How I Knew that Alcohol was Hurting my Liver

Gillian May

Photo by Justin Aikin on Unsplash

I quit drinking almost 5 years ago. Before that I drank heavily for many years. Drinking was a regular part of my family life. I still remember the pride I felt when I had my first alcoholic drink for my thirteenth birthday.

You heard that right, I was thirteen years old when I was introduced to the favorite family past-time. Alcohol still is our family crutch, friend, and unfortunately, our demise.

My father died of alcoholic cirrhosis, along with his first cousin. Other family members have died from biliary disease, heart disease, diabetes, and malnutrition — all of which are related to alcoholic liver damage. I’ll explain more about why these health problems are related, but first, let me tell you that I knew alcohol was damaging my liver too. And even with that knowledge, I still didn’t quit drinking for many years.

Somehow, our alcoholic brains make us believe that we’re all good and perhaps, even invincible. Or, we just don’t really care. Because life without our best friend doesn’t seem worth living when you believe that’s all you have in the world. Or when alcohol is your only self-medication.

I should also say that I only knew my liver was stressed because I used to be a nurse. I found my pathophysiology classes extremely fascinating and enjoyed learning about how the body works. Knowing all of this, helped me put the pieces together, whether I liked it or not.

The signs didn’t really show up until I hit my thirties. It takes time for the damage to reveal itself. This is why I feel sad when I see young people drinking so heavily. They don’t know what I know now, those weekend binges that turn into daily drinking catches up later on.

The initial signs were constant fatigue, foggy brain, and some indigestion issues. Of course, I just popped some antacids, just like everyone else did in my family.

Next, came the slow arrival of neuropathic pain in my joints, feet, and hands. I also found my hands shaking during activities that required dexterity like sewing, or writing with pen and paper, or even picking at a pimple on my face.

Soon enough, I found my memory lapsing, my face and hands were puffy, I had constant anxiety and depression, my toes wouldn’t bend without jittering, and I had trouble digesting fats and proteins.

What does this have to do with the liver you might ask? The answer is: everything. The liver is one of the most essential organs in our body. It is responsible for over a dozen crucial functions such as metabolizing food, drugs, and vitamins, creating blood cells and blood clotting proteins, removing waste products, stabilizing blood sugar, and many other functions.

Alcohol causes immediate interruptions in a few of these functions. And over time, alcohol slowly kills liver cells due to toxicity. Although the liver can regenerate and compensate, the degree to which this happens is unique to each individual. And over time, the liver won’t be able to keep up.

Some of us have a very resilient liver, while others do not. But everyone is subject to damaged liver cells if they engage in heavy drinking frequently.

The trouble is, this damage doesn’t always show up on blood work and imaging tests. By the time the damage is evident on these tests, the liver may be getting close to the end of its rope.

Below, are the top five signs of early liver damage. Understanding these signs is important information for alcoholics everywhere.

1. Issues with metabolism

First, a liver that is stressed will prioritize the metabolism of medications and toxic substances before food. This is very important because the early signs are often the sluggish digestion of fats and proteins, which causes that classic indigestion or tummy upset.

2. Vitamin B1 (Thiamine) deficiency

Next, alcohol slows the absorption of Vitamin B1, otherwise known as thiamine. This is absolute. Anyone who drinks heavily and frequently will be lacking in Vitamin B1.

Thiamine (B1) is required for several functions that directly affect the cardiovascular and nervous system. Without this vitamin, these functions slow down, which causes heart and neurological diseases.

Vitamin B1 deficiency is why many alcoholics have symptoms like heart palpitations, shaky hands, memory problems, neuropathic pain, and high blood pressure. Having this deficiency often begins early on, but the actual damage doesn’t show up until later on.

3. Type 2 diabetes

Another frequent sign is type 2 diabetes. This one is confusing because there are genetic predispositions along with issues around obesity and metabolic problems that also cause type 2 diabetes. However, a damaged liver can’t help stabilize blood sugar, which may also result in the development of diabetes.

4. Malnutrition

Over time, heavy drinking causes malnutrition because the liver isn’t prioritizing digestion. This means that several other vitamins beside B1 are not getting absorbed.

This malnutrition causes macrocytic anemia (larger and fewer red blood cells), iron deficiency, calcium and magnesium deficiency, and many others. All of these deficiencies are linked to mood, neurological, cardiovascular, and digestive disorders.

5. Inflammation

Lastly, nights of heavy drinking will inflame the liver, which throws inflammatory cells out into the rest of the body. This accounts for why we get headaches, swollen bellies and faces, red skin, frequent allergies, and other problems linked to inflammation.

In short, our health becomes a broken mess, but we’re not quite sure how to unravel it all. Indeed, many people show up to the doctor with various symptoms that could be caused by other issues. This is why alcoholic liver problems are tough to diagnose or understand.

Except that we, as alcoholics, usually have some red flags in the back of our minds. Or, if you’re like me, and you were cursed with way too much pathophysiology knowledge, you have more than just a red flag.

I knew my liver was getting damaged. I knew that all my symptoms could be traced to the slow and complicated destruction of my liver function. Yet, I didn’t quite believe it. Or I didn’t let myself believe it.

The day I understood that alcohol would kill me was when it finally killed my father. I’d watched for decades all the symptoms he had, that I had too. We laughed at how all of us seemed to struggle with “bad nerves” or “bad guts.” It became the family joke until it stopped being funny, at least to me.

He always said that he could handle his drinking, that his liver was excellent, and his test results were normal. And then all of a sudden, his belly bloated, his legs swelled up, he turned yellow, and he died three weeks later.

It hit me that we can lie all we want to ourselves, but our liver will not lie.However, it will give us clues and a hell of a lot of chances. It has tremendous compassion for us and works tirelessly to keep us going despite the abuse we throw at it.

Our liver is our ultimate enabler until it just can’t do it anymore. Then it packs its bags, relinquishes its responsibilities, and silently slips out the back door.

Below are some references that I used to write this article.

The Role of Thiamine Deficiency in Alcoholic Brain Disease
How Does the Liver Work?
Metabolic Syndrome
Liver Cirrhosis and Diabetes
Liver Regeneration
Elevated Liver Enzymes
Increased Prevalence of Intestinal Inflammation in Patients with Liver Cirrhosis
Inflammation in Alcoholic Liver Disease

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I'm a former nurse turned freelance writer. I have extensive experience in administration, frontline care, and education in mental health, public health, and geriatrics. However, after 20 years, I needed a change and always wanted to write. I have personal and family experience in mental health and addictions, so I'm passionate about advocacy and education in those areas. I'm also a traveler, photographer, and artist. I funnel all my various expertise into my writing and hope to provide valuable content that is entertaining and educational. Join my email list if you want to read more of my work -


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