Symptoms of Heavy Drinking

Gillian May
Photo by Thomas Picauly on Unsplash

Recently I had a chat with Heather, who struggles with her alcohol use but was open enough to reach out and talk to me. Heather is currently contemplating a move towards sobriety as her health issues are increasing, and she’s tired of feeling crappy all the time. Of course, sobriety is no easy feat, and I told her how amazing it is that she’s even reaching out and being honest about her drinking. That, in and of itself, will likely save her life.

Most alcoholics are not honest, and this behavior is a bone of contention for them and their loved ones. Addiction absolutely makes us deny and sneak around to protect the addiction. I would find genius ways to skirt conversations or responsibility altogether when I was drinking. Not because I was being a jerk, but because alcohol, for me, was a literal life-saver, or so I thought.

But it turns out that alcohol eventually does the opposite of saving lives. For many alcoholics, we usually feel okay when we first start drinking. Alcohol is a fantastic pain-reliever and can initially suppress all bad feelings. And suppressing bad feelings is likely the reason many of us drink heavily. If you didn’t know, heavy drinking is anything past 8 drinks per week for a woman and 15 drinks per week for a man.

Once addiction takes hold, the nervous system is hijacked, making cutting down difficult due to withdrawal symptoms. Also, the brain and nervous system become so accustomed to the neurotoxic effects of alcohol that they don’t know how to function without it. This causes a vicious cycle that makes getting sober difficult.

In the meantime, alcohol slowly erodes our health and damages our organs and body systems. The damage accumulates over time, bit by bit, until we become disabled by physical and mental health issues. This is what is currently happening to Heather. She tells me her main symptoms are itchy skin which bruises and breaks easily, cognitive fog, memory issues, poor balance, distended abdomen, diarrhea, numbness in the hands and feet, and feeling cold easily, almost as if her bones are cold.

Also, after talking with Heather more about her symptoms, I found out that she suffers from PTSD and takes several mental health medications to manage the PTSD and alcohol withdrawal symptoms. PTSD causes serious emotional pain, and many opt to use alcohol to numb the pain, only to cause worsening physical and mental health issues. One study shows that people with PTSD are 54.5% more likely to develop an alcohol use disorder.

So it seems Heather’s story is likely similar to many others out there. What’s important to note, however, is that combining mental health medications with alcohol not only decreases their effect but increases the damage to certain organs. This means that Heather’s PTSD symptoms are likely not getting the benefit from her medications but also combining her medications with alcohol may be making her physically sicker.

Even without combining alcohol with medications, the damage that alcohol does to our body is well-known yet not talked about enough. Heather tells me she’s worried about the health of her liver, considering her symptoms. She says she’s had a few test results that show high liver enzymes — a hallmark of liver inflammation and the first sign of liver damage. Indeed, some of her symptoms are on par with the beginning signs of alcoholic liver issues.

I suspect that many people are exactly like Heather but don’t dare to talk openly about it the way she does. In any case, let’s look at Heather’s symptoms and look at what they mean, given the research and my background as a nurse. Understanding these symptoms can provide vital clues about how our bodies are holding up under alcohol abuse. The more we know this, the more we can empower ourselves to make a change.

To simplify, I have grouped her symptoms into five categories of symptoms as they are interrelated.
Photo by Towfiqu barbhuiya on Unsplash

Skin issues

As Heather says, her skin is itchy and prone to breakage and bruising. There are several reasons for this symptom, given her history of drinking and medications. The mildest reason for skin problems in alcoholism is inflammation. Alcohol causes an inflammatory reaction in our gut and nervous system, which has far-reaching consequences, including skin issues. Itchy skin is most certainly a sign of inflammation, as is bruising.

Another issue is vitamin deficiencies which often affect the skin and coagulation abilities. Over time, heavy drinking can disturb the necessary vitamin absorption needed for bone marrow and red blood cell production. As I mentioned above, some of this is also related to the inflammatory component. For example, anemia is quite common in alcoholism due to iron deficiency and inflammation and can cause itchy skin and easy bruising.

However, one last issue around skin problems is the early development of alcoholic liver disease. Heavy drinking over a long time can seriously damage the liver, which is insidious and constant. Heather has already developed liver inflammation, as evidenced by her high liver enzymes. These enzyme levels often fluctuate wildly as our liver is a powerful organ that can find genius ways of keeping balanced. But not having elevated enzymes doesn’t mean the liver is doing well, especially if heavy drinking persists.

One of the early manifestations of liver issues is skin problems. A liver with a reduced capacity to function can’t perform all of its duties efficiently, and thus, other organs that work with the liver are affected. As liver issues rise, malnutrition, inflammation, and problematic blood clotting abilities can cause the skin symptoms that Heather mentions.

