Alcohol

9.3 million people in Germany between the ages of 18 and 69 have harmful high levels of alcohol consumption, with the majority of alcohol intake in the form of beer and a smaller proportion in the form of wine, sparkling wine, and spirits.

Consequences of alcohol consumption

Next to smoking, alcohol is the most important factor for severe health impairment and for the development of chronic diseases. In addition, alcohol abuse is associated with physical as well as psychological dependence. Physical dependence is manifested by clear disturbances and conflicts of the physical condition. If an alcoholic is deprived of the stimulant, withdrawal symptoms such as sweating, trembling or nausea set in. Changes in the psyche manifest themselves in the form of stress states, neglect of professional as well as domestic duties, problems in dealing with people and psychological pressure. Affected individuals feel a compulsion and a decreased ability to control their alcohol consumption.

Metabolism

Alcohol (ethanol) is converted to acetaldehyde by alcohol dehydrogenase (ADH), which is immediately further metabolized (metabolized) to acetate by aldehyde dehydrogenases (ALDH). Acetate can then be used to synthesize (produce) fatty acids. This is one reason why frequent alcohol consumption can lead to obesity. Acetaldehyde is blamed for the “hangover.” Experimental studies also show that acetaldehyde damages deoxyribonucleic acid (DNA for short), primarily by causing double-strand breaks. As a result, neoplasms or tumor diseases (C00-D48) can occur. Alcohol-induced changes in metabolism or damage to the liver cause hypoglycemia. Under these circumstances, the glycogen reserves in the liver are insufficiently filled due to an extremely low intake of food and thus carbohydrates. If the liver, which controls serum glucose levels, is also severely impaired in its function, hypoglycemic shock may result. Severely depressed serum glucose levels can lead to fatigue, irritability, and difficulty concentrating. Alcoholics have a high risk of developing hyperuricemia (gout). In addition to an increase in uric acid production, they experience an inhibition of renal uric acid excretion. Thus, uric acid concentration increases and the development of gout is favored

Cardiovascular System

Cardiovascular disease may also result from increased alcohol intake. There is a possibility that the heart muscle will become inflamed and heart failure will develop as a result. In this case, the heart is no longer able to perform as required – ejection of blood and absorption of venous return. The risk that many organs can no longer be adequately supplied with oxygen and vital substances (micronutrients) is greatly increased due to the circulatory disorders that occur. Furthermore, alcohol consumption is associated with hypertension (high blood pressure). If men consume more than 30 grams and women more than 20 grams of alcohol daily, a significant increase in blood pressure can be observed. Above all, the consequences of alcohol influence such as magnesium deficiency, increased cell membrane permeability for sodium and calcium increase within the cells are the reasons for high blood pressure. The blood pressure-increasing effect also underlies high sympathetic nervous system activity and increased steroid hormone secretion. Since high blood pressure in alcohol abuse occurs independently of additional smoking, obesity, and coffee consumption, such additional risk factors significantly increase the risk of high blood pressure. In the worst case, a stroke (apoplexy) can result from high blood pressure (hypertension) and cause body paralysis or even death [2.1. ].Excessive alcohol consumption increases the risk of atherosclerosis, moderate consumption – one glass of wine/day – reduces the risk of atherosclerosis of the carotids. Caveat (attention)!In men who consume more than 21 drinks per month, the risk of apoplexy (stroke) increases by 22% (= every day a glass of wine is already too much). A lower mortality (death rate) than non-drinkers have men aged 50-64 years with an alcohol consumption of 15-20 units per week or 0.1 to a maximum of 1.5 units per day.The same applies to women aged 65 and over who consumed a maximum of 10 units per week. A major international overview study shows that the guideline values for alcohol consumption need to be revised: Consumption of more than 100 grams of pure alcohol per week – the equivalent of about five and a half glasses of wine or 2.5 liters of beer – already increases the mortality risk (risk of death) as well as the risk of dying from cardiovascular diseases. The life expectancy of participants aged 40 years is reduced by 6 months with consumption of up to 200 g of alcohol per week, by 1 to 2 years from 200 g to 350 g, and by up to 5 years above 350 g per week. Alcohol consumption can also trigger cardiac arrhythmias, which are dose independent and occur regardless of the presence of cardiovascular disease. For example, as the alcohol dose increases, the likelihood of atrial fibrillation increases. A higher alcohol dose can lead to sudden cardiac death in the presence of alcoholic cardiomyopathy (heart muscle disease). Likewise, hemorrhagic insults (stroke due to cerebral hemorrhage) and intracranial hemorrhage (bleeding within the skull; parenchymal, subarachnoid, sub- and epidural, and supra- and infratentorial hemorrhage)/intracerebral hemorrhage (ICB; cerebral hemorrhage) occur more frequently with increasing alcohol dose. Note: A protective effect of alcohol with respect to cardiovascular morbidity (cardiovascular-related morbidity) is exclusively provided by small amounts of alcohol of less than 10 g/day (eg, 1 glass of beer, wine, or liquor).

