Disclaimer: If you are a recovering alcoholic/recovering from a health issue or are a modern puritan, this blog post may not be suitable for you. In the case of 1. Good luck. In the case of 2. Get ye gone! I’m sure even reading this blog is sinful in some way. Are you still here? Get! Shoo!
“Paleo diet? But I like booze!”
Is this you on New Year's Eve?
Apparently this blog is called Highbrow Paleo, so I’m going to quickly address the Paleotude of alcohol. Our gut flora produce a small amount of ethanol, about 3g, every day,. So it isn’t like ethanol is this completely foreign substance that we don’t know how to handle, like synthetic trans fats, far from it. Drinking alcohol provides a lot more alcohol than we would have seen during the bulk of evolution, but if the metabolic pathways exist already, then there isn’t as much reason to think that alcohol is something that we can’t handle. There is definite reason to think that it is problematic, but the degree to which it is depends upon the body’s response to it, and that’s the topic of this post. Alcohol doesn’t belong in the same category as trans fats, and while it has been tied to many diseases, it is my belief that a generally unhealthy lifestyle deficient in nourishment and high in unhealthy foods, combined with a lifestyle that is at odds with our biology is the driving factor that determines alcohol’s toxicity. It is still toxic no matter what, but less toxic when we hack our biology with nutrition and other tools. This is a guide on how to do so.
Too much ethanol is toxic, but why? There are many reasons, but the main reason cited has to do with its metabolism inside the liver. Ethanol is metabolized to acetaldehyde, and then hopefully to acetate, because acetaldehyde is very toxic; it is highly reactive and is the main reason why alcohol produces liver damage. When metabolism of acetaldehyde is sluggish, meaning that the aldehyde dehydrogenase enzyme is downregulated, it is a very slow conversion and we see acetaldehyde accumulate all over the place. In the liver of course, in the blood, in the heart, and the brain. We all know that feeling, it isn’t a pleasant one. We want to reduce the amount of acetaldehyde that gets produced, and detoxify the acetaldahyde that does get produced while preventing the damage it does while it’s on the loose. Our bodies are well equipped to do this, but if they aren’t properly nourished or if the immune system is sloppy and sluggish, then repairs will turn into demolition and we won’t be built up again but torn down.
So we need to upregulate the aldahyde dehydrogenase enzyme first and foremost, this will clean up acetaldehyde and reduce the toxicity of alcohol by converting it into a more benign molecule. By far the most effective way I know how to do it is to take pantethine. Pantethine is the precursor of coenzyme A, which is needed for various metabolic conversions, one of them is the Acetaldehyde –> Acetate –> Acetyl CoA pathway, and its effects on reducing acetaldehyde in the blood are quite pronounced (1). Unfortunately, it is only effective in some people; for those who have significant facial flushing from alcohol consumption, pantethine won’t do much to reduce acetaldehyde after drinking, but for everyone else it is excellent for reducing the toxic acetaldehyde load. Those who get very flushy are out of luck here, and aren’t the best candidates to be drinking to the extreme in the first place, but then again there is much that can be done to make drinking healthier for these people, which takes us to the heart of the topic.
Even if we can find biohacks to reduce the amount of acetaldehyde we have to deal with, we can’t eliminate its production entirely, so we must protect against it and detoxify it. The best way to do this is by supporting the body’s natural defenses, the sulfur-containing antioxidant enzymes, namely glutathione, one of our best antioxidants and detoxifiers which works in tandem with the rest of our antioxidant team.
Much of the work in the field of alcohol research is done in rodents, because apparently it is unethical to try to kill people with booze. The evidence that can be garnered from rat studies isn’t a perfect reflection of what would happen in humans, but it can give us good grounds to experiment for ourselves, and usually the mechanisms are approximately the same in humans and rats and I’m confident that supporting the same defenses in humans will produce the same results in the major aspects discussed.
The format of these studies usually goes something like this: A big mean scary scientist guy tries to kill some rats with toxic doses of booze, oh sure it’s fun at first and every rat gets lucky, but sooner or later the alcohol takes its toll and the rats in the control group get diseases. The rats in the intervention group get the protective nutrients, and we compare the difference in health between them. Science, bitchez, it, like, works!
