Why can’t I drink like I used to?

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If those couple of drinks you have after a long day have been affecting you differently lately, Father Time might be trying to tell you that it’s time to slow down. As you age, your body changes and you may notice a difference in how your body reacts to alcohol now versus when you were in your 20s, especially if you have health problems. 


So before you imbibe, consider some of the changes that occur as you age and how alcohol can affect these changes, making them more problematic. 

  • Body composition

    As we age, our body composition changes. The proportion of fat to muscle tends to increase, even if there’s no change in weight. Because of this, drinking the same amount over time will enhance the effects that alcohol has on you. 

  • Coordination and reaction time 

    Coordination, balance and reaction time tend to decrease with age, and alcohol exacerbates this problem. If you slip or fall and injure yourself, it could lead to more serious health consequences.

  • Medication side effects
    Many medications are metabolized by the liver. As alcohol is also metabolized by the liver, alcohol consumption may enhance the side effects of many medications. In addition, liver function tends to decrease with age which is when many people take more medications and when metabolism is affected by body composition changes.

  • Dehydration

Most of us know that alcohol causes the body to be dehydrated. In fact, dehydration is one of the hallmarks of a hangover. Ethanol, a toxic chemical in alcohol, works as a diuretic in the body, which can lead to dehydration, among other hangover symptoms like headache, nausea and sensitivity to light. 

As for curing a hangover, there really are no scientifically recommended treatments. Some people might benefit from increased hydration. Others may find relief by taking a pain reliever like ibuprofen. There are many folk remedies out there but none have proven to be of great benefit.

Poor hydration can also lead to skin changes such as puffiness, red cheeks and more pronounced veins on the face. 

 

Alcohol intake: how women and men differ 

Women tend to be smaller than men in general, so they take longer to metabolize the same quantity of alcohol. Additionally, hormone levels, which are more pronounced in women than men, may affect alcohol metabolism. Drinking alcohol can cause a spike in estrogen levels and a decline in progesterone in premenopausal women. Why does this matter? Because as women reach their 40s, the amount of progesterone in their body is already on the decline when they need it most. Furthermore, drinking too much alcohol may only aggravate menopause symptoms, such as hot flashes, trouble sleeping and mood changes.

Health benefits of drinking

Chances are, you’ve heard reports that drinking a glass of wine a day has health benefits, but there are no randomized controlled trials of this. The current medical information is based on observational studies, which aren’t as scientifically robust as randomized controlled trials. These observational studies do suggest certain cardiovascular benefits in some individuals, which may be due to the impact alcohol has on cholesterol levels.

The key takeaway is, if you’re going to drink, do so in moderation. Moderate alcohol use for healthy adults means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger. But remember that even moderate alcohol use is not risk-free. 

Long-term alcohol use can lead to many other health issues, including liver disease and cirrhosis.


Randell Wexler specializes in family medicine at The Ohio State University Wexner Medical Center Outpatient Care Gahanna.
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