Alcoholism, Part 1 — Metabolic Chaos
Alcoholism is a problem of such magnitude that the task of organizing the information in a useful way for the reader is daunting. Alcoholism affects 10 to 20 percent of men and 3 to 10 percent of women. Nearly 14 million people in the United States abuse alcohol or are alcoholic. This disease contributes to over 50 percent of car and industrial fatalities, drownings, and child or domestic abuse. Half of us have a close family member who is alcoholic. In 2002, 2.6 million binge drinkers were between the ages of 12 and 17.
In each of the last three years there have been 17,000 alcohol-related traffic fatalities. In addition to traffic accidents, alcohol abuse causes: 1,400 deaths, 500,000 injuries, 600,000 assaults, and 70,000 sexual assaults. Life expectancy is decreased by about 15 years. Men who consume more than two alcoholic drinks per day are at increased risk for cancer, cardiovascular disease, accidents, and violence.
Twenty-one years ago, alcoholism was recognized and defined as an illness by mainstream medicine. Rehab centers abound and everyone knows the name “Alcoholics Anonymous,” the famous 12-step program for recovering from alcohol and other addictions. Alcohol treatment is a hot topic. In fact, established modes of treating alcoholism are essentially hallowed ground, not easily challenged.
Alcoholism is a chronic disease in which a person drinks alcohol to excess in spite of alcohol's severe deleterious effects, which include: mental and physical illness, job impairment or loss of work, and impaired relationships (work, social, and family). If one's alcohol use negatively impacts any of the above areas of life, one is alcoholic. This is a 2-part article, with part I focusing on a description of alcoholism and the profound metabolic problems caused by drinking. Next month, we will look at a wide variety of treatment options, which must include repair of damaged body chemistry from head to toe.
Signs and Symptoms
The biggest problem in treating alcoholism is admitting that one has a problem with drinking. Breaking through denial allows the individual to find the motivation for help.
The signs and symptoms are vast and affect every organ system, causing literally hundreds of different symptoms, including:
1. Craving for alcohol, inability to control or stop drinking, withdrawal symptoms (nausea, sweating, shakiness, and anxiety), when alcohol use is stopped after a period of heavy drinking.
2. Tolerance (the need for increasing amounts of alcohol in order to feel its effects)
4. Cardiovascular symptoms
5. Repeated infections
7. Weakened immune system
8. Central nervous system disorders—unsteady gait, depression, anxiety, tremor, cognitive impairment (poor memory and concentration), blackouts, coma, psychosis, and sleep disorders. We will go into a great deal of detail about the problem with impaired neurotransmitter functioning in alcoholics.
10. Interruption of normal menstrual periods
11. Pancreas inflammation and pancreatitis. This is an excruciatingly painful illness and can be fatal.
12. Liver toxicity and hepatitis
13. Slow wound healing
15. The endocrine system is severely strained and drained by heavy drinking. Every endocrine gland can be adversely affected. Hormones are “distant communicators,” messengers sent, for example, from the thyroid, to regulate the metabolic rate of every cell. Loss of correct thyroid function means that each cell is “on its own,” slowly deteriorating and losing the unifying, central mechanisms that keep the human body working as a whole.
Some people can drink to excess and not have a problem. Others, who know they are abusing alcohol can simply quit and be done with it. Those who are most at risk are: genetically predisposed, have a pre-existing psychiatric disorder, began drinking during teenage years, and have an impaired capacity for coping with stress as well as strong emotion. These are the predisposing factors. Absence of all of these factors does not make one immune from becoming alcoholic.
Alcohol, or ethanol, does its damage by disturbing metabolism in every organ and in countless, important metabolic pathways. Alcohol is a toxin as is acetaldehyde, the primary metabolic product of alcohol. Acetaldehyde toxicity is most prevalent in the liver, brain, gastrointestinal tract (GI), (adrenal glands and pancreas. These toxins are powerful generators of free radicals, causing metabolic chaos through oxidative stress. Once a person stops drinking, his or her body does not suddenly return to normal. If a person has been drinking heavily for five years or longer, there is often permanent brain damage, although it may be quite subtle.
Alcoholics have very poor blood-sugar management. They are getting half of all their calories from alcohol and their body has gotten used to using sugar and simple carbohydrates for energy. Unfortunately, sugar does not turn into protein. Alcoholics are always malnourished and have protein deficiencies with massive amino-acid abnormalities. Because protein is required for all the structures in our body, for cell structure and function, for neurotransmitters, enzymes and hormones, one can quickly see that the protein deficiency alone is devastating to the body of an alcoholic. The malnutrition of the alcoholic depletes all vital nutrients—vitamins, minerals, essential fatty acids, healthy carbohydrates, and amino acids. For this reason, a treatment program must address the complex metabolic and nutritional issues. No matter how well one works his 12-steps, no matter how committed he is to recovery, his body will not spontaneously recover.