Digestive tract

Alcohol passes through all the organs of the upper digestive tract from the oral cavity to the small intestine, impairing their functions. In the oral cavity, alcohol abuse reveals mucosal changes, periodontitis, and premature, marked caries Bacteria accumulate on the enamel surface and form a sticky acidic plaque. In the plaque, acids are formed by bacteria from food residues, which attack and destroy the tooth hard substances. The deficiencies of vital substances and malnutrition can increase the damaging effect of plaque. Alcoholics lose their teeth two to three times more often than people who hardly consume this stimulant.Lowered pressure caused by excessive alcohol consumption can be observed in the lower esophagus, which causes reflux of acidic stomach contents and thus heartburn. Furthermore, inflammation can occur, which eventually is the trigger for pain and damage to the esophagus and often causes nausea.In the stomach, alcohol leads to injuries of the mucous membrane, which can also become severely inflamed – gastritis. Accordingly, the function of the stomach is impaired and food intake and utilization develop into a problem. The stomach rejects the food and vomiting occurs. Due to the acidified stomach contents, mucosal tears may develop in the entrance of the stomach with severe bleeding as a result of vomiting. Furthermore, the tooth enamel can be severely attacked and the loss of food through the oral cavity can be accompanied by high potassium losses. The reasons for the absorption disorders of water-soluble vitamins – vitamins B1, B6, B12, folic acid -, some amino acidsleucine, lysine – and essential fatty acids in the small intestine are the functional as well as external changes of the mucous membrane of the small intestine as a result of the folic acid deficiency frequently occurring in alcoholics. In turn, injuries to the mucosa lead to absorption disorders and negatively influence the vital substance balance in the body. Excessive alcohol consumption inhibits sodium and water absorption in the small intestine, which promotes constipation and diarrhea. Due to such damage, the mucosa is increasingly permeable to bacteria, pollutants, heavy metals and other toxic substances from alcohol. The small intestine is thus exposed to a great risk of being heavily colonized by bacteria and germs. This results in intestinal symptoms such as pain and tremendous feelings of pressure and fullness

Liver

Heavy alcohol consumption shortens life expectancy by 10 to 15 years. Although excessive alcohol abuse stresses every organ in the human body, diseases of the liver, upper digestive tract – oral cavity, esophagus, stomach, small intestine – and central as well as autonomic nervous systems are the most common.The majority of alcohol is metabolized in the liver, where the toxic acetaldehyde is also formed as a degradation product. The toxic effect of alcohol or its degradation product causes severe liver changes. Fats can no longer be broken down and accumulate in the liver, which eventually leads to fatty degeneration [2.1]. If inflammation is added – alcoholic hepatitis – swelling, hepatomegaly and remodeling of the liver structure in the form of an extreme proliferation of connective tissue (cirrhosis) follow. The function of this organ is now severely reduced, resulting in jaundice, a tendency to bleed and disturbances in blood flow. As the disease progresses, portal vein pressure increases, which can cause the spleen to enlarge and bleeding to occur in the esophagus.

