Alcohol consumption can significantly impact nutrient absorption and contribute to various deficiencies in the body. 

How serious is it?

People, who frequently consume alcohol, are often deficient in one or more vitamins, particularly folate, vitamin B6, thiamine, and vitamin A. While inadequate dietary intake is a primary cause of these deficiencies, other factors may also play a role. Alcohol use can impact the absorption, storage, metabolism, and activation of many vitamins.¹ This article explores the factors that alter the absorption, storage, and metabolism of these essential vitamins and provides recommendations for managing vitamin deficiencies in chronic alcoholics.

This disruption occurs because alcohol damages the cells lining the gastrointestinal tract, impairing nutrient uptake and metabolism. Additionally, heavy drinking can lead to poor dietary choices, further exacerbating nutrient deficiencies. Over time, these deficiencies can result in serious health issues including weakened immunity, neurological disorders, and impaired cognitive function. Understanding the relationship between alcohol and nutrient deficiencies is crucial for promoting overall health and well-being.¹

What causes this?

Alcoholic can cause the following problems which could lead to malnutrition:

• Insufficient intake of essential nutrients, especially water-soluble vitamins.
• Reduced nutrient absorption.
• Impaired utilization.
• Increased nutrient requirements. 
• Genetic predispositions to deficiencies.

Consequently, nutrient deficiencies are almost an inevitable outcome of alcohol abuse. This is not only because alcohol replaces food with 'empty calories',⁴ but also because it directly disrupts the body's ability to use nutrients, rendering them ineffective even when present in the diet.¹

Adverse Effects on Health

Heavy alcohol consumption leads to inflammation in the stomach lining and digestive tract, which impairs the body’s ability to absorb essential vitamins. In addition, poor dietary habits and lack of proper nutrition further deplete the body’s vitamin reserves. It can also lead to several neurological disorders, many of which are linked to deficiencies in vitamins crucial for normal brain function. Excessive alcohol consumption may also lead to hypoglycemia.²

Drinking affects the hormones that control your appetite, making you more likely to eat junk food after drinking.⁵

Alcohol is a diuretic, meaning it causes your body to remove fluids (and including electrolytes, vitamins and minerals)¹⁰ from your blood via the renal system. Alcohol can also lead to dehydration.⁹

Among the essential nutrients that require immediate attention are magnesium, thiamine, and other B vitamins. Nutritional therapy has been shown to assist in recovery from alcoholism, with patients who receive it experiencing reduced alcohol cravings, increased nutrient intake, and cravings.²

Vitamin B1

Vitamin B1 (Thiamine) deficiency, though uncommon in most developed countries, is prevalent among individuals who consume excessive amounts of alcohol.

As many as 80% of people with alcohol addiction develop Vitamin B1 deficiency.³

Thiamine deficiency can lead to symptoms such as:

• Loss of appetite
• Constipation
• Fatigue
• Blurry vision
• Changes in heart rate
• Irritability
• Nausea and vomiting
• Reduced reflexes, and tingling in the arms and legs
• Shortness of breath
• Muscle weakness

Other individuals at risk of thiamine deficiency include older adults, those who have undergone bariatric surgery, and people with HIV/AIDS or diabetes.³

Magnesium

Alcohol acts as a diuretic, causing an increase in the urinary excretion of magnesium of certain other electrolytes. During chronic intake of alcohol and development of alcoholism, the body's magnesium stores become depleted.¹⁰ In clinical studies, magnesium deficiency was found in 30% of alcoholics.¹¹

Magnesium helps digest the food we eat into energy, and make sure the parathyroid glands work normally.¹² Magnesium deficiency can lead to symptoms such as:¹³

• Nausea
• Vomiting
• Loss of appetite
• Fatigue
• Weakness

Drinking coffee, tea or soda regularly, can have diuretic effects, mildly increasing your risk of magnesium deficiency, but not enough research has been done to back this.

Vitamin B12 and Folate

Lack of these vitamins can lead to anaemia, meaning your body has difficulty transporting oxygen around your body.^14,15. Symptoms of vitamin B12 and folate deficiency include:

• Extreme tiredness and lack of energy.
• Pins and needles.
• Sore and red tongue, mouth ulcers.
• Muscle weakness.
• Vision problems.
• Psychological problems (ranging from mild depression or anxiety to confusion and dementia).
• Problems with memory, understanding and/or judgement.

How much can I drink?

The UK Department of Health states that you should consume no more than 14 units per week, and have several drink-free days with no bingeing.⁶

As an estimate, 14 units per week is around:⁷

• 6 pints of 4% strength beer or cider
• 6 medium (175ml) glasses of 13% strength wine
• 12 shots (25ml) of 40% strength spirits like gin or vodka

Should I Quit Drinking?

One in seven adults in the UK (that's 14%) never drink alcohol, and more than half of them (52%) say they are ex-drinkers.⁸

There are benefits to quitting alcohol completely,⁵ such as:

• No more hangovers.
• Better sleep.
• Lose excess weight.
• Have more energy.
• Better control of you appetite, helping you meet diet goals.

 There are many more negative impacts alcohol has on the body, and the list is always growing. For further information please see alcohol.org and drinkaware.co.uk.

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