Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. This week I’m going to talk about the pros and cons of alcohol: the good, the bad, and the ugly. 

ALCOHOL has been a hot topic on a few of my favorite podcasts, one being Dr. Andrew Huberman, THE HUBERMAN LAB. This has spurred me to do a little research on my own which I feel the need to share with you as we head into the holiday season.  

Note: Alcohol consumption generally goes up during the holidays. There are some studies that show that light drinking may have its benefits (i.e., protecting your heart), but the majority of evidence says otherwise.

Let’s dive in. 


Is Alcohol Good For You? The Bad 


When you practice medicine for as long as I have, you see a lot of the bad effects alcohol can have on people. Is alcohol good for you? For the most part, no. It’s a toxin. Most people drink because it makes them feel good initially. It lightens the mood and for some helps with sociability, but this is short lived. The truth is that the length of time you feel good is much less than the time you feel bad.  

There are many adverse effects to drinking alcohol. In Dr. Huberman’s podcast on Alcohol, he talked a lot about a recent study on whether low levels of alcohol consumption thins your brain cortex. It was pretty conclusive that even small amounts of alcohol make your brain smaller. It destroys neurons, both gray matter (the cell body) and white matter (the neuroconnections you see that are wrapped in a fatty myelin sheath). Note: this same myelin sheath is what gets destroyed in MS disease (Multiple Sclerosis). Bottom line, you do lose neurons when you drink. 

Does it matter how much you drink? Yes. This seems to be the key. For example, does it matter if you drink 1 drink a day or 8 drinks on the weekend? Not really. Cumulatively, it all has the same effect. Of course, you might prefer one drink per day versus getting drunk on the weekends, but it all adds up.  

There’s really no nutritional value in alcohol. It’s what we call empty calories. You’re not going to get any benefit nutritionally from alcohol. Alcohol is very penetrable. It’s both water and fat soluble. That’s why it gets into your brain so fast. It’s fat soluble. Your brain is made up of water and fat.

Alcohol (ethanol) is broken down, or metabolized, by an enzyme in your liver cells known as alcohol dehydrogenase. It actually turns it into acetaldehyde, which is a toxin. So, really it’s the liver that takes the biggest hit with alcohol. That’s why it causes cirrhosis and liver damage. When you’re tipsy (or even really drunk) what you’re doing is disrupting these neural pathways that we’ve talked about. That’s why your speech gets slurred and your motor movements become affected. 

Alcohol does a lot of other (bad) things to you as well: 

  • It slows your ability to perform mentally and physically. 
  • It affects your prefrontal cortex. You may do things you don’t remember, and sometimes things you’re not proud of (i.e., losing your inhibitions). 
  • It affects your memory, both short and long term.  

Alcohol has a range of effects. It’s different for different people. Some people have better tolerances for alcohol than others. Some people can have one or two drinks and they’re immediately drunk. This is because they don’t have enough alcohol dehydrogenase to effectively break down the alcohol. 

Note: If you do drink, drink with something on your stomach. It will diffuse the effects of it a little bit. 

What’s interesting is that the people who drink a lot seem to not be as affected the next day. Those people are more likely to become alcoholics than those who don’t tolerate it as well. 

It’s important to note that people have different tolerances. The more you drink, the more it takes to get drunk. It is addictive, no doubt about that. Note: Genetics play a part in alcoholism, so look at your family history. 

It gets ugly…

  • Alcohol inhibits your neurotransmitters (i.e., serotonin and dopamine). 
  • Alcohol affects your cortisol, the stress hormone. 
  • Alcohol affects your gut microbiome, which increases leaky gut. Alcohol is definitely not good for your gut! 
  • Alcohol affects your hormones. 
  • Alcohol increases aromatization of testosterone to estradiol. That’s one reason why alcohol in women can increase the risk of breast cancer, and in men it can increase the risk of enlarged breasts (gynecomastia).  
  • Alcohol affects pregnant women terribly. Pregnant women should not drink anything. It actually changes the DNA of the fetus. We’ve all seen the effects of fetal alcohol syndrome. These babies are born with craniofacial defects and also mental retardation.
  • Consuming alcohol creates a long term change in your brain. Again, we don’t use all of our brain anyway, so you’ve got some room to spare there for most of us. But it still has the same effects whether you are drinking a little bit or a lot. Of course, drinking a lot is worse. 