Nervous System

Alcohol has a strong effect on the central nervous system, causing central nervous complaints such as restlessness, sleep disturbances (insomnia), sweating, perceptual disturbances, and misorientation to appear. Likewise, alcoholics often suffer from the “Wernicke-Korsakow syndrome”, which manifests itself in the form of eye muscle paralysis, changes in character, and memory and consciousness disorders. The vitamin B1 status in the body is decisive for the appearance of the syndrome. If affected persons have low thiamine levels, there is an increased risk of developing this syndrome.In addition to the central nervous system, the peripheral nervous system is also severely impaired in its function – polyneuropathy. There are insensations related to pain and temperature, numbness, tingling and disturbances of positional sensation. High alcohol consumption is a risk factor for ischemic insults and cerebral hemorrhage.A study from the Netherlands-5,395 study participants-shows that low alcohol consumption (men < 35 grams/day and women < 20 grams/day) is associated with a lower risk of macular degeneration and a 58% lower risk of dementia. Research indicates that even alcohol consumption considered moderate can cause damage to the brain. People who drink 110-170 g of alcohol per week for decades – corresponding, for example, to five to seven glasses of wine (0.1 l each) or bottles of beer (0.5 l each) – have a two- to threefold increased risk of atrophy (shrinkage) of the brain mass in the hippocampus compared with non-drinkers. The hippocampus is part of the limbic system in the brain and is primarily involved in memory formation (information storage, associations, information retrieval) and spatial orientation. “Moderate alcohol consumption” is defined differently worldwide. The professional societies for nutrition in Germany, Austria and Switzerland (D-A-C-H) consider a daily alcohol consumption of 10 g (equivalent to approximately 0.1 l of wine) to be acceptable for healthy, non-pregnant women and 20 g (equivalent to approximately 0.5 l of beer) for healthy men. The German Centre for Addiction Issues (DHS) speaks of a “low-risk threshold dose” at 12 g of alcohol per day for a woman and 24 g for a man. By comparison, the threshold dose in the UK is 16 g alcohol/day and 28 g in the US.

Tumor diseases (cancers)

Close to 6% of all cancer deaths can be attributed to alcohol consumption (worldwide). The World Health Organization (WHO) classifies alcoholic beverages and especially the metabolite (metabolic intermediate) acetaldehyde (see above) as a class 1 carcinogen. This makes alcohol comparable in its carcinogenic (cancer-causing) effect with, among others, formaldehyde, plutonium and processed red meat (sausage, ham). Heavy drinkers – that is, women who consume eight or more alcoholic drinks/week or men who consume 15 or more drinks/week – are at increased risk for the following tumor diseases:

  • Tumor diseases of the oral cavity and pharynx (throat): 5.13-fold – slightly increased risk even with occasional alcohol consumption.
  • Squamous cell carcinoma of the esophagus (esophagus): 4.95-fold
  • Laryngeal carcinoma (cancer of the larynx): 2.65-fold
  • Liver carcinoma (hepatocellular carcinoma): 2.07-fold – At this point, it should be noted that regular coffee consumption reduces the risk of developing liver carcinoma by more than half.
  • Colon carcinoma (colorectal cancer): 1.44-fold.
  • Mammary carcinoma (breast cancer): 44%.

Moderate alcohol consumption, that is, one alcoholic drink for women and two for men, also increases the risk for the tumor diseases listed previously (except for liver carcinoma).

Mortality (mortality)

People who regularly consume between one and three alcoholic drinks per week have a lower mortality (death) risk than people who never drink alcohol, according to a large-scale study (PLCO study). However, as alcohol consumption increases, cardiovascular (affecting the cardiovascular system) mortality increases again.

The following are the major diseases that may be contributed to by alcohol dependence:

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Malformations of the child

Respiratory system (J00-J99)

  • Laryngitis (inflammation of the larynx)
  • Pharyngitis (pharyngitis)
  • Pneumonia (pneumonia)

Blood, blood-forming organs – immune system (D50-D90).