Toxins will need to be slowly removed. Body tissues and organs will need to be rebuilt. Neurotransmitters will take time to return to normal, but the process is incredibly slow without providing the brain the nutrients it requires to make neurotransmitters.
Toxins and free radicals, produced during the breakdown of alcohol, kill cells in every organ of the body. A free radical is any molecule that is missing an electron. Wherever a free radical goes, it steals an electron from healthy tissue, slowly eating away at normal body chemistry. Organs that suffer the most initial cell damage are the brain, liver, pancreas, adrenals, stomach and GI tract. Alcohol irritates the lining of the gastrointestinal tract, eventually leading to leaky-gut syndrome.
The liver is one of the main targets of alcohol and acetaldehyde toxicity, depleting the liver of glutathione (GSH). GSH is our body's number one detoxifier, one of our five essential anti-oxidants, and is critical to energy chemistry. A body depleted of GSH cannot defend itself against the constant onslaught of free radicals and toxins. While this article cannot elaborate on how to repair every metabolic pathway and every damaged organ, suffice it to say that GSH can be restored to healthy levels through nutritional supplementation, especially with the amino acid, N-acetyl cysteine.
The most significant metabolic problems caused by alcoholism may be: 1) depleted neurotransmitters, 2) impaired sugar metabolism (with resulting hypoglycemia), 3) a damaged gastrointestinal tract, and 4) damaged detoxification function. Various sources cite serotonin and endorphins as the key neurotransmitters that are depleted by alcohol abuse. That is not the case. Let's take a quick look at the major neurotransmitters that are depleted in alcoholism:
Dopamine, the feel-good neurotransmitter. The amino acid L-Tyrosine makes dopamine.
Serotonin is a feel-good, mood enhancing, and sleep-promoting neurotransmitter. L-Tryptophan and 5-HTP (5-hydroxy-tryptophan) are the amino acids that make serotonin.
Norepinephrine deficiency leads to a huge array of cognitive problems, including poor memory and concentration, anger, outbursts, fatigue, depression, emotional instability, tremors, and insomnia. L-Tyrosine is the amino acid that makes norepinephrine.
Endorphins are our body's powerful, self-manufactured painkillers. Alcohol causes a temporary increase in serotonin and endorphin levels, which is why alcohol makes so many people feel good. But, over time, serotonin and endorphin receptor sites are strained to the max. Acetaldehyde binds with endorphins, shutting down the body's own production of endorphins and serotonin. This toxic process diminishes the brain's ability to produce its own feel-good neurotransmitters, serotonin and endorphins, which then produces depression and other mental disorders. The brain is producing less and less of these neurotransmitters, so the individual drinks more and more in order to create more serotonin and endorphins to fill their “up-regulated” receptor sites.
Acetylcholine deficiency impairs memory, general nerve health, and neurotransmitter transmission. Acetylcholine also carries impulses from neurons to muscle cells, where it generates muscle contractions. Impaired acetylcholine chemistry leads to muscle problems, weakness, and muscle atrophy.
Researchers at Scripps Institute and articles in the journal, Science , point to the neurotransmitter GABA (gamma amino butyric acid) as one of the keys to understanding the alcoholic brain…. if not THE key. GABA is an inhibiting neurotransmitter that makes us feel relaxed. The GABA receptor site is where minor tranquilizers like Xanax and Valium work. In the short-term, alcohol increases GABA transmission in the amygdala, which is a major pleasure center, but it is also involved in fear. When a person overdrinks, GABA becomes depleted. Alcohol is believed to mimic the effects of GABA, binding to GABA receptor sites. The GABA-starved brain craves anything to regain balance. We feel miserable when GABA is depleted. And so the alcoholic drinks more and more, partly to compensate for the loss of GABA.
Unlike norepinephrine and serotonin that can be boosted relatively easily by supplementation with their respective nutritional precursors, namely L-Tyrosine and L-Tryptophan, increasing brain GABA levels is difficult. You will be able to find GABA in any health food store, but there is a big problem. Very little GABA crosses the blood-brain barrier and gets into your brain. Some GABA is made from the amino acid L-Glutamine and some is a product of sugar metabolism. Because alcohol acts like sugar, one of its functions is to create more GABA temporarily.
One cannot ingest huge enough amounts of L-Glutamine to raise GABA levels. Eighty percent of the L-Glutamine we ingest is taken up and used by the GI tract. The 20% that is absorbed is used by muscle, the immune system, and the brain. In the brain, L-Glutamine turns into the inhibitory neurotransmitter, GABA, as well as the excitatory neurotransmitter, Glutamate. We don't want a large excess of glutamate.
