Anemia and alcohol abuse go hand in hand. Heavy alcohol consumption affects iron metabolism, leading to deficiencies. Low iron levels in the bloodstream may increase your risk of developing anemia, a condition that causes extreme fatigue, dizziness and shortness of breath, among other symptoms.
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Heavy drinking can either increase or reduce your iron levels. In some cases, alcohol may affect the body’s ability to absorb this mineral, leading to iron deficiency anemia. Drinking too much can also cause iron overload, affecting your liver and other organs.
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Why Is Iron Important?
Popeye the Sailor Man, one of the most popular cartoon characters of all time, ate spinach for good reason. Like other leafy greens, this vegetable is chock-full of iron and other essential minerals. A diet rich in iron won't cause your muscles to grow overnight — as it did for Popeye — but it can boost your health and wellbeing.
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This mineral plays a key role in the production of hemoglobin, a protein that transports oxygen from your lungs to other tissues, as the National Institutes of Health (NIH) points out. Low hemoglobin levels can be a sign of anemia, iron deficiency, liver problems and even cancer. Your diet, hormones and exercise habits may affect hemoglobin levels in the bloodstream, too.
Iron also supports metabolic health, hormone synthesis and normal cellular functioning. Approximately 6 percent of the iron in your body is a component of certain enzymes and protein, according to the University of California San Francisco. The average woman has about 30 milligrams of this mineral stored (as ferritin) in her body, while men have about 1,000 milligrams of stored iron.
Certain health conditions and lifestyle factors can affect iron absorption. In this case, your body will use stored iron to sustain itself. If your iron levels continue to drop, you may develop anemia. Certain groups are at greater risk of iron deficiency, according to the NIH. These include:
- Pregnant people
- Infants and children
- Frequent blood donors
- People with heart failure, cancer and certain digestive disorders
Another risk factor is heavy drinking, which may interfere with your body's ability to absorb and metabolize iron. Over time, alcohol consumption can lead to iron deficiency anemia and other health problems.
Alcohol and Iron Absorption
Alcohol consumption is directly responsible for 25 chronic diseases, according to a 2014 review published in Alcohol Research. Alcoholic gastritis, liver failure, hepatitis and cardiomyopathy are just a few to mention.
Heavy drinking also contributes to more than 200 disorders, including depression, epilepsy, hypertensive heart disease, ischemic stroke and cancer. The effects of alcohol on these conditions are dose-dependent.
For example, light to moderate drinking may reduce diabetes risk and improve insulin sensitivity, as noted in the above review. Drinking too much, on the other hand, can put you at risk for diabetes. Excessive alcohol use may also lead to cardiovascular problems, high blood pressure, fatty liver disease and digestive disorders.
Alcohol has a direct impact on vitamin and mineral absorption. According to the Mayo Clinic, it can affect your body's ability to absorb folate, vitamin C and other nutrients, leading to deficiencies. Furthermore, heavy drinking is a contributing factor to several types of anemia, as reported in a February 2018 research paper featured in Discovery Medicine.
The Washington Health Care Authority warns about the dangers of alcohol abuse. Excessive drinking may cause low iron levels, premature aging, anxiety and sleep problems. It's also a risk factor for macrocytic anemia, a condition characterized by the presence of macrocytes, or enlarged red blood cells.
Signs of Iron Deficiency Anemia
An occasional drink is unlikely to affect your iron levels and cause nutrient deficiencies. Heavy drinking, on the other hand, can lead to iron deficiency anemia, liver disease and cardiac events. Iron deficiency anemia is characterized by hemoglobin concentrations lower than 12 to 13 grams per deciliter, per the NIH.
This health condition affects every system in your body. You may experience digestive symptoms, diminished exercise or work performance, headaches, chest pain and overall weakness. Other symptoms of iron deficiency anemia may include:
- Pale skin
- Restless leg syndrome
- Cold hands and feet
- Poor mental focus
- Arrhythmia
- Inflammation of the tongue
If you're constantly tired and low on energy, anemia might be the culprit. Fatigue, one of its main symptoms, can affect your ability to work and focus on the tasks at hand. When you have low iron levels, your body doesn't produce enough hemoglobin. As a result, your cells and tissues won't get enough oxygen to function properly.
Without adequate treatment, anemia may increase your risk of infections, cardiovascular problems, depression and pregnancy complications. If you have a chronic disease, your symptoms may worsen.
Heavy Drinking and Iron Overload
Half of all cases of anemia are due to iron deficiency, according to a February 2016 review published in the Lancet. As mentioned earlier, anemia and alcohol abuse are strongly connected. But did you know that heavy drinking may also lead to iron overload?
A research paper featured in the journal Molecules in April 2019 discussed the effects of alcohol on serum iron levels and other minerals. Ethanol, the active compound in alcoholic beverages, increases ferritin synthesis, leading to dangerously high levels.
Ferritin, a form of iron stored in the body, can exceed 10,000 milligrams per liter in those who are struggling with alcoholism and alcohol-related conditions, such as hepatitis. Under normal conditions, ferritin levels are below 1,000 milligrams per liter.
If you continue to drink, iron can accumulate in your tissues and cause organ damage. Excessive iron is particularly harmful to your liver and may lead to excess hepatic fat and cirrhosis. Furthermore, it may contribute to the onset of cancer and accelerate tumor growth.
These findings indicate that alcohol abuse can lead to either iron overload or iron deficiency. To stay safe, limit your alcohol intake or take the steps needed to quit drinking. According to the 2015-2020 Dietary Guidelines for Americans, adults should not exceed one to two drinks per day.
While there are some potential benefits associated with moderate drinking, no amount of alcohol is safe. The risks are even greater for pregnant people, people with liver disease and individuals under medical treatment. Alcohol can interact with certain medications and cause dangerous reactions.
- USDA: "Nutrition Facts for Spinach (Raw)"
- MedlinePlus: "Hemoglobin Test"
- University of California San Francisco: "Hemoglobin and Functions of Iron"
- NIH: "Iron"
- Molecular Aspects of Alcohol and Nutrition: "Molecular Effects of Alcohol on Iron Metabolism"
- Alcohol Research: "Chronic Diseases and Conditions Related to Alcohol Use"
- Mayo Clinic: "Vitamin Deficiency Anemia"
- Discovery Medicine: "The Unusual Nutritional and Toxin-Related Underproduction Anemias: Approaching the Riddle Beyond Iron, Cobalamin, and Folate"
- Washington Health Care Authority: "Alcohol Use Treatment"
- Journal of General and Family Medicine: "Diagnosis and Treatment of Macrocytic Anemias in Adults"
- NIH: "Iron-Deficiency Anemia"
- NCBI: "Fatigue and Acute/Chronic Anaemia"
- The Lancet: "Iron Deficiency Anaemia"
- Molecules: "Serum Iron, Magnesium, Copper, and Manganese Levels in Alcoholism: A Systematic Review"
- American Association for Clinical Chemistry: "Ferritin"
- Nature Reviews Cancer: "Iron and Cancer: More Ore to Be Mined"
- Health.gov: "Dietary Guideines for Americans, 2015-2020: Appendix 9. Alcohol"
- Mayo Clinic: "Alcohol: Weighing Risks and Potential Benefits"
- NIH: "Mixing Alcohol With Medicines"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.