The liver is a highly adaptive and crucial organ to our health and wellbeing. When the liver gets stressed, many health issues can happen. Alcohol is a common threat to the liver and most people know that drinking huge amounts can cause liver damage and possibly liver failure. But very few people know that there are many health issues that can stem from alcoholic liver problems.
You would think that as a former nurse and recovering alcoholic, I would have known about the link between certain health problems and alcoholic liver damage. But unfortunately, it's a complex process that is rarely flagged by health professionals. Also, the liver is highly confusing, and the symptoms of damage overlap with other issues.
Before I quit drinking, I had a few health conditions that were problematic and mysterious. I had a lot of nerve pain, problems with my balance, digestive issues, a puffy face, and anemia. I had no idea they were linked to a liver trying to do its job while filtering out all the alcohol I drank.
Also, the denial inherent in alcoholism means that we don’t often let our doctors know about our drinking. Even after I got sober, I still didn’t understand. But then, my own father died from alcoholic cirrhosis, and I became passionate about learning and teaching about alcohol and liver issues.
The liver has a huge role in our metabolism, blood clotting, digestion, and many other body functions. The liver is one of the most essential organs in our body, and without it, we would die. The good thing is that the liver has a fantastic ability to regenerate, but only if we treat it well.
However, if we throw too many toxins at the liver, it can become permanently damaged. But before permanent damage sets in, there are usually warning signs manifesting as health issues in various parts of the body. Even though the liver can work hard and withstand a lot of abuse, it does get tired and sluggish. Unfortunately, early liver damage doesn’t always show up in scans or bloodwork.
Although many types of liver diseases exist, alcohol-related liver damage behaves a bit differently. The signs and symptoms of liver problems due to alcohol often get covered up, misdiagnosed, or ignored.
The good news is that the health conditions linked to liver damage can tell us how our liver is functioning. These conditions can also happen in people who don’t drink alcohol, which can be confusing. But for heavy drinkers, these conditions are significant clues that can help them talk to their doctors.
It’s vital that heavy drinkers, who have these conditions, speak with their doctor and let him/her know the exact amount of alcohol consumed on a daily basis. This information helps doctors provide the best diagnostic and treatment options.
I also hope this information encourages people to either choose sobriety or take up a harm reduction approach. Harm reduction is where we stay within, or at least close to, the safe limits of alcohol consumption. The safe drinking limit is 1 drink per day for women and 2 drinks per day for men.
In my case, I chose sobriety as I knew I could never stick with the safe drinking limits. The complex nature of alcoholism is such that many of us can’t control our drinking.
Type 2 Diabetes
Type 2 diabetes can show up in anyone with a genetic predisposition and other risk factors. However, since the liver helps store and manage blood sugar, these functions can be compromised if the liver is overwhelmed.
Unfortunately, adding too much glucose to the blood can also impact the liver in negative ways. So it becomes a vicious cycle of a struggling liver leading to an impaired glucose management problem, which further harms the liver.
Chronic alcoholism can lead to increased enlarged spider veins on the face and upper body. This is caused by a severely damaged liver that increases estrogen levels in the blood (for both men and women). These issues are usually signs of late-stage liver disease.
Other skin issues that appear from a struggling liver are increased acne, increased allergic skin issues, and puffiness in the face and hands. Also, along with large spider veins, men can also begin to grow breast tissue due to the high estrogen levels.
There are many causes of heart disease besides a struggling liver. However, alcohol has a detrimental effect on the heart by increasing the heart rate and blood pressure while drinking. This alone can be problematic if there are other risk factors for heart disease.
However, when a liver gets severely damaged, it causes portal hypertension. The portal vein carries blood to the liver. A scarred liver puts pressure on the portal vein causing a back-up of blood above the liver. One of the signs of portal hypertension is increased blood pressure and bulging vessels in the chest and digestive tract. This puts a lot of pressure on the heart, leading to heart damage and increased heart attack risk.
The liver and digestive tract are highly dependent on each other. The liver sends bile into the digestive system to break down food. It also helps with the absorption of certain nutrients. But most importantly, most of the toxins that the liver has to filter come from the digestive system.
When the liver is stressed, digestive symptoms are often the first clue. Symptoms like heartburn, gas, slow digestion and nausea can all stem from a stressed liver. It can be confusing because there are many other reasons for these symptoms as well. However, if you’re a heavy drinker and have these symptoms daily, it means the liver is highly stressed.
Gout is an inflammatory condition causing uric acid build-up in the joints. It is caused by excessive purines along with genetic predisposition. Alcohol intake is a significant risk factor for increased gout attacks as it contains a lot of purines.
Unfortunately, gout also increases the risk of developing liver damage due to high uric acid levels. In turn, liver damage also increases the development of gout.
As we discussed above, the digestive tract and the liver work hand in hand to digest and absorb nutrients. Malnutrition is not the absence of food; it’s the absence of vitamins and nutrients essential for the body to function. Chronic alcoholism can block certain functions of the liver that help absorb vitamins.
The most important one is vitamin B1 (thiamine). Most chronic drinkers are deficient in vitamin B1, and over time, this deficiency can cause significant disability and even death. More so, as liver damage increases, vitamin B1 stores in the liver are diminished. Also, a damaged liver has to divert its attention away from digestion and towards filtering toxins. This leads to low food intake and worsened malnutrition. Other vitamins affected by alcohol are iron, vitamin B6, zinc, folate, and vitamin A.
Neuropathy can affect any part of the nervous system, while peripheral neuropathy affects only the hands and feet. The pain of peripheral neuropathy is often described as an electric shock, tingling, or a strange numb feeling. Autonomic neuropathy can cause balance issues, body temperature changes, heart rate changes, urination problems, and bowel problems.
Alcoholics with liver damage have a high risk of developing generalized neuropathy. In one study, more severe liver damage results in more severe neuropathy. Also, excessive alcohol alone can cause peripheral neuropathy independent of liver damage.
Blood Production Issues
The liver is responsible for iron synthesis and blood clotting factors. Therefore, a damaged liver may not be able to keep up with these functions, leading to anemia and blood clotting issues. Blood clotting problems tend to be more prominent in advanced liver issues, while iron deficiency anemia begins in the early stages.
These are the most common conditions associated with alcoholic liver damage. You may be surprised to know that there are many more complicated symptoms. And you may also be surprised to learn that liver damage rarely shows signs in the liver as it doesn’t have pain receptors.
The only time a liver may show symptoms is if it’s enlarged or heavily scarred, in which case it would show up on a liver scan.
I believe this information and education is vital for the general public. Even though it may be complex, sharing this information may help save lives and limit disability. Knowing how these conditions are linked to alcoholic liver damage can help you make choices towards harm reduction or sobriety.