Endocrine, nutritional and metabolic diseases (E00-E90).

Factors influencing health status and leading to health care utilization (Z00-Z99).

  • Burnout syndrome

Skin and subcutaneous tissue (L00-L99)

  • Skin aging
  • Nail psoriasis (nail psoriasis)
  • Pityriasis simplex capitis (dandruff of the head)
  • Psoriasis (psoriasis)
  • Rosacea (copper rose)

Cardiovascular system (I00-I99)

  • Apoplexy (stroke)
  • Atherosclerosis (arteriosclerosis, hardening of the arteries)
  • Heart failure (cardiac insufficiency)
  • Cardiac arrhythmiasextrasystoles (heart stumbles; extra heartbeats), but especially paroxysmal tachycardia.
  • Hypertension (high blood pressure)
  • Hypotension (low blood pressure)
  • Cardiomyopathy (heart muscle disease)
  • Coronary artery disease (CAD; diseases of the coronary arteries).
  • Atrial fibrillation (VHF)

Infectious and parasitic diseases (A00-B99).

  • Diarrhea (diarrhea)
  • Legionellosis (Legionnaires’ disease)

Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

  • Acute pancreatitis (inflammation of the pancreas).
  • Chronic pancreatitis
  • Diabetes mellitus (diabetes)
  • Hepatitis B (liver inflammation)
  • Hepatitis C
  • Liver cirrhosis – connective tissue remodeling of liver tissue with subsequent loss of function.
  • Steatosis hepatis (fatty liver)

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

  • Acute gastritis (inflammation of the stomach).
  • Ulcerative colitis – chronic inflammatory disease of the mucous membrane of the colon or rectum.
  • Dysbiosis (imbalance of the intestinal flora).
  • Enteritis (inflammation of the small intestine)
  • Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
  • Gingivitis (inflammation of the gums)
  • Dental caries
  • Colon adenoma (colon polyps)
  • Mallory-Weiss syndrome – clustered longitudinal (elongated) tears of the mucosa (mucous membrane) and submucosa (submucosal connective tissue) of the esophagus occurring in alcoholics, which may be associated with potentially life-threatening hemorrhage of the external esophagus and/or the entrance to the stomach (gastrointestinal hemorrhage/GIB) as a complication
  • Pulpitis (inflammation of the dental nerve).
  • Ulcus duodeni (duodenal ulcer)
  • Ulcus ventriculi (gastric ulcer)

Musculoskeletal system and connective tissue (M00-M99)

  • Dupuytren’s contracture – progressive formation of a contracture of one or more finger flexors.
  • Fractures (fractures of bones) due to hazardous behavior.
  • Osteonecrosis of the femoral head – demise of bone tissue on the thigh.
  • Hyperuricemia (gout)
  • Myopathy (muscle weakness)
  • Osteopenia – reduced bone density.
  • Osteoporosis (bone loss)

Neoplasms – tumor diseases (C00-D48)

  • Malignant tumors of the mouth, pharynx (throat), and esophagus (food pipe).
  • Bronchial carcinoma (lung cancer).
  • Hepatocellular carcinoma (liver cancer)
  • Colon carcinoma (colon cancer)
  • Gastric carcinoma (stomach cancer)
  • Mammary carcinoma (breast cancer) of the woman
  • Pancreatic carcinoma (pancreatic cancer)
  • Spinalioma (prickle cell cancer)

Ears – mastoid process (H60-H95)

  • Dysacusis (hearing disorder)
  • Meniere’s disease (disease of the inner ear, usually affecting only one ear).