Significant improvements in health after alcohol feeding have been seen with basic combinations of nutrients that you can get at a supplement store. The scientists in reference (2) had this to say in their summary:
“Greatest protection against anesthesia and lethality was obtained at 2 mM/kg with each of the following:l-cysteine N-acetyl-l-cysteine, thiamin HCl, sodium metabisulfite, andl-cysteic acid. A combination of l-ascorbic acid with l-cysteine, and thiamin·HCl at reduced dose levels (2.0, 1.0 and 0.3 mM/kg, respectively) gave virtually complete protection.”
Lucky rats, take that Mr. Reaper! L-cystine and n-acetyl-l-cysteine are precursors to glutathione, and ascorbic acid (Vitamin C) is important for glutathione’s redox. Thiamin, vitamin B1, appears to be important in protecting against acetaldehyde toxicity, and is greatly reduced by consumption of large amounts of alcohol. Sulfur itself (MSM in supplement form) improves glutathione status as well, acting as a rate-limiting factor for its synthesis from amino acids. We want to be supporting the synthesis of glutathione and our other antioxidant enzymes daily with a healthy diet and reasonable supplementation. But if we’re drinking frequently, supplementation is going to be a boon. Physical activity prior to drinking is also very protective as it increases production of antioxidant enzymes and protects against ethanol toxicity in the liver and the brain. (3) (4) (5)
The active component of milk thistle, silymarin, has a pronounced protective effect on the liver when it is under stress from alcohol, it too works to preserve the health of the liver and its antioxidant enzymes (6), so do consider it.
Alcohol is intimately tied to another aspect of the cirrhosis spectrum diseases called fatty liver disease. Some of you may have heard about non-alcoholic fatty liver disease, which some believe sugar to play a role in. It is by far the less fun fatty liver disease to give yourself. The gist of it is that fat accumulates in the liver (steatosis) where it impairs its functioning, the liver becomes inflamed (steatohepatitis) as all of the damage needs to be repaired, but the dysfunctional immune system ends up being the nail in the coffin of the liver. There is fibrosis, an abnormal growth of fibrous connective tissue, and our liver becomes very insulin resistant, creating problems elsewhere. If we’re going to be abusing our livers, we should at least be sure that our immune system is on our side and we are doing everything we can to control inflammation. We’re degenerates, not imbeciles, thank you very much!
Possibly the biggest part of that is avoiding excessive amounts of omega-6 fatty acids, particularly the ones that have been oxidized and come from seed oils. Mice fed a diet high in omega-6 fatty acids develop the final stage of non-alcoholic fatty liver disease (and were lucky to not get any alcohol or it would have been worse) but conversely, when they are fed coconut oil or other saturated fatty acids it is actually protective due to the generation of adiponectin, a protective hormone that prevents insulin resistance and is a powerful anti-inflammatory signaler (7) (8). Adiponectin is lower in people with a lot of visceral fat, people eating low fat diets, low fiber intake, low activity level, excessive inflammation, and other generally unhealthy practices (9) (10). But I’m assuming that you’re health-conscious, probably following the paleo diet, and don’t need to be told to do any of these things. Regardless, you absolutely can’t be low in methionine or choline or your liver won’t be able to metabolize fat (11), so eat your eggs or else! Keeping the liver in good shape allows it to deal with a toxic load when it happens.
The list of maladies associated with excessive consumption of alcohol also includes brain damage and damage to the mucosal barrier of the gut, leading to a permeable or “leaky” gut. Reducing and detoxifying acetaldahyde will play a big role in preventing this, but we also want to enhance cellular defenses as much as we can, particularly. We already touched on glutathione, and it has also been found that polyphenols in strawberries protect the mucosa through stimulating production of defenses (12), and zinc has also been shown to be protective (13) (14). Various amino acids like glycine and glutamine will help to repair the mucosa, as well as Vitamin A. Carnosine, found in red meat, is an excellent protector of the brain (15), as are all sorts of berries. These things are all prevalent in the paleo diet for most, but it may be wise to ensure an especially high intake around the time of drinking or afterwards. Bone broth and gelatin have significant amounts of glycine, glutamine, and arginine which protect the gut and liver from alcohol as well (16) (17). It would be a great next-morning breakfast along with coffee or tea.
