How Much is Too Much?

Nothing is quite so controversial as alcohol ingestion.  A small amount of red wine has been shown to improve the HDL (good cholesterol) and is felt to be good for the heart.  I define a "small amount" as four glasses a week for women and six for men.  Given the very real risks of drinking too much alcohol, I feel there is absolutely nothing wrong with complete abstinence.  I have noticed in my practice an interesting phenomenon as I see new patients.  We have them fill out a personal health inventory which includes a family history.  I have yet to see a patient come in and report that they have a problem with alcohol.  Some will report that they had a problem in the past.  It is, however, very common for patients to report that family members have an issue with drinking too much alcohol.  It is easy to deny that there is a problem.  Here is a list of four simple questions.  If you answer yes to any of these, you should speak to your doctor about your alcohol intake.

1. Have you ever felt like you should cut down on your drinking?
2. Have people annoyed you by criticizing your drinking?
3. Have you ever felt bad or guilty because of your drinking?
4. Have you ever taken a drink first thing in the morning to steady your nerves or get rid of a hangover?

It surprises many to learn that the definition of a "heavy" drinker is someone who has three drinks per day.  I remember questioning an older man who when asked if he drank alcohol, he responded "only occasionally."  After further questioning he reported having 4-5 beers a day.  Surprised, I reminded him of his previous response.  He declared, "I'm from South County (home of Anheiser Busch), that is what we drink.  I don't drink alcohol."  He was not pleased to hear that yes, beer counts as alcohol too.  Water remains our best source of hydration.

The adverse affects from alcohol are numerous.  It is well known to be toxic to the developing fetus.  Our brain is affected short and long term.  Chronic balance issues are seen as well as cognitive (thinking/memory) functions.  It can even cause a peripheral neuropathy in our arms and legs (numbing nerve damage).  The majority of all fatal car accidents involve alcohol.  In our digestive tract it is more than just the liver that can be damaged.  Alcohol is tied to acid reflux and esophageal cancer as well.  The pancreas is certainly involved.  The heart can be weakened and it is well known to trigger rhythm problems such as atrial fibrillation.  This is just a short list.  Do you want to be healthy?  Keep the alcohol to a minimum.