Psyche – nervous system (F00-F99; G00-G99)

  • Alcohol withdrawal deliriumpsychosis due to withdrawal.
  • Alcohol jealousy delirium
  • Anxiety disorder
  • Auditory Perception Disorder (AVD) – due to alcohol consumption during pregnancy.
  • Attention deficit hyperactivity disorder (ADHD) – due to alcohol consumption in pregnancy.
  • Cluster headache
  • Dementia
  • Depression
  • Diabetic polyneuropathy – chronic disorders of the peripheral nerves or parts of nerves in diabetes mellitus. These lead mainly to sensory disturbances in the affected areas of the body.
  • Epilepsy
  • Erectile dysfunction (ED; erectile dysfunction)
  • Hallucinations
  • Insomnia (sleep disturbances)
  • Korsakoff syndrome (amnesic psychosyndrome) – a form of amnesia (memory disorder) first described in alcoholics.
  • Libido disorders of the woman / man
  • Marchiafava-Bignami syndrome (synonym: corpus callosum atrophy) – rare neuropsychiatric disorder whose cause has not yet been conclusively determined; occurs mainly as a result of chronic alcoholism in conjunction with malnutrition.
  • Migraine
  • Alzheimer’s disease
  • Obstructive sleep apnea syndrome – pauses in breathing during sleep caused by obstruction of the airway.
  • Personality disorders
  • Polyneuropathy (nerve damage)
  • Pontine myelinolysis – damage to the central nervous system due to rapid compensation of hyponatremia (sodium deficiency).
  • Psychosis
  • Restless Legs Syndrome (RLS)
  • Somatoform disorders
  • Transient ischemic attack (TIA) – sudden onset neurologic disorder that resolves within 24 hours, the only distinction from apoplexy (stroke)
  • Wernicke’s encephalopathy – brain and nerve changes caused by vitamin B1 deficiency.

Pregnancy, childbirth and puerperium (O00-O99).

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99)

  • Emesis (vomiting)
  • Urinary incontinence (involuntary, involuntary leakage of urine).
  • Icterus (jaundice)
  • Nausea (nausea)
  • Pyrosis (heartburn)
  • Rhonchopathy (snoring)
  • Sinus tachycardia (accelerated heart rate; impaired stimulation).
  • Suicidality (suicide risk)
  • Tremor (shaking) of the hands
  • Underweight
  • Vertigo (dizziness)

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

  • Amenorrhea – no menstrual bleeding until age 15 (primary amenorrhea) or no menstrual bleeding for more than three months (secondary amenorrhea)
  • Infertility – inability to carry a pregnancy to viability of the child.
  • Nephrolithiasis (kidney stones).
  • Testicular atrophy – reduction in the size of the testicles due to tissue atrophy.
  • Urolithiasis (urinary stones)

Injuries, poisonings, and other consequences of external causes (S00-T98).

  • Food allergy (immunologic reaction)

Further

  • Sense of guilt and shame
  • Social problems, especially in the partnership and at work.

If tobacco or caffeine is consumed in addition to alcohol, the health impairments as well as the symptoms of disease intensify and there is an additive effect. The body is confronted with several toxic substances at the same time and does not have sufficient defense mechanisms – due to the constant degradation – to make the toxic substances harmless

Fertility (fertility)

Alcohol consumption impairs fertility in both women and men. Sex hormones cannot be broken down appropriately due to alcohol-induced liver damage, leading to hormonal dysfunction at the hypothalamic-pituitary level, that is, at the level of the diencephalon and pituitary gland. This causes disturbances in follicular maturation and the menstrual cycle, which limits female fertility. In men, increased alcohol consumption leads to poorer sperm quality: Spermatozoa density is reduced and the proportion of malformed spermatozoa increases. In young men, high alcohol consumption leads to a disturbance in the development of the testicles, so that they subsequently become smaller (testicular hypotrophy). Fertility can be impaired as a result. Testicular volume also correlates with BMI (Mody Mass Index/body mass index): thinner men often have testicles that are too small.