Anything that controls inflammation can prevent the inflammatory liver damage that occurs when the liver is damaged, and while the paleo diet is generally strongly anti-inflammatory, extra ammunition will help nearly anyone. Ginger tea, quercetin, curcumin, resveratrol, and various herbs and spices protect the liver against ethanol toxicity and are helpful prior to or after a night of drinking (10) (18) (19) (20) (21). Red wine and quercetin are apparently a match made in heaven as red wine facilitates the absorption of quercetin (22). Score one more for booze! How’s that for healthy pills in your drink? Bound to confuse somebody, but not you.
Of course we want to stress moderation if possible, but if you find yourself just a little too drunk, amazingly consuming sugar will eliminate the alcohol from your blood faster (23). I recommend fresh fruit, which also has other protective elements.
Summary
Prior to drinking
- Exercise
- Pantethine
- Glutathione-supporting nutrients: n-acetyl cysteine 500mg, alpha-lipoic acid, 500mg, MSM powder or comparable amount of sulfur from food – 5g
- Thiamin 100mg
- Choline 500mg
- Carnosine 500mg
- Milk thistle 500mg
- All kinds of spices
- Berries
- Gelatin
- Vitamin E (gamma tocepherol and tocetrienols, not just alpha-tocepherol and definitely not the synthetic form)
During or just before drinking
- Curcumin 500mg
- Quercetin 500mg
- Ginger tea
- Resveratrol 200-500mg
- Anything else that is anti-inflammatory
- Vitamin C
- Vitamin E
The next day
- Tea including ginger tea
- Coffee
- Gelatin/bone broth
- All other nutrients that were consumed prior to drinking, because they will be low
This isn’t an exhaustive presentation of ways to protect yourself from alcohol’s ill effects, and everyone should look further to find more remedies that work. There are other mechanisms that I haven’t touched on, but the tips and tricks proposed within this article are likely to be protective in other ways that weren’t mentioned. If you have a particularly good remedy, please share it, and have a happy holiday season, hopefully you will remember it! Cheers.
References
1. http://www.ncbi.nlm.nih.gov/pubmed/3893199
2. http://www.springerlink.com/content/g414523058x71604/
3. http://www.ncbi.nlm.nih.gov/pubmed/18551810
4. http://www.ncbi.nlm.nih.gov/pubmed/20028365
5. http://www.ncbi.nlm.nih.gov/pubmed/20705416
6. http://www.ncbi.nlm.nih.gov/pubmed/17133738
7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1398076/?tool=pubmed
8. http://perfecthealthdiet.com/?p=509
10.http://www.wellnessresources.com/studies/resveratrol_supports_adiponectin_by_reducing_inflammation/
11. http://www.ncbi.nlm.nih.gov/pubmed/11531217
12.http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0025878
13. http://www.wellnessresources.com/studies/zinc_and_liver_damage
14.http://www.wellnessresources.com/studies/zinc_protects_against_alcohol_induced_intestinal_damage/
15. http://www.springerlink.com/content/e5478341649ul9rj/
16. http://www.ncbi.nlm.nih.gov/pubmed/15027101
17. http://jpet.aspetjournals.org/content/299/3/832.full
18. http://www.ncbi.nlm.nih.gov/pubmed/20599394
19. http://www.ncbi.nlm.nih.gov/pubmed/20383223
20. http://ajpgi.physiology.org/content/284/2/G321.long
21. http://www.ncbi.nlm.nih.gov/pubmed/20668581
22.http://www.wellnessresources.com/studies/resveratrol_supports_adiponectin_by_reducing_inflammation/
23. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1760706/?tool=pubmed
24. http://www.ajcn.org/content/28/3/254.full.pdf
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Tags: Alcohol, Bio Hacking, Drinking, Stabby Racoon
Wow, I did not realize that raccoons were so versed in biochemistry and also had a penchant for libations. Seriously, I love the fact that this is such a well referenced post. Well stabbed!
