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How Much Alcohol Does it Take to Damage Your Liver?

The liver converts nutrients, vitamins, and medications into substances our bodies can use. It also creates proteins, enzymes, and hormones to fight off infections. 

Another primary function of the liver is to break down and filter harmful substances in the blood, manufacture bile for digestion, and store glycogen for energy. For example, it processes over 90 percent of the alcohol you consume. The rest leaves your body via urine, sweat, and breathing.

It takes around one hour for the body to process one alcoholic drink. This time frame increases with each drink. The higher an individual’s blood alcohol content is, the longer it takes to process alcohol. 

The liver can only process a specific amount of alcohol at a time. When someone drinks too much, the alcohol left unprocessed by the liver travels through the bloodstream. The alcohol in the blood begins to affect the heart and brain, which is how individuals become intoxicated.

Chronic alcohol use leads to the destruction of liver cells. This causes scarring of the liver (cirrhosis), alcoholic hepatitis, and cellular mutation that may result in liver cancer. These conditions usually develop from fatty liver to alcoholic hepatitis to cirrhosis.

However, excessive drinkers may develop alcoholic cirrhosis without first developing hepatitis. 

A safe amount of alcohol to drink depends on an individual’s body weight, size, and gender. Women absorb more alcohol from each beverage than males, so they are at greater risk of liver damage.

Drinking two to three alcoholic drinks daily can harm a person’s liver. Binge drinking or consuming four or more drinks in a row can also lead to liver damage.

Can Moderate Alcohol Intake Cause Liver Problems?

When an individual drinks alcohol, the liver is responsible for filtering the alcohol from the blood. Moderate alcohol consumption typically does not affect a normally functioning liver or result in alcohol-related liver disease (ARLD)

Moderate drinking is typically considered one drink per day for women and two per day for men. One alcoholic beverage includes:

  • 2 oz beer
  • 4 oz wine
  • 1 oz liquor
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Early Signs of Liver Damage From Alcohol

Your liver is responsible for breaking down potentially toxic substances, including alcohol. When you drink alcohol, different enzymes in your liver break it down to remove it from the body. When you consume more than your liver can properly process, alcohol and its byproducts can hurt your liver.

This typically takes the form of extra fat in your liver, but it can lead to inflammation and the accumulation of scar tissue in time.

The early stages of liver damage from alcohol typically have no symptoms. If you have early stages of liver damage from alcohol, you may not even realize it.

If symptoms of early liver damage are present, they may include:

  • Swelling of the liver, which may lead to discomfort in the upper right side of the abdomen
  • Fatigue
  • Unexplained weight loss 
  • Loss of appetite
  • Nausea
  • Vomiting

Late Signs of Liver Damage From Alcohol

Once liver damage from alcohol progresses, its symptoms become easier to recognize.

The more noticeable signs of late-stage liver disease include:

  • Jaundice, or a yellow tint of the whites of the eyes and skin edema
  • Swelling of the lower limbs
  • An accumulation of fluid in the abdomen, known as ascites
  • Hepatic and biliary disorders
  • Shivering
  • Extremely itchy skin
  • Fingernails that curve significantly, known as clubbing
  • Losing a considerable amount of weight
  • General weakness and wasting muscles
  • Blood in the vomit and stools 
  • Bleeding and bruising more easily
  • More sensitive reactions to alcohol and drugs

Once these symptoms are noticeable, the condition has developed to an advanced stage. Visiting a doctor immediately is crucial.

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Can the Liver Repair Itself From Alcohol Damage?

The liver is very resilient and can regenerate itself. Each time your liver filters alcohol, some of the liver cells die. While the liver can create new cells, prolonged alcohol misuse over many years can reduce its regenerating capabilities.1

This can lead to severe and permanent damage to the liver.

Is Alcohol-Induced Liver Damage Treatable?

Successful treatment for alcohol-induced liver damage usually depends on whether a person is willing to quit drinking and change their lifestyle to improve their liver health.

The best treatment for alcohol-induced liver damage is quitting drinking. This is recognized as abstinence, which can be crucial depending on what stage the condition is at.

If you have alcoholic fatty liver disease, the damage may be reversed if you quit drinking for at least two weeks. After this point, it is typically safe to begin drinking again in moderation. 

If you have a more severe alcohol-related liver disease such as alcoholic hepatitis or cirrhosis, lifelong abstinence is suggested. This is because quitting drinking is the only way to stop your liver damage from worsening and potentially preventing you from dying of liver disease.

Stopping drinking is often challenging. An estimated 70 percent of people with alcohol-related liver damage have a problem with excessive alcohol consumption.2 

However, if you have alcohol-related cirrhosis or alcoholic hepatitis and do not quit drinking, no medical or surgical treatment can protect you from liver failure.

When to See a Doctor + Treatment Options

If you drink heavily, speak with your doctor so they can check if your liver is damaged. 

Alcohol-related liver damage does not typically cause any symptoms until the liver has been severely damaged. This means that ARLD is often detected during tests for other conditions or at a stage of advanced liver damage.2

Psychological Therapy

Once you have quit drinking, you may need additional treatment to ensure you do not start drinking again. The initial treatment offered is usually psychological therapy.

Psychological therapy typically involves meeting a therapist to discuss your thoughts and feelings and how they affect your behavior and wellbeing. 

If psychological therapy alone is not effective in preventing relapses, you may also require medicine to help you abstain from alcohol, such as:

  • Acamprosate
  • Disulfiram
  • Naltrexone

Peer Led Groups

Many people with an alcohol use disorder find it helpful to attend peer led groups to help them stop drinking. Alcoholics Anonymous is one of the most famous, but many other support groups can help. 

Medication

The use of medicine to directly treat alcohol-related liver damage is controversial. Many experts say there is limited evidence for its effectiveness.

For those with severe alcoholic hepatitis, treatment at the hospital may be required. Treatment using corticosteroids or pentoxifylline medication may be used to lessen liver inflammation in some people with this condition. Nutritional support is also an essential part of treatment in such cases.

Other medications that have been used to treat liver damage include:

  • Anabolic steroids (a more potent type of steroid medication) 
  • Propylthiouracil (a type of medicine initially designed to treat overactive thyroid glands)

However, there is a lack of solid evidence that these medications help. They are no longer used for severe alcoholic hepatitis.

Liver Transplants

In the most severe cases of ARLD, the liver loses its capabilities to function. This leads to liver failure. In these cases, a liver transplant is the only way to treat irreversible liver failure.

A liver transplant may be considered if:

  • You develop progressive liver failure, despite not consuming alcohol
  • You are otherwise well enough to survive the operation
  • You commit to not consuming alcohol for the rest of your life

Resources

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Alcohol-related liver disease, National Health Service (NHS), August 2018

Alcohol-related liver disease Treatment, National Health Service (NHS), August 2018

Osna, Natalia A et al. “Alcoholic Liver Disease: Pathogenesis and Current Management.” Alcohol research : current reviews vol. 38,2 (2017): 147-161

Patel R, Mueller M. Alcoholic Liver Disease. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan

Walsh K, Alexander G, Alcoholic liver disease, Postgraduate Medical Journal 2000; 76:280-286.

Trefts, Elijah et al. “The liver.” Current biology : CB vol. 27,21 (2017): R1147-R1151

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