Cognitive and memory issues

Research has shown that alcohol is dangerous for the brain and nervous system, even in low doses. Since alcohol is a neurotoxin, it causes damage to the nerves and brain, which causes symptoms like cognitive and memory issues. Heather mentions that she has cognitive fog and memory issues which all fall in line with nervous system damage.

Brain and nervous system damage due to heavy drinking are especially pronounced in women due to our lower water content and high amounts of estrogen. Unfortunately, most people don’t know that estrogen and alcohol do not go well together. Estrogen itself is pretty harsh on the body and nervous system so mixing it with alcohol, which is also harsh on those systems, can be devastating. Also, one study confirms that alcohol combined with estrogen effects makes women more susceptible to alcohol-related liver issues. And as liver damage ramps up slowly over time, it can also cause various problems with cognition and memory.

Numbness and Tingling in Hands and Feet

Numbness and tingling are common signs that tend to pop up after a more lengthy history of heavy drinking. As I mentioned above, alcohol causes malnutrition and vitamin deficiencies. Over time, alcohol can damage the digestive tract enough that it has difficulty moving food through the gut and absorbing the nutrients.

Although alcohol can cause deficiencies in many vitamins, the most important one that may explain Heather’s symptoms is vitamin B1 (thiamine) deficiency. Alcohol causes reduced food intake, impaired food absorption in the gut, and impaired thiamine utilization in the cells. These issues make thiamine deficiency very common in almost anyone with serious heavy drinking issues. The main symptoms of thiamine deficiency are numbness and tingling in extremities, poor balance, reduced cognition, and heart and gastrointestinal problems. Thiamine deficiency could very well be the cause of many of Heather’s symptoms.

Aside from the apparent thiamine deficiency issue, numbness and tingling due to nerve damage can also be a sign of liver issues. With the liver at a reduced capacity, it can’t perform all of its vital functions effectively, which means the liver can’t help with food digestion and blood cell production. This can lead to macrocytic anemia, decreased platelet production, and issues with clotting abilities, all of which can lead to numbness and tingling in the extremities. Alcohol itself can cause these issues but add in potential liver issues, and the problem doubles.

Feeling excessively cold

Heather’s reported symptom of feeling cold, almost as if her bones are cold, reminds me of another man I spoke with who had severe alcoholic liver disease and needed a transplant to survive. He mentioned that one of the most prominent symptoms he felt was being excessively cold. There are many reasons for this strange symptom, and all of them are tied to the effects that alcohol has on the organs.

For one, feeling cold is a prevalent symptom of anemia which happens for various reasons in alcohol abuse, as mentioned above. Anemia often occurs due to reduced bone marrow response, malnutrition, and inflammation. Alcohol itself can cause this, but the problem is doubled when alcoholic liver disease is present.

Secondly, feeling cold can also be a nervous system response. With the nervous system receiving so much damage from alcohol, it can fall into autonomic disarray, which can account for lack of balance in body temperature stability. Again, liver issues can also add to this problem as well.

Distended abdomen and bowel changes

This last group of symptoms is also related to the above symptoms. As discussed, alcohol and budding alcoholic liver problems can seriously compromise gut health. The earliest sign of a developing issue with the liver is a bloated belly, bowel changes, and indigestion.

However, alcohol itself can damage the gut in anyone who drinks past the safe drinking guidelines: one drink per day for a woman and two drinks a day for a man. It’s not only the presence of alcohol in the gut but also how alcohol causes damage to the nervous system. By now, most know that the gut functions largely due to the nervous system, so when this system is damaged, it affects the gut and bowels as well. The horrible combination of gut toxicity and a deranged nervous system can create symptoms like bloating, slowed digestion, constipation, diarrhea, indigestion, etc.

This article discussed five common symptoms of heavy drinking and what they may mean. I’m confident that Heather’s story is similar to many others out there, but since we rarely talk about the health issues of alcoholism, these symptoms may not be widely known. My goal is to help heavy drinkers understand what’s happening in their bodies and why. It’s my firm belief that information can make a big difference to people when delivered in a simple easy-to-read way. Many of these symptoms are common complaints of the general public, and they can have a variety of causes. However, when observed under the lens of heavy drinking, these symptoms suddenly make more sense than when they are looked at alone.

Stories like Heather’s are why it’s so crucial for heavy drinkers to tell their doctors exactly how much they drink each week and how long they’ve held this pattern. Once doctors know this information, they can help us make a lot more sense of the vague and confusing symptoms accompanying heavy drinking. However, even if doctors know how much a person drinks, they may not always investigate further, a problem likely steeped in stigma around addiction. Heather is taking matters into her own hands and requesting a liver scan and further tests to help understand her symptoms. However, she’s aware that her health issues mean that she likely needs to quit drinking at some point soon.

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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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