1) So do you actually employ the full arsenal of suggestions you’ve listed each time you drink or have you found a few of the things in particular provide enough bang for the buck…unless you are drinking enough to kill a small farm animal?
2) Have you done any “controlled” tests to see your n=1 hangover with and without the supplementation? If so, any anecdotes you can share?
Thanks,
Aravind
Raccoons love to PARTY!
I do many but not all. Sometimes it’s redundant like taking two powerful anti-inflammatories at once.
I have never done anything scientific, but I have my anecdotes which say that this stuff works, as long as I don’t fall down and hit my head or get into the baked goods…
Hi Stabbie!
I’m wondering why anecdotally people believe that consuming sugary drinks (anything with sour mix, girl scout cookie inspired martinis, anything with godiva chocolate liqueur) gives them a worse hangover, when you say that consuming sugar helps the body rid itself of etoh faster? this is such an awesome post, i want to make out with it! but that might be the booze talking. thank you!!
They feel that because the sugar puts more stress on their liver and brain. I say that because it does clear alcohol faster and make them lesser drunk, but acetaldehyde is more toxic than ethanol itself. Sugar reduces ethanol but increased acetaldehyde. So that’s why I recommend fresh fruit, it’s not toxic like a pepsi.
NOW liver detox…
Calories 10
Total Carbohydrate 1 g <1%*
Dietary Fiber 0.7 g 3%*
Vitamin C (from Ascorbyl Palmitate) 12 mg 20%
Milk Thistle (Standardized Extract) (Seeds)
(Silybum marianum) (min. 80% Silymarin) 300 mg †
Proprietary Herbal-Nutrient Blend
Artichoke (Cynara scolymus) (Leaf), Beet (Beta vulgaris) (Leaf), Black Radish (Raphanus sativus) (Root), Bladderwrack (Fucus versiculosus) (Whole Plant),Raspberry (Rubus idaeus) (Leaf), Phosphatidyl Choline, Pancreatin (Pancreatic Enzymes), Blue Flag (Iris versicolor) (Root), Cleavers (Galium aparine) (Aerial Parts 250 mg †
L-Glutathione (Free-Form) (Reduced) 100 mg †
N-Acetyl Cysteine (NAC) 100 mg †
Bupleurum (4:1 Conc. Extract) (Root) (Bupleurum chinense) 100 mg †
Grape Seed (Standardized Extract) (Vitis vinefera) (min. 90% Polyphenols) 100 mg †
Dandelion (4:1 Conc. Extract) (Root) (Taraxacum officinale) 100 mg †
L-Carnitine Base 50 mg †
Scute (4:1 Conc. Extract) (Root) (Sculellariae baicalensis) 50 mg †
Pueraria (4:1 Conc. Extract) (Flower) (Pueraria thunbergiana) 50 mg †
Schisandra (Fruit) (Schisandra chinensis) 50 mg †
Barberry (Root Bark) (Berberis vulgaris) 30 mg †
Turmeric (Root) (Curcuma longa) 30 mg †
L-Methionine 20 mg †
* Percent Daily Values are based on a 2,000 calorie diet.
Just in time for New Year’s Eve, thanks Stabby! I look forward to my own n=1 this weekend.
Can verify ginger tea and gelatin is awesome mix.
The NAC/Vitamin C combo works, but it seems a little dangerous to me. You can take this combo before every drink and make money drinking people under the table. But causing all those chemical reactions in your body just can’t be good.
“Those who get very flushy are out of luck here, and aren’t the best candidates to be drinking to the extreme in the first place, but then again there is much that can be done to fix that.”
What is the fix for this flush syndrome, whether it be caused by ALDH2 deficiency or otherwise? You suggest that B5 is not sufficient to prevent flush, and I wonder what can be done to prevent it.
