Anemia And Alcohol: What The Connection?

About 65% of American adults over age 21 drink alcoholic beverages. Alcohol affects the human body in multiple ways, from impairing judgment to affecting one's iron levels. Increased alcohol usage can trigger health concerns such as heart problems, liver damage, and even anemia. 

Anemia is a condition in which a person has low levels of red blood cells. These are the cells that carry oxygen from the lungs to the rest of the body. This article explores the connection between anemia and alcohol consumption. 

Can alcohol cause anemia?

Heavy alcohol consumption can lead to the development of anemia. This can happen in several different ways. Alcohol directly affects the bone marrow, where red blood cells are produced. It can also cause nutrient deficiencies, which lead to anemia.

The most common cause of anemia is iron deficiency. Iron is needed to make hemoglobin, which is the protein in red blood cells that carries oxygen. Alcohol can lead to deficiencies of iron, as well as other nutrients that are important in making red blood cells.

How does drinking alcohol affect anemia?

Alcohol has multiple adverse effects on blood cells and their functions. Increased alcohol consumption can affect the bone marrow, causing suppression of blood cell production. It can also cause the production of structurally abnormal red blood cells, which don’t function as well as normal cells and are destroyed more quickly. 

In addition, heavy alcohol usage leads to nutritional deficiencies that affect the production and function of various blood cells. People who drink a lot of alcohol often develop deficiencies of essential minerals, such as iron, calcium, magnesium, and zinc. They may also have deficiencies of vitamins like vitamins A, C, D, E, K, and B.

In people who drink a lot of alcohol, nutritional deficiencies can occur through a few different mechanisms, including:

• Iron deficiency related to gastrointestinal bleeding

• Increased loss of nutrients through urinary excretion, diarrhea, and vomiting 

• Decreased absorption of nutrients, due to damage to the lining of the digestive tract and reduced transport of some nutrients into the bloodstream

• Decreased consumption of nutrients, because a large proportion of the person’s caloric intake is made up of alcohol

Important nutrients for making red blood cells include iron, vitamin B12, folate (also known as vitamin B9), and vitamin C. Increased alcohol usage can lead to low levels of all these nutrients. 

Can you drink alcohol while you're anemic?

If you already have anemia, then heavy drinking of alcohol could make the problem worse. Alcohol can cause anemia in many different ways. If you already have anemia, then alcohol is likely to worsen the problem. The more you drink, the more likely it is to have a negative effect on your anemia.

However, there’s some evidence that suggests that light drinking could actually enhance the body’s absorption of iron. Drinking just one alcoholic beverage might help your body absorb the iron in your food.¹

In general, if you don’t already drink alcohol on occasion, researchers don’t recommend that you start drinking just to get the increased iron absorption. There are other ways to enhance iron absorption that don’t carry the risks of alcohol, like drinking some orange juice with your food. However, if you enjoy an occasional alcoholic beverage, there’s no reason to worry about continuing to have a beer or a glass of wine once in a while. It’s heavy drinking that causes anemia; light drinking is generally considered to be okay.

Types of anemia caused by alcohol use

There are many different types of anemia. Chronic alcohol consumption can cause a few different types, including:

Megaloblastic anemia

In people with megaloblastic anemia, the red blood cells are larger than normal and don’t function well. It’s often caused by a deficiency of vitamin B12 or folate. Heavy drinking can lead to these nutritional deficiencies. People who drink a lot tend to get most of their calories from alcohol, so they don’t get enough nutrients. In addition, alcohol can alter the absorption of certain nutrients from food. 

Sideroblastic anemia

In people with sideroblastic anemia, iron isn’t able to be properly incorporated into hemoglobin molecules. Hemoglobin is the protein in red blood cells that carries oxygen. Alcohol can interfere with the activity of an enzyme that’s necessary for making hemoglobin.

When hemoglobin can’t be synthesized, the leftover iron ends up being stored in a protein known as ferritin. Ferritin accumulates in red blood cell precursors, forming granules. These iron-filled precursor cells are known as sideroblasts, and they’re unable to mature into normal red blood cells.

Iron deficiency anemia

Having too little iron in the body can also lead to anemia, as iron is an important component of red blood cells. People who drink a lot of alcohol may become deficient in iron in a few different ways. They may not eat enough iron, as alcohol is providing most of their calories. 

They also may experience bleeding in the gastrointestinal tract. Chronic or severe blood loss depletes the body’s iron stores. This is because the red blood cells lost through bleeding contain iron, and there often isn’t enough iron intake to replace what’s lost.

Hemolytic anemia

Hemolytic anemia occurs when red blood cells are destroyed more quickly than normal. Chronic consumption of alcohol can cause the formation of abnormal red blood cells, which break more easily. The body isn’t able to make enough new red blood cells to replace those that are lost, leading to anemia.

Symptoms of alcohol-induced anemia

The symptoms of anemia are generally similar, no matter what causes the condition. Symptoms of anemia may include:

• Headache

• Cold hands and feet

• Feeling lightheaded

• Pale skin

• Fatigue

• Weakness

• Difficulty concentrating or thinking clearly

• A strong desire to eat ice or other items that aren’t food (this is known as pica)

• Irregular heartbeat

• Chest pain

How to treat alcohol-related anemia

When anemia is caused by alcohol consumption, then abstaining from alcohol will usually cause a significant improvement in the red blood cell count. In cases where nutritional deficiency caused or contributed to the anemia, taking supplements may be helpful. Some people may need supplements of folate or vitamin B12. 

Those who have low iron levels may be given iron supplements or may choose to focus on eating foods that are high in iron, such as:

• Green leafy vegetables

• Dried fruits

• Red meat, pork, and poultry

• Seafood

Prevention of anemia from alcohol abuse

The best way to prevent anemia is to moderate alcohol consumption. In people who are experiencing alcohol dependency, a rehabilitation program may be helpful. After years of heavy drinking, quitting alcohol suddenly can be dangerous, and it’s important for a medical professional to oversee the process.

In addition, addressing deficiencies of vitamins and minerals can be helpful. This may involve treating conditions that cause blood loss in order to help with iron deficiency. Some people may need to pay closer attention to eating enough healthy foods to meet their nutritional needs. Others may benefit from taking supplements of certain nutrients to replenish their levels. 

The lowdown

Anemia is a condition characterized by insufficient red blood cells. These are the cells that transport oxygen to the body's tissues. There are many potential causes of anemia.

Chronic consumption of alcohol can lead to anemia in a number of ways. It can lead to nutrient deficiencies, including iron, folate, and vitamin B12. It can also directly affect cells in the bone marrow, which interferes with the production of red blood cells. The cells that are produced may be structurally abnormal and may be destroyed too quickly for the body to replace them.

The most important treatment for alcohol-induced anemia is reducing or eliminating alcohol consumption. In addition, increasing vitamin and mineral intake may help. Visit your doctor if you notice symptoms of anemia or if you find it difficult to stop drinking alcohol.