Now here is the good news in this sad story. Meditation will increase GABA and will balance the stress hormones that contribute to neurotransmitter chaos and depletion. Secondly, while very little ingested GABA makes it into the brain, it does make it into the blood. Every cell in our body is covered with GABA receptor sites, and those cells outside the brain will be in a healthier state when circulating GABA levels are increased.
But—some orally ingested GABA does make it into the brain, although this varies from person to person. For a minority of people, GABA will produce some relaxation. But don't think that, “more is better.” While 2,000 to 4,000 mg a day may help some of you to relax, doses from 6,000 to 8,000 mg will produce severe anxiety and panic.
If you could open up the GI tract and lay it out, it would be the size of two tennis courts. Its main functions are to: absorb nutrients, keep toxins out of the body, and act as our first line of immune defense.
Alcohol damages the lining of the GI tract as well as other critical parts of digestion, including the liver and pancreas. The assault on the GI tract causes three major problems for the alcoholic:
Due to damage of the cells of the GI tract, the alcoholic does not absorb all the food he eats. To add to the problem, as mentioned before, an alcoholic is often getting half of his calories from alcohol. The result of malabsorption and poor diet is malnutrition and massive protein deficiency.
2. Leaky-gut syndrome
Undigested food particles slip directly into the blood stream from the GI tract. White blood cells “see” a small piece of food, identify it as foreign and make an antibody to it. The antibody gloms onto the food particle, resulting in a food-antibody complex. These complexes deposit in the tissues of your body, creating irritation and inflammation wherever they deposit. Leaky gut and food-antibody complexes are closely related to allergy. Alcoholics have a much higher incidence of allergic reactions than do non-alcoholics.
Alcohol is made through fermentation of yeast with grains, fruits, and sometimes sugar. These happen to be the ideal foods for yeast or candida. I have devoted two entire articles in The Light Connection to candida. In-and-of-itself, it is a huge topic. If one only has to treat candida, one has a big job. All of us have a balance of yeast (candida albicans) and healthy bacteria in our GI tracts. An imbalance can occur, in which healthy bacteria become depleted, yeast is being fed, with the result that yeast explodes, proliferating throughout the GI tract. Intestinal candidiasis (yeast) can cause nearly every GI symptom. In addition, candida often becomes systemic, moving from the GI tract into the blood and into the tissues of the body.
Systemic candida causes fatigue, depression, muscle wasting, hypoglycemia, allergy, rashes, poor memory and concentration, asthma and much more. And this is just one component of alcoholic metabolism. The average alcoholic who gets motivated for treatment will be referred to AA and may be put on some medications, such as anti-depressants. Or he may be put on Antabuse, which works by making the individual incredibly sick when he drinks. This is aversive therapy. The idea is that, once an alcoholic on Antabuse has experimented, taken the gamble, and lost, he won't drink again. Sometimes that strategy works. Sometimes, the alcoholic just stops taking the Antabuse.
The components of the immune system are made up primarily of amino acids (protein) and essential fatty acids. Acetaldehyde, the toxic byproduct of alcohol, alters proteins. These abnormal proteins can result in the immune system mounting unwarranted immune responses, including allergy. In addition, there is a dramatic decrease in white blood cells, a major component of our immune system.
Due to a weakened immune system, the alcoholic gets frequent infections, gets unusual infections, and has a hard time shaking them off.
All of the metabolic damage you've just read about has its most pronounced effects on sugar metabolism and brain chemistry. The alcoholic is prone to hypoglycemia, and is consuming mainly sugar and simple carbohydrates. In addition, he probably has systemic candida, which further worsens blood-sugar problems. The entire fuel system is thrown far off balance.
Because of poor fuel, blood-sugar problems, candida, free radicals, and malnutrition, the alcoholic brain cannot make a normal amount of neurotransmitters. When the brain is way out of balance, life becomes a living hell.
This article, Alcoholism Part I, is intended to show you the extraordinary complexity of alcoholism, what alcoholism is, and how excessive drinking slowly poisons every organ…but especially how the alcoholic brain limps along, no longer able to generate its own neurotransmitters. Alcohol serves both as surrogate fuel and surrogate neurotransmitters. The alcoholic drinks more and more because his brain is calling out for serotonin, dopamine, norepinephrine, beta endorphin, and GABA…and alcohol provides a temporary relief from suffering, temporarily mimicking some of these neurotransmitters.
Information is power. This information is not intended to demoralize those of you with drinking problems but rather to help you see exactly what is going on, why you are addicted, how your body is trying to compensate, and why the compensation fails. Complexity does not mean that you are hopeless. Rather it means that treatment has to be deep, wide, and covering as many bases as possible.
