There are several forms of excessive or problem drinking recognized by health organizations, like the Centers for Disease Control and Prevention (CDC) and the National Institutes on Alcohol Abuse and Alcoholism (NIAAA). One that is less publicized but very dangerous is heavy drinking.
While many people have an understanding of binge drinking or alcoholism due to media reports, heavy drinking is not discussed nearly as often. However, Americans are drinking more alcohol, more regularly. One report found that 30 percent of American adults don’t drink at all, and 30 percent consume less than one drink per week. However, in the top 30 percent, the eighth decile drink nearly seven drinks per week, the ninth decile drinks close to 16 drinks per week, and the final decile, or the top 10 percent, drink 74 drinks per week (between 10 and 11 servings of alcohol per day).
What Is Heavy Drinking?
Part of the problem is due to Americans not understanding what heavy drinking is. The definition of heavy drinking varies a little based on gender.
- For men: more than four drinks per day or more than 14 total drinks per week
- For women: more than three drinks per day or more than seven drinks total in one week
Similarly, the Substance Abuse and Mental Health Services Administration (SAMHSA) states that heavy alcohol use is binge drinking (four or more servings of alcohol in a two-hour period) on five or more days per week.
Heavy drinking is likely to lead to alcohol dependence, meaning you may feel like you need to drink alcohol to feel normal or less stressed out. Drinking a lot of alcohol on a regular basis will likely lead to serious health consequences in the long-term. While you are at less risk of alcohol poisoning, you are at more risk for heart problems, liver damage, and cancer.
Anemia is one of the risks of heavy drinking, but this condition has multiple causes among people who struggle with chronic alcohol abuse.
What Is Anemia?
Anemia is a disorder in which the body does not create a sufficient amount of healthy red blood cells to transport oxygen from the lungs to the rest of the body. There are seven types of anemia:
- Sickle cell anemia
- Aplastic anemia
- Iron deficiency anemia
- Hemolytic anemia
- Pernicious anemia
- Fanconi anemia
Iron deficiency anemia is the most common type, usually due to blood loss of some type, leading to an increased demand for iron in the body. However, the body may also fail to make new red blood cells or healthy-shaped red blood cells when old blood cells die; the body may also kill healthy red blood cells before they have gone through a full life cycle. Vitamin deficiencies, internal bleeding, and genetics all contribute to the risk for developing some form of anemia.
- Pallid or yellowish skin (lack of blood, cirrhosis)
- Irregular heartbeat
- Shortness of breath
- Feeling lightheaded or dizzy
- Chest pains
- Cold hands, feet, or other extremities
Mild anemia may go unnoticed, but chronic anemia from an underlying cause, like alcohol abuse, will get worse over time and can lead to severe health problems and even death.
Drinking While Anemic
- Decreased red blood cell production in the bone marrow
- Loss of blood through ulcers or inflammation
- Destruction of red blood cells from heart valve issues, inflammation, immune system damage, or a cancerous tumor
People who drink heavily are more likely to skip meals and choose to drink instead, which can lead to malnutrition. Additionally, a lot of alcohol in the body reduces how much some nutrients, especially B12 (thiamine) and folate (folic acid), are absorbed in the intestines for use in producing red blood cells. A reduction in nutrients in the body will also prevent bone marrow from producing more red blood cells or healthy red blood cells. Bone marrow abnormalities may occur in people who drink an extremely large amount of alcohol for many years – for example, heavy drinkers who consume 74 drinks per week.
Liver dysfunction can also affect how red blood cells are managed by the body. Anemia is a common complication associated with liver disease, and alcohol is known to cause damage to the liver, leading to fatty liver, alcoholic hepatitis, cirrhosis, and even liver cancer. The main sign of liver damage is jaundice, when the skin or whites of the eyes turn yellow due to unprocessed toxins in the body. Anemia is associated with jaundice, so a doctor may begin treating anemia while they also treat liver damage.
Red blood cell decreases may be associated with fewer platelets in the body, so experiencing alcoholic anemia can reduce the body’s ability to form clots. This can show up as simple nosebleeds but may lead to a stroke. Stomach upset from chronic inflammation due to the presence of alcohol and less food will lead to ulcers. These ulcers are less likely to heal and more likely to bleed excessively, which can cause anemia among other serious health issues.
One condition caused by alcohol abuse is Zieve’s syndrome. This is a rare disease with three main symptoms: jaundice, anemia, and transient hyperlipidemia (elevated lipids in the blood). While it is not often diagnosed, some medical researchers believe it may be more common in heavy drinkers, although it is rarely recognized.
Preventing Anemia from Alcohol Abuse
There are many ways to overcome anemia, such as iron supplements, a dietary plan, surgery to close internal wounds, or treatment for a chronic disease. The best way to stop anemia caused by alcohol abuse is to get evidence-based treatment for alcoholism. Your physician will diagnose anemia and work to find the underlying cause; this means they can refer you to treatment with an appropriate addiction specialist or rehabilitation program.
If you do not have anemia but are worried about your drinking, you should still get help. SAMHSA offers an online treatment finder and associated hotline, so you can search for medically supervised alcohol detox, and rehabilitation. The National Institute on Drug Abuse (NIDA) has a list of Principles of Effective Treatment to help you navigate offerings that are right for you.