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Can Alcohol Cause Anemia? Exploring the Link

Can Alcohol Cause Anemia? Exploring the Link

Alcohol misuse can lead to anemia through multiple mechanisms; however, it is usually treatable and reversible.

According to the National Center for Drug Abuse Statistics (NCDAS), about 10% of Americans aged 12 or more have Alcohol Use Disorder (AUD).Unfortunately, alcohol misuse can negatively impact different systems of the human body, resulting in mental health conditions, high blood pressure, weakening of the immune system, and liver disease. The hematological complications of alcohol include premature destruction and decreased production of red blood cells, causing anemia. Anemia is usually characterized by increased fatigue, pale skin, shortness of breath, dizziness, heart arrhythmias, and chest pain. However, certain measures can help manage the symptoms of alcohol-related anemia.

Confidant Health offers a virtual alcohol rehabilitation program that involves weekly online sessions to help you overcome alcohol dependence. Furthermore, it provides Medication-Assisted Treatment (MAT) that involves medications and behavioral therapy to manage alcohol misuse and AUD.

What is Anemia?

Anemia is a hematological disorder characterized by insufficient or dysfunctional red blood cells. It leads to reduced hemoglobin and oxygen supply to the body’s tissues. Normal hemoglobin levels are between 13 - 16 g/dL for males and 11.6 -15 g/dL for females. A person is considered anemic when hemoglobin levels fall below 13.2 g/dL.

Anemia is regarded as a major health concern affecting 1.6 billion people globally. The overall prevalence of anemia among all age groups was 22.8% in 2019. According to the World Health Organization, about 30% of women aged 15-49 suffered from anemia in 2019.

Signs of Anemia

The symptoms of anemia depend on various factors, such as cause, severity, and type of anemia. Common signs of anemia include the following.

  • Fatigue
  • Brittle nails
  • Pale skin and sclera
  • Tachycardia (Increased heart rate)
  • Dyspnea (Shortness of breath)
  • Dizziness and weakness
  • Chest pain
  • Loss of appetite
  • Hypothermia
  • Irritability and difficulty in concentration

Common Causes of Anemia

Common causes of main types of anemia include the following.

Iron deficiency anemia

Cause:Low iron levels (e.g., pregnancy), Heavy blood loss as in Heavy menstrual bleeding, or Gastrointestinal tract ulcers.

Anemia of Chronic Disease

Cause: Chronic inflammatory diseases such as Crohn’s disease, Rheumatoid Arthritis, HIV/AIDS, and Chronic Kidney Disease(CKD) are the causes of anemia.

Aplastic Anemia

Cause: Inadequate production of RBCs from bone marrow due to Autoimmune disorders, Leukemias, and exposure to certain chemicals or radiations.

Hemolytic Anemia

Cause:Abrupt decline in RBCs due to hemolysis in life-threatening conditions such as Sickle-cell Anemia, Hereditary spherocytosis, Thalassemia, Wilson’s Disease, Lead Poisoning, and G6PD-Deficiency.

Pernicious Anemia

Cause: Deficiency of intrinsic factor that leads to inadequate absorption of vitamin B12. This results in an increased size of red blood cells, also known as megaloblastic anemia. This type of anemia is common in people with excessive alcohol intake.

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Does alcohol cause anemia?

Prolonged use of excessive alcohol causes a generalized defect in RBC production and morphology. Moreover, alcohol causes premature destruction of red blood cells, leading to anemia. Let’s discuss the main mechanisms behind alcohol-related anemia. 

  1. Blood cell precursors need folic acid, vitamin B, and other nutrients for their production and functioning. Unfortunately, alcohol consumption causes a deficiency of these nutrients, leading to decreased production and increased destruction of red blood cells.
  2. Alcohol consumption can damage the liver, causing chronic liver disease and cirrhosis. Anemia is the most common complication of chronic liver disease, affecting about 75% of cases.

Understanding Alcohol Use Disorder (AUD)

Alcohol Use Disorder (AUD) is a long-term medical condition characterized by an impaired ability to control or stop alcohol consumption, affecting one’s mental and physical health. It develops gradually and causes cognitive impairment and severe damage to other vital organs (e.g., cirrhosis, hypersplenism, pancreatitis, dementia, anemia, and chronic kidney disease). 

In most cases, a healthcare professional’s guidance and treatment are required to overcome AUD and related disorders. It is because one would develop impaired cognition about and increased dependence on alcohol consumption. Confidant Health offers Medication-Assisted Treatment (MAT) that involves effective medications and psychotherapies to treat AUD. 

Effects of Alcohol on Red Blood Cells

High intake of alcohol has many drastic effects on blood cells, mainly RBCs. These consequences can be for a short duration or lifelong. Following are some long-term and short-term effects of alcohol on RBCs

  • Macrocytic Anemia:

Long-term use of alcohol causes premature destruction of RBCs leading to abnormally large-sized and irregularly shaped RBCs. These defective RBCs cause  Macrocytic Anemia.

  • Aplastic Anemia:

Severe alcohol dependence leads to the suppression of hematopoiesis in the bone marrow. This affects RBC precursors generating a decreased number of red blood cells, causing Aplastic anemia.

  • Iron deficiency Anemia:

High alcohol consumption depletes the iron stores in the body. Reduced iron levels or impaired absorption of iron by the body leads to low hemoglobin levels in the RBCs. This results in small-sized red blood cells causing Iron-deficiency microcytic anemia.

  • Megaloblastic anemia:

Folic Acid is a vitamin essential to make RBCs. Alcohol consumption causes a deficiency of folic acid resulting in decreased and defective production of RBCs larger than usual.

Symptoms of Alcohol-induced Anemia

RBCs carry oxygen to the body’s tissues to perform normal functions. A decline in the number of RBCs indicates a reduction in oxygen delivered to the tissues. Decreased oxygen supply to different organs and tissues can produce many symptoms, such as the following

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Is Alcohol-induced Anemia Reversible?

Alcohol-induced Anemia is a condition that can be reversed through abstinence from alcohol misuse. Usually, a healthcare professional would get to the root cause of alcohol-induced anemia and then treat the exact cause. For instance, a physician would prescribe folic acid if someone has developed alcohol-related anemia due to folic acid deficiency.

After receiving treatment, healthy and functional RBCs will be produced. These RBCs will exhibit normal morphology, an adequate amount of iron, enough hemoglobin, and regular function.

Treatment for Alcohol Use Disorder and Anemia:

Alcohol use disorder is a major health concern affecting billions of lives. It is difficult to stop consuming alcohol suddenly because of withdrawal effects. Thus, one should seek a professional’s help and take prescribed treatment to overcome this issue. The following steps can help an individual manage AUD and alcohol-related anemia.

  • Consult a mental health professional for quitting or moderating drinking habits.
  • Consult a physician to get to the root cause of anemia.
  • Take the prescribed supplements that may include folic acid, vitamin B, or other nutrients necessary for RBCs’ production and functioning.
  • The U.S. Food and Drug Administration (FDA) has approved MAT therapy for alcohol misuse and related disorders.

Nonetheless, one should keep in mind that the main line of treatment is to stop or moderate alcohol consumption so that alcohol-related anemia can be managed and prevented.

Consult with Confidant Health’s Professionals

Confidant Health is an online platform that provides an alcohol rehabilitation program and Medication-Assisted Treatment (MAT) to manage alcohol misuse. You can download Confidant Health’s app to consult with healthcare professionals experienced in dealing with people struggling with alcohol misuse.

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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