Note: The earlier you start drinking the more likely you are to have a problem with it. The same goes for marijuana. I do not like kids smoking marijuana because it really affects them their whole life if they start too early.

I promise I’m not here to put a total downer on those of us that drink alcohol. So let’s get into some of the good..


Is Alcohol Good For You? The Good 


Around 80% of us drink alcohol and would like to think there is some good in it. There are some studies that show modest drinkers may benefit by having a healthier heart and living longer.  Some scientific papers say alcohol may be somewhat protective against cardiovascular disease and decrease your mortality. If you drink a little red wine, will you live longer and be more healthy? 

Note: There’s a thin line between what’s modest and what’s a moderate (regular) drinker. So be sure to think about whether you’re a modest drinker, moderate drinker, or excessive drinker as you read this section. 

A study this year in Scientific Reports assessed the risks and benefits associated with modest drinking (no more than one drink per day) and found that 23% of modest drinkers gain an average of 0.94 years of life, plus had an 8% reduction in all cause mortalities. That sounds like a good report. 

BUT (back to the bad)….. moderate drinkers (drinking more than one drink a day) had a 43%  INCREASE in overall mortality and actually lost 6.9 years of life! Not so good a report. Moderate drinkers also had a 2 to 4 fold increase in oral and esophageal cancers. So, for most people, the good benefits are negated by the risk of cancer. 

Excessive drinking definitely increases your cardiovascular mortality, cancer, and liver disease. It weakens your immune system. Excessive drinking definitely causes cognitive impairment (short and long term), and can be responsible for a lot of mental illnesses. A study in Molecular Psychiatry found that 10 or more glasses of wine per week shortened the length of your DNA (called telomeres) and shortened lives. The more alcohol you consume, the shorter those telomeres are, and the shorter your lifespan will be. 

Note: Excessive means more than 4 drinks per day, or 8 drinks for the week in women. In men, it’s 5 drinks a day or 15 drinks per week. Men have a little better tolerance for alcohol than women do. 

What about binge drinking? It’s the same risk for binge drinkers. If you’re doing all your drinking on the weekends, it can be just as bad (maybe even worse) because it can lead to recklessness. Note: not to mention accidents, which compounds the problem with alcohol. 

NOW (back to the good)…

Another study in AGING MAGAZINE found that the probability of living to 90 increases in women who drank a modest amount of wine, but in men it had the opposite effect. Note: they did have a modest increase if they drank a small amount of liquor. So, it seems that wine may be better for women than men, and liquor may be better for men. Again, this is less than 1 drink per day. There’s a lot of gray area here. 


Is Alcohol Worth The Risk? 


If you’re drinking more than one drink per day, or more than 5-8 drinks per week, the risks definitely outweigh the benefits of alcohol. As you know, there’s a fine line. And we’re not even talking about drunk drivers, falls, or accidents that can be caused by drinking. 

The bottom line (since most of us do consume some alcohol) is know your tolerances. If you think you’re overdoing it, or the people around you think you’re overdoing it, you probably are. 

I’m not saying don’t drink, but know the risks of consuming too much. 

TRUTH: The only way to make sure you’re not going to be an alcoholic is to not drink at all. That’s not reasonable for most people, but you need to be aware of the things that alcohol can cause because there’s no doubt it’s a toxin and it impairs you (even though a lot of us like the relaxation effect). 

Just know yourself. Everybody is a little different in how they react to alcohol, so be careful and have a safe and happy holiday season! 

Till next week.