Alcoholics have special needs for vitamins and minerals. Alcoholics often get smaller amounts of nutrients because they consume less food. Many alcoholic beverages can be seen as “empty calories” because they supply energy without the nutrients needed to burn that energy.
Alcoholics may be more sensitive to excesses of certain nutrients. People with a history of liver disease or alcoholism may be more susceptible to the adverse effects of excessive niacin intake. For those with alcoholic cirrhosis, the safe dose of iron may be lower than the normal upper intake level of 45 mg daily. Alcoholics may also be susceptible to vitamin Atoxicity at low doses. This applies to all forms of vitamin A except beta-carotene.
Several B vitamins are adversely impacted by alcohol consumption. These B vitamins are essential for energy production. Thiamin deficiency is common among alcoholics. Alcohol impairs the absorption of thiamin, while increasing its elimination.
Niacin is used up in the conversion and detoxification of alcohol. Also, vitamin B12 absorption is diminished in alcoholics. Another B vitamin, vitamin B6, is depleted by the consumption of alcohol. Alcohol is broken down to acetaldehyde in the body. Acetaldehyde breaks the vitamin B6 coenzymes loose from their enzymes and the vitamin B6 is lost.
Drinking alcohol can decrease the absorption of folate. In addition, heavy consumption of alcohol can prevent the liver from retaining folate. Alcohol increases losses of folate. Without enough folate, homocysteine levels in the blood can rise, contributing to heart disease.
Vitamin C levels are depleted by alcoholism. In addition, the alcoholic liver has problems activating vitamin D.
Magnesium depletion is frequently encountered in chronic alcoholics, both from low dietary intake and increased urinary losses. Some alcohol withdrawal symptoms such as delirium tremens may be related to magnesium deficiency. In cases of severe alcoholism, low magnesium levels can cause bone loss.
Low levels of phosphorus are rarely seen except in near starvation or in alcoholism. Alcoholism also increases the risk of low blood potassium. Alcoholics are at increased risk of zinc deficiency both from impaired absorption and increased urinary losses. One-third to one-half of alcoholics have been found to have low zinc levels.
Keeping alcohol consumption to moderate levels will limit the health-depleting effects. Moderate levels are often defined as one drink per day for women and two drinks per day for men. Drinking alcoholic beverages with food and water can also reduce some of the deleterious effects. Special supplementation may be warranted for alcoholics who do not eat enough nutrients.
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