[Exonerate]

Level of intoxication is not a reliable indicator of other possible damage being done. However, tolerance can be a sign of heavy usage - if you have always had high tolerance that might be just your particular biochemistry at work, but if your tolerance has gone up that might not be a good sign.

I thought that your tolerance actually decreases if you drink too much, since as your liver's ability to process alcohol degrades, you actually need to drink less to reach a certain blood alcohol level.

[Superman]

I thought that your tolerance actually decreases if you drink too much, since as your liver's ability to process alcohol degrades, you actually need to drink less to reach a certain blood alcohol level.

Tolerance actually tends to increase. You can see the same thing with almost any type of drug addict; the usual doses don't work after a while, so they need more.

Alcoholics are usually 'heavyweights' from their first drink. In fact, tolerance is thought to be a genetic marker for alcoholism.

[Broomstick]

I thought that your tolerance actually decreases if you drink too much, since as your liver's ability to process alcohol degrades, you actually need to drink less to reach a certain blood alcohol level.

That decrease in tolerance occurs only after a long time of increased tolerance, and signals the destruction of the liver. Before that point, there could be decades of very high tolerance.

[Medic]

snip
You might find this interesting. These are brain PET metabolic images in a normal control subject and an alcoholic subject tested 2 weeks after the last use of alcohol. What you're seeing is decreased cortical metabolic activity in the alcoholic person.

To clarify, do you mean that literally? That's what an alcoholic's brain looks like 2 weeks after drinking or that's what an average person's brain looks like 2 weeks after drinking?

(if the latter: how much?!)

[kinnison]

Guesswork; the second pic is of a long-term alcoholic, 2 weeks after not drinking; i.e. a record of the permanent damage done, which is considerable.

[Seggybop]

Some research has gone against the old idea of alcohol actually killing brain cells from what I recall. IIRC the gist of it was that alcohol interfered with the connecting tissue, which would then repair, but scarring would result.

From what I gathered the effect wouldn't be noticeable for any but the most heavy consumers over a long time, i.e. alcoholics. The build up of scarring in the brains pathways could lead to long-term damage and personality changes I think it was.

So does this mean that any alcohol exposure at all will cause some small amount of damage, but that it's only in the heavy drinkers that this damage becomes really noticeable?

[His Divine Shadow]

Well I found this:
http://www.wonderquest.com/BrainCells.htm

For 16 years, Roberta J. Pentney, professor of anatomy and cell biology at the University at Buffalo, has studied chronic alcohol abuse and brain function. She concludes that alcohol does not kill brain cells but rather damages dendrites--the branched ends of nerve cells that bring messages into the cell.

Alcohol surely affects the brain, as we all know, causing slurred speech, clumsiness, slow reflexes, and a loss of inhibition. But alcohol doesn't destroy the brain cells to cause these problems.

Rather, alcohol dilates the channels in the cellular structure that regulates the flow of calcium. More calcium than normal flows into the cells and stimulates increased activity. Somehow this abnormal "turning on" of activity causes a loss of the end segments but does not kill the whole cell. Losing the end segments, however, means losing incoming messages, which disrupts brain function.

The good news is: the damage to the brain cells, for the most part, isn't permanent. The brain repairs itself but the recovery process does change nerve-cell structure. So most function returns to normal but some does not.

So if this damaging and repairing process occurs long enough period of heavy drinking (years, maybe decades?), then it will eventuall cause noticeable changes in the brain. Ofcourse I think you will have to worry about damage to the body at that point.

[kinnison]

It's a bit peripheral, but you have to consider the effects of the malnutrition that often accompanies long-term alcoholism. It would probably be possible to reduce the damage by making sure your nutrition was OK while getting wasted on a frequent and regular basis; but many, perhaps most, don't - if only because many alcoholics can't afford it.