Alcohol: Impacts on the Body & Risks with Lupus

Research into the potential health benefits of moderate alcohol consumption on the body can seem to change with the seasons. But, the known risks, including negative interactions with medications, are well documented.

Is it bad for a person with lupus to drink alcohol? Unfortunately, the answer to that question is not so straightforward. Research into lifestyle factors, like consumption habits, is challenging to conduct and to interpret. It relies on:

• Accurate self reports
  • These types of self reports are known to be inaccurate, particularly at higher levels of alcohol consumption
• Large participant cohorts
  • It is unethical to make particular groups of participants consume alcohol. Because of this, correlational study designs are used. 
  • Causation can not be determined from correlational studies
• Standardization of lupus disease activity
  • Current measures of lupus disease activity rely on clinician assessment, which can add variability to comparisons

Despite these complications, there have been a number of studies on the impact of alcohol on lupus. Most of the studies focused on whether or not drinking increases the risk of developing lupus. It does not appear that this is the case. A 2008 meta-analysis even concluded that “moderate drinking might be protective” for the development of SLE.

A prospective 2017 study found similar results. In the study, 204,055 women shared health information for over 22 years (in two different groups). The researchers found an inverse correlation between moderate drinking and SLE risk. In this study, the average was half a drink per day.

How much is moderate drinking?

U.S. Health and Human Services and the U.S. Department of Agriculture define moderate drinking as up to 1 drink per day for women and up to 2 drinks per day for men. 

A drink could be:

• 12 fl oz of beer
• 5 fl oz of wine
• 1.5 fl oz of distilled 80-proof alcohol

Effects of alcohol on the body

According to a 2001 analysis in the Lancet, light to moderate alcohol consumption can prevent people from dying from certain illnesses. The mechanisms and precise causes of death that moderate alcohol consumption prevents are unknown. So, researchers call this a drop in all-cause mortality. Notably, this “all cause mortality” reduction includes a lowered risk of heart disease and stroke. 

Scientists believe that moderate alcohol use has anti-inflammatory properties which may provide some benefit for people with lupus. A 2004 study on men with diabetes found that moderate alcohol consumption was also associated with lower levels of particles associated with inflammation. This included tumor necrosis factor (TNF) receptor-2 and fibrinogen, both of which are associated with lupus symptoms and flares.

Alcohol is also a known vasodilator – a medicine or substance that relaxes the muscles around blood vessels and helps blood flow more easily through the body. Vasodilation is responsible for letting more blood into the capillary networks in the skin. This causes the blushing and the sensation of warmth that is associated with drinking. 

The use of vasodilators by people with autoimmune disease should be closely monitored. Immune system cells also flow through the bloodstream. However, people with lupus often have damaged and stiffened circulatory systems and vasodilators can help offset this, offering protection against heart attack and stroke. Studies show that mild vasodilation is linked to better cardiac health in lupus patients.

Alcohol and lupus medications: Unwanted interactions

The benefits that alcohol can provide are completely negated at more than moderate consumption, and drinking comes with many risks. 

One of the biggest risks of alcohol is its interactions with many lupus medications and the stress that it puts on the liver. The liver processes many medications used to treat lupus. As a result, medications may not function as desired when combined with alcohol.

The following medications are known to negatively interact with alcohol:

• Corticosteroids
• Tylenol
• Warfarin
• methotrexate 
• NSAIDS (non-steroidal anti-inflammatory drugs)
  • Increased risk of ulcers and internal bleeding

NOTE: This is NOT an exhaustive list. Check all labels before taking medications and speak with your lupus treatment team to minimize risks. Some interactions can be fatal, especially when using pain medications.

Exacerbating lupus health issues with alcohol

If you eat a diet full of rich and fatty foods, alcohol will also increase your risk of developing gout. Gout is an inflammatory condition that causes painful, needle-like crystals to form in joint tissue. In addition to joint pain, the inflammation can make many of the other symptoms of lupus worse.

Alcohol can also cause inflammation by interacting with the gut microbiome. You can read more about the gut microbiome and how it interacts with lupus, here. Alcohol contributes by feeding some of the microbes in the gut with sugar, and killing others with ethanol. This changes which microbes are present in the gut. It also interacts with the membranes in the intestine. Between microbiome changes and gut changes, alcohol can contribute to increased gut permeability, also known as “leaky gut.” As particles from the microbes in the gut leak into the bloodstream, they cause inflammation and many health problems for people with lupus. 

Next, alcohol can impact the brain and is linked to fatigue and brain fog. It may also contribute to premature aging and many stress-related health issues.

Finally, alcohol interferes with proper organ function and can cause issues with how the body regulates the immune system. Both lead to more problems for people with lupus, including flares and organ damage. Heavy drinking increases these risks and negates any potential benefits.

Should I drink with lupus?

Drinking can feel like a pervasive part of culture — which means not drinking can feel like giving up time spent with friends. And, it can be frustrating to have to constantly explain why you aren’t drinking. Still, with lupus, the risks outweigh the benefits.

In the United States, the consumption habits are starting to change and people are drinking less alcohol. This is leading to more alternatives like teas and simple sodas.

If you do decide to drink, be sure there are no potential interaction effects with your medications. Plus, know when to call it a night.

In the end, exercise and diet are much better options for controlling lupus and dealing with the stresses of the day. You can find out more about exercise and diet on LupusCorner 🙂