I’m not entirely sure, because the enzyme deficiency is a huge piece in the puzzle, and has no immediate fix, I did say that these people aren’t the best candidates to be drinking large amounts. The best thing to give these people as much tolerance as possible would be to do everything to improve glutathione status, and especially make sure to be exercising the day of drinking, that tends to make all metabolic pathways work better, and increase glutathione in the body. Milk thistle, NAC, the vitamins, etc. Just so everything else as best you can and you should see improvements.
so, my mother has a acetaldehyde dehydrogenase deficiency (beats me; shes purely northern european) and she started taking a ranitidine (Zantac™), an H2 histamine receptor antagonist, before she drinks and it has fixed her issue with flushing. she doesn’t drink a lot, but it allows her to go out to dinner and have a glass of wine or two without looking like Barney™. she picked up that little trick from some asian college students who load up on antacids before hitting the bars.
“Ranitidine reduces alcohol breakdown causing serum alcohol levels to increase substantially. Studies with rats have indicate that ranitidine, and to some degree other H2-receptor antagonists, impair alcohol dehydrogenase (ADH) activity when taken at therapeutic doses. Ranitidine also demonstrated either mixed or competitive inhibition of rat hepatic ADH. Thus, in alcoholics and in social drinkers who require treatment with H2-receptor antagonists, the prescribing physicians might choose to prescribe famotidine, instead of ranitidine or cimitidine, as a less problematic H2 blocker. Of course, stopping alcohol consumption represents a more direct route to eliminating this risk and would most likely also provide significant benefits in reducing the symptoms for which the ranitidine was originally prescribed. Even so, the levels of alcohol intake necessary to induce this interactions may be significantly higher than commonly consumed by most social drinkers on any consistent basis.
(Caballeria J, et al. Dig Dis Sci 1991 Dec;36(12):1673-1679.)”
I’ve run across a fair number of epidemiological studies finding an association between coffee consumption and decreased risk of liver cirrhosis. Do you have any take on that:
http://www.springerlink.com/content/x342322h01722p63/
http://www.sciencedirect.com/science/article/pii/S104727970100223X
Either way, I love me some Irish coffee.
The anti-inflammatory and antioxidant effects it has will play a role. I’m sure there are other mechanisms. For those who are adverse to coffee there are many alternatives like the ones that I mentioned. But for those who do well with coffee and keep it to the AM and not too much, then it will probably be good for the liver
So does alcohol actually kill brain cells? I don’t think I would remember to take supplements after drinking vodka. I usually just sleep it off. I do like the idea of a egg breakfast though. Or an egg drop soup with a bone stock.
Yes it does, but it does a whole lot less if you take the supplements before drinking. While drinking may be a little better, especially with nutrients with a shot half-life in the body like vitamin c, but it’s not completely necessary. Using this stuff in the days leading up to the big night out drinking will probably help out too, we want to maintain the health of our livers for when shit happens, not just throw them a bone right before it happens. Although since you follow a primal diet you will be far more resistant to alcohol’s effects than most people. If you are the low carb variety of primal you may have more of a problem with it than the moderate carbers, that’s just my observation.
Great article Stabby, keep it up!
“We’re degenerates, not imbeciles, thank you very much!”
LOL! Thank YOU very much, Stabby, both for the article and the line.
Best,
KKC
Stabby the Raccoon, can you write an article that will teach me how to read studies with all the Ps, Cs, metas, cohorts, relative risks, absolute risks, correlations and stuff ?
While I really really really appreciate the bloggers simplifying it down for me, I would like to have some insight without having to retake my statistics course.
Bacon and Butter,
Diana
Hey Diana, I’m pretty sure you could find someone better than me to explain it. I have a vague knowledge of this stuff but within Highbrow Paleo there are people who know more than I do. What I do is read read read and it falls into place. Wikipedia is helpful.
But to be more useful to you, do what you can now and then buy Denise Minger’s new book that’s coming out, it will have a primer on that stuff and teach both of us a thing or two.
Cheers.