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Alcohol metabolism

Alcohol metabolism

Written by Dr Dan Rutherford, GP


We may all overindulge from time to time, but alcohol has a wide range of ill-effects when consumed in excess amounts.

  • Too much alcohol is toxic to vitamins and minerals and at high levels acts as an anti-nutrient.
  • It has a high calorific value, which is why it contributes to weight gain.
  • Alcohol also causes low blood sugar levels and dehydration, leading to an increase in appetite and the classic 'binge eating' that happens at the end of a heavy drinking session.
  • Drinking too much on a regular and sustained basis has been linked to high blood pressure, strokes, heart disease, osteoporosis and certain cancers. These risks increase for drinkers who smoke.


People who shouldn't drink
When you drink alcohol it enters your cells and is broken down into a toxic compound known as acetaldehyde.

An enzyme called aldehyde dehydrogenase 2 (ALDH2) then converts the acetaldehyde into acetic acid, which your body can use for energy. (We all know acetic acid better as vinegar!)

Some people have an alteration in the ALDH2 gene, called a polymorphism, that makes it impossible for them to convert acetaldehyde into acetic acid. They cannot break down alcohol efficiently, which makes them feel ill and turn red as soon as they have a drink.

If you have this deficiency, avoid alcohol.

Not all bad news

All about ABV ABV stands for alcohol by volume.

It's used to measure the strength of alcohol in your tipple.

To work out the units of alcohol for yourself, you need to know the ABV and size in ml of your drink.

Multiply the ml of drink by the ABV, and then divide by 1000. Below are examples.

One pint (568ml) lager 5% ABV

  • 568 x 5= 2840
  • 2840 ÷ 1000= 2.8 units.


Standard glass (175ml) white wine 13% ABV

  • 175 x 13= 2275
  • 2275 ÷ 1000= 2.3 units.


Safer drinking
  • Stay within the recommended number of units of alcohol per week and spread these units over the week.
  • Most lager, beer and wine has a stronger alcohol content than the amount used for the unit guidelines. If you have one glass of white wine a night (2.3 units), you will exceed the guidelines for safe female drinking.
  • Avoid binge drinking (eight or more units for men and six or more units for women on the same day).
  • Always try to eat something either before or while you are drinking.
  • Try to alternate alcoholic drinks with water, or try diluting the alcohol, ie wine with soda water in a white wine spritzer.
  • If you have drunk large quantities of alcohol, drink plenty of water before you go to bed. This will counteract dehydration.


The morning after
Avoid coffee the morning after a drinking session.

Instead, a breakfast of carbohydrates (cereal and toast), a glass of fresh fruit juice and a cup of green tea should bring your blood sugar level up to an acceptable level and help to re-hydrate your body.

Don't be tempted to drive – it will take your body at least until midday to get rid of all the booze and there's no way to speed up this process.

Other articles in this series



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