Are Some People More Prone to Developing Alcoholic Liver Disease (ALD)?

Gillian May
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I’m a former nurse and recovering alcoholic, and my mission is to provide solid education around how alcohol abuse affects health and mental health. Recently, I received a good question regarding alcohol abuse and alcoholic liver disease (ALD).

The question was: Are some people more prone to developing ALD? More so, are there certain health factors that make it more likely to develop this devastating condition?

The answer is yes, and I will explain in detail below. Although I’m not a doctor, I have a master’s degree in nursing, and I did a lot of research on this topic after my father died from ALD in 2016. Nonetheless, if anyone is concerned about their liver health, they should check with a doctor. In fact, that is my hope for writing these articles — that someone who suffers from alcoholism will get the help they need from their doctors before it’s too late.

1. Amount of Alcohol

Clearly, the first factor in the development of ALD is the amount of alcohol consumed per day and how much gets consumed over time. The more a person abuses alcohol, and the longer the person drinks heavily, the more likely they can develop ALD. However, most people think this is the only factor.

The truth is some people may drink heavily for years and never develop the condition. But also, there are others (including even younger people), that develop ALD and they don’t drink as heavily as other people who abuse alcohol. The following factors may explain this phenomenon.

2. Genetic Issues

Some people are born with genetic issues that already weaken their livers at an earlier age. Some examples are people with genetic cholesterol issues, people born with RH negative blood, people who have genetic liver diseases or autoimmune issues, etc. Also, some people have higher high blood iron and an over-production of red blood cells which can weaken a liver.

3. Acquired Conditions

People who have contracted chronic Hepatitis B or C already have a very weakened liver. Should they drink alcohol on top of this chronic infection, they are more likely to get ALD. Other conditions like mononucleosis, malaria, or liver cancer will weaken the liver. Anyone suffering from these conditions should not drink any alcohol until the condition is fully healed.
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4.The Use of Hepatotoxic Medications

There are several types of medications and herbal medicines that are metabolized by the liver and as such, they are considered hepatotoxic or toxic to the liver; these medications include:

- Acetaminophen (Tylenol)
- Cholesterol lowering drugs (i.e. Atorvastatin)
- Diabetes medications (i.e Metformin)
- Certain herbal medications (i.e. chinese herbs)
- Opioid pain medication (i.e. percocet, heroin)
- Some mental health medications (i.e. Valproate, Chlorpromazine)
- Some seizure medications (i.e. Carbamazepine)
- Some antibiotics (i.e. sulfanomides)
- Some cancer, immunosuppressants, and antifungals

These are just to name a few more common medications. The important thing to know is that these medications on their own are hard on the liver. People who don’t have other risk factors can tolerate these medications well. However, these medications mixed with alcohol have a much higher chance of causing serious liver damage. For people taking these medications, it’s recommended not to consume alcohol at all.

Also, for someone who takes, for example, both Metformin for diabetes and Valproate for a mental health issue, the risk then doubles when these medications are mixed with alcohol. Taking more than one hepatotoxic medication is already highly toxic to the liver. Now if you add alcohol on top of that, the danger is very high.

5. Other health conditions that may affect the liver

Besides the acquired liver conditions stated above, there are other conditions that can be hard on the liver. Diabetes is a common condition that is very stressful for the liver. Also the medications needed to control diabetes are also very hard on the liver. So adding alcohol to the mix is like a triple whammy.

Kidney disease is another condition that can cause liver issues. Kidney disease causes a build up of toxins due to kidneys that can’t filter them out properly. These toxins are then difficult for the liver to process. Unfortunately, kidney issues are also caused by diabetes, so often these two conditions go hand in hand. Adding alcohol on top of both conditions is highly toxic to the liver.

Autoimmune diseases can often cause liver damage as well. There’s also an autoimmune liver disease that directly attacks the liver. Many autoimmune diseases use medications that can be hepatotoxic, so adding alcohol on top of any autoimmune disease is not advisable.

There are more conditions that may interact with alcohol and make ALD more likely. The best thing to do is consult your doctor, do some research, and ask questions.

These are just five factors that can make the development of ALD more likely for some people. If you or anyone you know drinks heavily and has one or more of these factors, it’s worth talking to a doctor to get more information and come up with a strategy to prevent ALD.

In many cases, it’s strongly recommended not to drink at all if you have any of these factors. However, for those with an active and serious alcohol addiction, this may be a difficult task. As such, it’s recommended to get help and support with the alcohol addiction as soon as possible. Also, there may be measures you can take to reduce the risk if you can not fully quit drinking. Be sure to consult a doctor and an alcohol addiction specialist.

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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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