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Ask the Doctor: Am I on a slippery slope drinking every day?


Picture posed

Picture posed

Picture posed

Q I lost my job and have been feeling very low during the coronavirus pandemic. I have gotten into the habit of opening up a bottle of wine every afternoon and find myself finishing it by evening. I am in good health otherwise but worry that I might be doing some long-term damage. I see many of my friends doing much the same and while I would never have considered myself a problem drinker, I wonder if I am on a slippery slope. Should I be seeking some help?

A I am sorry to hear that you lost your job and I really hope that you will rebound from this very soon. You are one of many adversely affected people who have turned to alcohol in their time of need, knowing full well that this was not the best source of comfort. Alas, you are only human. The important thing is you have insight and express a desire to change. Some might say you are halfway there already!

Assuming you are drinking well above the HSE low risk guidelines of 17 units of alcohol per week for a man, and 11 units per week for a woman, then you really do need to start calculating your exact weekly alcohol intake. For help with this check out drinkaware.ie. Obviously, these units of alcohol should not be taken in one sitting, as six or more units is considered binge drinking. The other important question is can you go 2-3 consecutive days alcohol-free during the week? This allows the liver to recover somewhat.

In terms of the health dangers linked to alcohol, we know that it can cause some cancers, stomach ulcers, liver disease, high blood pressure and heart disease. Moreover, drinking excessive amounts of alcohol makes the diagnosis of a mood disorder like depression more challenging, as you get a classic chicken and egg scenario.

For a comprehensive assessment of your health, you are best attending your GP who can determine after a complete history, physical examination and a new set of blood test results if you need to go for further testing. The liver is responsible for the storage of vitamins, minerals and sugar, the removal of bacteria and toxins (including alcohol), the breakdown of nutrients from food and the production of bile, protein and blood clotting factors. It's easy to comprehend why we cannot live without a healthy liver!

Commonly, abnormal liver blood tests from your GP, for example when both the Gamma Glutamyl Transpeptidase (GGT) and the alkaline phosphatase are elevated, prompts a referral for a special liver ultrasound scan called a liver fibroscan. Sometimes an enlarged liver or other stigmata of liver disease can be found on clinical examination along with a history of heavy alcohol consumption will also prompt referral.

Alcohol causes liver damage in two ways. Firstly, when alcohol reaches the liver, it produces a toxic enzyme called acetaldehyde that can damage liver cells. Secondly, the liver needs lots of water to function properly and as alcohol is a diuretic it causes dehydration resulting in further liver damage. Prolonged heavy alcohol consumption, even in your case over a few short months, can lead to liver damage. Some people are more at risk than other, factors such as age, gender, genetics and your pattern of drinking come into play.

I strongly encourage you to reduce back to ideally less than two bottles of wine per week. You should also consider attending your doctor for a clinical examination and routine blood tests.

⬤ Dr Jennifer grant is a GP with Beacon HealthCheck

Irish Independent