Alcohol consumption and vital substances

Due to the high energy content of alcohol – 7.1 calories in one gram – a large proportion of energy requirements are met by alcoholic beverages when consumed regularly. Thus, for example, 160 grams of alcohol – in 2 liters of wine – can contain 70% of energy needs, which in most cases neglects the intake of foods containing essential vital substances such as proteins, iron, calcium and potassium. Alcoholic beverages are usually free or poor in important nutrients and vital substances and thus represent empty energy sources for the body. Apart from that, the stimulant in high concentration causes severe metabolic disorders due to the increased formation of its degradation product acetaldehyde. On the one hand, there is a dysfunction of the cell membranes as well as the mitochondria, which serve the cells as power plants, and on the other hand, there is a change in proteins, which themselves damage the liver cells in this state. Absorbed fats accumulate in the body due to disturbances in lipid metabolism, and the lipids that are not metabolized are stored [2.1]. Furthermore, metabolic impairment leads to changes in the vital substance balance and to disturbances in the conversion of certain vitamins – vitamins B1, B2, B6, folic acid, A, D and E – into their metabolically active form. Alcohol abuse leads to changes in the body which, on the one hand, result in reduced absorption of vital substances and, on the other hand, contribute to vital substance deficiency due to vital substance excess. These include alcohol-induced insufficient food intake, absorption as well as transport difficulties of vitamins, minerals, and trace elements, and increased excretion

Vitamin B Complex

The organism’s supply of water-soluble vitamins is not guaranteed with excessive alcohol intake, as their absorption, storage, and consumption are greatly affected. The stimulant inhibits the transport of vitamin B1 – thiamine – and blocks its conversion into the active coenzyme thiamine pyrophosphate, which is particularly responsible for energy production.Thiamine is required for the biochemical breakdown of alcohol and is therefore consumed in high quantities. Furthermore, it is released from the liver cells and increasingly excreted via the kidney. Considerable vitamin B1 losses lead to states of confusion, disturbances of the central as well as vegetative nervous system, palpitations and heart failure as well as personality changes, which can manifest themselves in the form of quarrelsomeness, aggressiveness, mood swings and depression. Vitamin B3, B6 and B12 also occur in the body in a reduced form, as malnutrition with significantly too few fresh fruits and vegetables prevents sufficient intake of these vitamins. Alcohol-related disturbances in liver metabolism and increased excretion in urine, contribute to the increased loss of the B vitamins, which is facilitated by their water solubility.

Folic Acid

Almost all people suffering from chronic alcoholism have extremely low folic acid status. In addition to reduced dietary folic acid intake, impaired storage capacity in the liver and increased depletion of folic acid reserves are also responsible for folic acid deficiencies. The toxic decomposition product acetaldehyde, the free radicals that occur more frequently under the influence of alcohol, and increased losses via the kidneys are also among the causes of impaired folic acid function. Since the trace element can only be effective if vitamin B12 is present in sufficient quantities in the body, the reduced vitamin B12 level due to alcohol has a negative effect on the folic acid concentration. In 40% of alcoholics, folic acid deficiency in the body results in anemia (anemia). In addition, alcoholics must live with a threefold increased risk of cardiovascular disease and increased risk of myocardial infarction because of folic acid deficiencies.

Vitamin C

Vitamin C absorption is blocked as a result of alcohol-induced gastrointestinal injury. Low levels of vitamin C in plasma, tissues, and blood cells are also due to increased urinary excretion

Vitamin A and beta-carotene

Fat-soluble vitamin A, or beta-carotene, is insufficiently present in the body due to insufficient food intake on the one hand, and damage to the mucosa in the digestive tract and disturbances in excretion, blood flow, and involuntary muscle activity as a result of toxic alcohol effects on the other. Under these conditions, vitamin A cannot be absorbed by the organism. Important metabolic pathways of this vitamin are impeded by chronic alcohol consumption, inhibiting the oxidation of retinol – a natural form of vitamin A in animal foods – to the important retinoic acid. Other causes of low vitamin A levels include increased transport from liver stores, increased vitamin breakdown, increased excretion of the vitamin, and finally zinc deficiency, which can accelerate the depletion of vitamin A stores in the liver. Since this vitamin is thought to play a special role in vision, growth, sexual development and tumor prevention, vitamin A deficiency increases the risk of night blindness and general loss of vision, growth disorders in children, fertility problems and laryngeal, bladder, prostate, liver, stomach and colon cancers, among others. Low serum beta-carotene levels in relation to alcohol consumption.