Having read what alcohol is doing to your body, or that of a loved one, please avoid a typical alcoholic response of shame and self-blame. You could say to yourself, “Oh, I am so ashamed. I had no idea I was destroying my body in the way this article describes.” If shame arises, simply note it, observe it, and realize that a “shame response” is also just part of the illness, part of the complete picture that we address in helping you not just to become abstinent, but to become happy and whole.
Alcoholism is not a life sentence or a death sentence. In the next issue, we will look at a wide variety of treatment options. While I recommend that my alcoholic patients go to AA, I must address the nutritional deficiencies, the brain abnormalities, the emotional issues not yet faced, the spiritual issues not yet faced, and the alienation from God or a Higher Power that is much higher in alcoholics than in the rest of the population. Look for solutions next month. We will look at the use of vitamins, minerals, amino acids, essential fatty acids, herbs, homeopathy, acupuncture, Alcoholics Anonymous, cranial electrical stimulation, mental imagery, meditation, and more.
David Gersten, M.D. practices nutritional medicine, psychiatry, and mind-body medicine out of his Encinitas office and can be reached at 760-633-3063. Please feel free to access 1,800 on-line pages about holistic health, amino acids and nutritional therapy at www.aminoacidpower.com and 1,200 on-line pages about mental
imagery at www.imagerynet.com
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I've been at my job for many years. I've earned my education, received two years of specialized training, and recently completed a six-month developmental assignment. However, my supervisor put someone else in the job so that I couldn't be promoted. She took the duties off my desk and gave them to higher-graded employees. When a position became vacant, which would have been a promotion for me, she placed another person in it. I don't understand it. I haven't done anything wrong. I'm a good employee, just old. Please tell me what to do.
C.M., Charlotte, NC
First, bless the supervisor with love. Begin to appreciate everything about her that you possibly can. Bombard her with love and appreciation. You want to change the energy around this situation. This way you're telling Life what you want, and giving thanks for it now.
Second, turn away from the problem, from outer appearances and from society's beliefs. Age may be a problem for others, but it doesn't have to be one for you. You're far more than outer reality. Universal Mind can do anything—give it a chance.
Finally, turn to Spirit and trust Life to take care of you in miraculous ways. We can get caught up in the problem or we can rise above it and let the Universal Mind find the perfect solution.
Use these affirmations: I am happy, healthy, and loved. I enjoy all of my life. I am appreciated at work. I have loving relationships with everyone I work with and for. I am in my right place. Life opens ways for me to prosper and succeed. I love and adore myself. All is well in my world.
While reading your book The Power Is Within You, particularly Chapter 6 (“Letting Your Feelings Out”), I realized that I have a problem with speaking up. Every time my friends hurt my feelings, I keep quiet. Sometimes I think that keeping quiet is the right choice, but other times I feel stupid. The thing I don't understand is that when my boyfriend hurts me verbally, I speak to him immediately, and we solve the problem and things turn out all right, but with my friends, I don't utter a single word. Am I normal?
L.M., South Africa
Of course you're normal! You just give your friends more power over you than you do your boyfriend. The next time someone says something, just picture your boyfriend and reply to them as you would to him. Affirm: I am comfortable and at ease with everyone. I lovingly speak up for myself. I am lovable and loving. Everybody loves me!
I'm a gay man who's lost ten jobs in the past ten years for various reasons. And I've also lost many lovers. At first, all of these relationships were blissful and loving, but they quickly turn sour, as if the guy was Dr. Jekyll and is now Mr. Hyde. I believe my inability to maintain either a job or a relationship for any significant length of time is metaphysically related. How can I change things in order to create the right job and right relationship for me?
W.A., Washington D.C.
Forgive your father. That's the first place to start. When you release this resentment you may have for him, your whole attitude will change and people will react to you differently. I'll list some affirmations at the end of this letter for you to use.
I'm glad that you realize that it's you that needs to change, not anyone else. Begin with your own thoughts. Watch them and your self-talk. Be very vigilant about this. Remove every critical, judgmental thought you can find, and listen to what you say and how you say things. Refuse to judge any person, place, or thing. Develop a growing sense of love for yourself. Look into the mirror and say, “I love you. I really love you.” Don't be concerned if you feel foolish. Do it anyway. You're breaking old patterns and becoming a dearly lovable person.
To your father and to your old lovers, affirm: I bless you with love and I release you. To the old jobs: I release you with love and open my heart to new opportunities. And a new affirmation for work is: Everybody loves me at work, and I love everybody there. I am loved and respected by everyone.
Do what I suggest and get the energy moving!
If you would like Louise to answer your letter in this publication, please send it to: Dear Louise Column, c/o Hay House, Inc., P.O. Box 5100, Carlsbad, CA 92018-5100, or e-mail your letter to: email@example.com (letters used in this column may be edited for length and clarity). Please visit Louise's website at: www.LouiseHay.com or the Hay House website at: www.hayhouse.com.
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