No doubt about it: We live in a drinking culture. It can seem like every time you turn around, there’s an opportunity to have a beer or a glass of wine. But what is that drink—or those nights of drinking—doing to your liver?
The liver, as you’ve probably heard, is the body’s largest internal organ. Befitting its substantial territory, it performs more than 500 functions, including metabolizing fats, carbs and protein; producing bile; and detoxifying the blood. When you take a drink of alcohol (otherwise known as ethanol), it’s absorbed through the stomach and small intestines, where it spreads into the bloodstream. Here’s what that does to your liver.
The liver’s primary job is to filter toxins from the blood. When you drink alcohol, the liver recognizes it as a toxin and begins working to clear it from the body. That means other harmful substances aren’t removed as readily.
The liver converts ethanol to a toxic substance called acetaldehyde, and ultimately harmless water and carbon dioxide, which is excreted from the body. A healthy liver can metabolize one alcoholic drink per hour. Have more than that, and toxic acetaldehyde builds up in the body, causing a hangover. Drink too much too often, and the liver suffers damage.
When you’re drinking alcohol, the liver burns acetaldehyde for the body’s fuel instead of fat, as it should. Drink too much too often, and a double whammy of damage can result: Acetaldehyde damages the liver, and fat is stored in the liver instead of elsewhere in the body or being burned off altogether. That can lead to a condition called fatty liver disease.
How to avoid the condition? “Don’t drink too much alcohol,” says Dr. Wynne Armand, assistant professor of medicine at Harvard Medical School. “How much is too much remains controversial, but it’s probably best to avoid alcohol completely.”
Toxic acetaldehyde from drinking alcohol can trigger inflammation in the liver that destroys liver cells, causing a condition called alcoholic hepatitis. It happens in some heavy drinkers and not in others; science doesn’t fully understand why. According to the Mayo Clinic, “If you’re diagnosed with alcoholic hepatitis, you must stop drinking alcohol. People who continue to drink alcohol face a high risk of serious liver damage and death.”
If alcoholic hepatitis persists, scarring develops in the liver. That scar tissue prevents the liver from functioning normally, leading to a condition called cirrhosis. Alcoholic hepatitis is reversible; cirrhosis is not. As cirrhosis progresses, the liver becomes unable to filter blood and the organ begins to fail, necessitating a transplant.
According to the American Cancer Society, most (but not all) people who are diagnosed with liver cancer have some evidence of cirrhosis.
So to keep your liver healthy, how much should you drink? Experts say no more than one drink a day for women, and two drinks a day for men younger than 65. After 65, men should dial back to one daily. Why? As we age, the stomach and liver naturally shrink, shortening the alcohol-to-stomach travel distance and reducing the liver’s capacity to detox.
“If you feel concerned about your liver functioning, speak to your doctor as soon as you can and find out what blood tests can help identify liver inflammation and dysfunction,” advises Jaffe. And always be honest with your doctor about how much you drink. Glossing over your drinking and eating habits is one of these 101 Unhealthiest Habits on the Planet.