Amount of alcohol per day Alcohol consumers with beta-carotene deficiency
< 15 g 10 %
16-30 g 16 %
31-60 g 19 %
61-90 g 41 %

Vitamin D, K

Vitamin D can be synthesized in the skin when we expose our bodies to the sun’s rays. However, alcoholics have impaired thermogenesis, where the energy of alcohol is immediately converted into heat energy in the body, resulting in a lot of heat production. Affected individuals avoid the sun’s rays due to the hot flashes and consequently exhibit reduced vitamin D synthesis. Liver damage due to regular alcohol consumption with subsequent inhibition of vitamin uptake and vitamin transport capacity, not only increases vitamin D deficiency, but also the consumption of vitamins E and K.Vitamin D deficiencies promote colon carcinoma and breast carcinoma, loss of minerals from bones with subsequent bone pain, weakness, and fractures, as well as disorders of the immune system [7.1]. Vitamin K deficiency is also extremely problematic for the organism. It can lead to coagulation disorders, causing abnormal bleeding, which manifests itself in the form of traces of blood in the stool or by prolonged bleeding in the case of injuries. Furthermore, the development of bone structure may be impeded and eventually the development of osteoporosis may be favored

Minerals and trace elements

Furthermore, deficiencies of many minerals and trace elements occur in the body under chronic alcohol influence. The causes of low zinc, magnesium, calcium, copper, and selenium status correspond to those responsible for vitamin deficiencies. Accordingly, heavy alcohol intake increases the loss of these vital substances due to inadequate nutrition, problems in absorption and transport of vital substances, and increased excretion due to liver dysfunction. Since alcohol irritates and inflames the mucous membranes of the stomach and intestines in particular, diarrhea (diarrhea) is common, resulting in increased flushing out of magnesium and selenium. Magnesium deficiencies can cause heart problems and muscle dysfunction. Zinc, as an essential trace element, is responsible for the detoxification of alcohol. Without zinc, the organism has difficulty breaking down the toxic stimulant. Poor, delayed alcohol utilization results in serious organ damage [7.2]. Occurring vitamin D deficiency additionally affects the balance of calcium in the body, causing increased loss of the mineral from the bones and subjecting them to significant damage.

Carnitine

Alcohol destroys the amino acid carnitine, which is formed from the amino acids lysine and methionine and is a natural component of heart and skeletal muscle. It is deficient in the body due to low dietary intake. In low concentrations, carnitine is no longer able to protect the liver from alcohol-related damage and fat accumulation. Furthermore, its important function of detoxifying the liver and excreting substances foreign to the body remains absent, resulting in increased accumulation of chemicals, drugs and heavy metals in the body. Excessive alcohol consumption – vital substance deficiency.

Vital substance deficiency Deficiency symptoms
Proteins
  • Disturbances in digestion and absorption of vital substances and resulting water and electrolyte losses.
  • Muscle atrophy
  • Growth disorders in children
Carnitine
  • Insufficient protection against alcohol-related damage to the liver, fat accumulation in the liver.
  • The function of carnitine to detoxify the liver and eliminate substances foreign to the body is impaired, resulting in increased accumulation of chemicals, drugs, and heavy metals in the body
Vitamin C
  • Weakness of blood vessels leads to abnormal bleeding, gingivitis, joint stiffness and pain
  • Poor wound healing
  • Personality changes – exhaustibility, melancholy, irritability, depression.
  • Weakness of the immune system with increased risk of infection
  • Decreased performance

Decreased oxidation protection increases the riskof

Vitamin A Increased risk of

  • Tumors of the lung, bladder, prostate, larynx, esophagus, stomach, and intestine.
  • Increased calcium excretion and thus increased risk of urolithiasis.
  • Decreased sense of smell, sense of touch
  • Night blindness, general loss of vision.
  • Steriltitude disorders
  • Growth disorders in children
Beta-carotene
  • Decreased protection against lipid peroxidation increases risk of heart disease, apoplexy
  • Weakened immune system and high susceptibility to infections.

Increased risk of

  • Eye diseases such as cataracts
Vitamin D
  • Loss of minerals – especially calcium – in the bone with subsequent bone pain, weakness and fractures – osteoporosis.
  • Loss of hearing, ringing in the ears
  • Hypertension

Increased risk of

  • Colon carcinoma as well as breast carcinoma
  • Immune system disorders
Vitamin E
  • Increased risk of sterility
  • Decay of cardiac muscle cells
  • Shrinkage as well as weakening of muscles
  • Neurological disorders
Vitamin K
  • Blood clotting disorders-permanent abnormal bleeding, prolonged bleeding from injury, small amounts of blood in stool.
  • Impairment of bone formation

Increased risk of

  • Osteoporosis
Vitamin B1, B2, B3 [1.1. ], B6,, B12 [1.1. ]Folic acid.
  • Sensitivity to light (photophobia).
  • Decreased production of red blood cells (erythropenia), anemia (anemia).
  • Decreased antibody formation

Increased risk of

  • Atherosclerosis
  • Coronary artery disease (CAD)
  • Heart palpitations and failure
  • Myocardial infarction
  • Reduced absorption of vital substances
  • Personality changes – depression, states of confusion, increased irritability, sensitivity disorders, quarrelsomeness, aggressiveness, mood swings.
  • Sleep disorders
  • Muscle pain
  • Diarrhea
  • Uncoordinated movements
  • Poor wound healing
  • Physical weakness, decreased ability to concentrate
  • Disturbances of the central as well as vegetative nervous system

Vitamin B1 deficiency increases the risk of

  • “Wernicke-Korsakow syndrome”, manifested in the form of eye muscle paralysis, changes in character, memory and consciousness disorders [2.2].
Calcium
  • Increased bleeding tendency
  • Poor mineralization of the bones
  • Osteoporosis
  • Cramp tendency of the musculature
  • Increased excitability of the nerve cells
  • Increased risk of caries and periodontitis
Potassium
  • Muscle weakness, muscle paralysis.
  • Decreased tendon reflexes
  • Cardiac arrhythmias, cardiac enlargements
Sodium
  • Fatigability, listlessness, confusion, lack of motive power, decreased efficiency.
  • Nausea, vomiting, loss of appetite, lack of thirst.
  • Muscle cramps
  • Decreased urination
Magnesium Increased risk of

  • Muscle and vascular spasms, muscle dysfunction.
  • Numbness and tingling in the extremities.
  • Heart palpitations, feeling of anxiety, hyperactivity.
  • Cardiac arrhythmia
  • Hypertension
  • Myocardial infarction
Iron

Increased lactic acid formation leads to

  • Muscle cramps during physical exertion

Increased risk of

  • Disorders in body temperature regulation
  • Increased absorption of environmental toxins
  • Disorders of psychological as well as physical development in children
Copper
  • Atherosclerosis
  • Insomnia (sleep disorders)
  • Fertility and growth disorders
  • Elevated serum cholesterol levels
Selenium Increased risk of

  • Rheumatic-arthritic complaints
  • Muscle weakness
  • Dilated cardiomyopathy (DCM)
  • Ocular diseases
Zinc
  • Alopecia
  • Delayed wound healing

Decreased alcohol degradation leads to

  • Deficient, delayed alcohol utilization, which entails serious organ damage
  • Digestive disorders
  • Learning disabilities
Amino acids such as leucine and lysine[2.1.]
  • Weakened immune system
  • Mood swings, anxiety, depression
  • Hyperactive nervous activity
  • Deficiency of growth hormone (STH)
Essential fatty acids such as.

  • Unsaturated fatty acids
  • Omega-3-und-6-Fettsäuren
  • Kidney disease
  • Reduced functionality of the red blood cells
  • Reduced liver function

Increased risk in children for

  • Disorders in whole-body growth as well as in the ability to learn.
  • Insufficient development of the brain