Importance of Vitamin B-12

Vitamin B-12 is required for a variety of bodily functions including red blood cell production, normal thought processes, short-term memory, DNA synthesis and healthy metabolism. A small amount of B-12 is made by friendly intestinal bacteria, but your body needs dietary sources to function properly.

Most animal products such as meat and dairy are good sources of B-12, although it needs intrinsic factor — a compound produced in the stomach — to be absorbed in the intestines. Lack of dietary B-12 and malabsorption are main factors associated with deficiency, which can take up to a few years to produce symptoms.

Common deficiency symptoms include anemia, fatigue, muscle weakness, loss of appetite, weight loss, mouth sores, numbness and tingling in the limbs, unsteady gait, low blood pressure, depression, confusion and poor short-term memory.

Reduced Absorption

Alcohol — especially in large amounts — irritates the mucosal lining of the stomach and intestines. When the stomach lining is irritated — a condition called gastritis — it produces less hydrochloric acid and may secrete less intrinsic factor too, both of which contribute to reduced B-12 absorption from food.

According to the National Institute on Alcohol Abuse and Alcoholism, alcohol not only impairs nutrient absorption by damaging the lining of the gastrointestinal system, but it also prevents nutrients from being fully utilized in the body by altering their transport, storage and excretion.

Furthermore, decreased hydrochloric acid production can stimulate the growth of intestinal bacteria that use B-12, which further reduces the amount available to your body.

Depleted Storage

Vitamin B-12 is water-soluble, but unlike other water-soluble vitamins, it’s stored in the body — mainly the liver — for many months or more before it becomes unusable or gets flushed out. According to Christina Dye of the Do It Now Foundation, chronic consumption of alcohol tends to drain the body’s stores of critical nutrients such as B vitamins.

Alcohol consumption also increases your risk of liver disease and inflammation — also referred to as cirrhosis — which may also impact the storage or utilization of B-12.

Promotes Poor Nutrition

The National Institute on Alcohol Abuse and Alcoholism notes that heavy drinkers and alcoholics tend to eat poorly and often don’t consume enough essential nutrients such as B vitamins. The reasons for poor nutrition are two-fold: intoxication impairs the ability to make healthy food choices, and alcohol is a good source of calories and often curbs appetite.

However, the Institute notes that moderate drinkers — two alcoholic beverages or less daily — seem to be at little risk for nutritional deficiencies and various medical disorders.

What alcohol does to your liver

The liver breaks down most of the alcohol you drink so that it can be removed from the body. This creates substances that are even more harmful than alcohol. These substances can damage liver cells and cause serious liver disease.

Alcohol causes 4 out of 5 deaths from liver disease.

Types of liver disease caused by alcohol include:

  • fatty liver (steatosis)
  • inflammation of the liver (hepatitis)
  • acute alcoholic hepatitis
  • scarring of the liver (cirrhosis)
  • liver failure and death

Fatty liver (steatosis)

Fatty liver is the most common type of alcoholic liver disease. Fat builds up in the liver, which stops the liver from working properly.

Inflammation of the liver (hepatitis)

About a third of people with fatty liver will develop a mild or moderate inflammation of the liver. This is alcoholic hepatitis. Hepatitis may not cause any symptoms at first, so you may not realise that you have it.

Acute alcoholic hepatitis

More serious and life-threatening inflammation of the liver can cause:

  • a loss of appetite
  • sickness
  • tummy pain
  • jaundice (yellow skin) 
  • liver failure or death

Around 1 in 3 people who develop severe alcoholic hepatitis will die.

Scarring of the liver (cirrhosis)

Around 1 in 5 heavy drinkers have scarring of their liver (cirrhosis).

Alcohol changes the chemicals that break down and remove scar tissue. This means that scar tissue builds up in the liver.

Scar tissue replaces normal healthy cells. This means that the liver can’t work properly and can fail, leading to death.

Cirrhosis may not cause symptoms.

Symptoms of liver cirrhosis include:

  • feeling unwell
  • vomiting blood
  • swollen tummy
  • loss of appetite
  • itching
  • muscle cramps

Most people who develop cirrhosis and liver failure don’t notice symptoms until it’s too late.

Reducing the risk of liver damage

You can reduce the risk of liver damage by cutting down or giving up alcohol. All liver diseases improve from giving up alcohol.

If you have significant liver scarring or cirrhosis, you should not drink alcohol. 

Fatty liver can be reversed and further damage avoided by not drinking alcohol. 

There is no cure for cirrhosis. But cutting out alcohol completely gives a much better chance of survival. You can live for decades with cirrhosis, if you give up alcohol in time.

Things that reduce the impact of liver disease include:

  • maintaining a healthy weight
  • not smoking
  • getting regular, adequate exercise
  • eating a balanced diet and avoiding processed food
  • drinking coffee
  • getting sunlight – a low Vitamin D level is bad for liver diseases


Alcohol’s Role in Gastrointestinal Tract Disorders

Among the many organ systems that mediate alcohol’s effects on the human body and its health, the gastrointestinal (GI) tract plays a particularly important part. Several processes underlie this role.

First, the GI tract is the site of alcohol absorption into the bloodstream and, to a lesser extent, of alcohol breakdown and production.

Second, the direct contact of alcoholic beverages with the mucosa1 that lines the upper GI tract can induce numerous metabolic and functional changes.

These alterations may lead to marked mucosal damage, which can result in a broad spectrum of acute and chronic diseases, such as acute gastrointestinal bleeding (from lesions in the stomach or small intestine) and diarrhea.

Third, functional changes and mucosal damage in the gut disturb the digestion of other nutrients as well as their assimilation into the body, thereby contributing to the malnutrition and weight loss frequently observed in alcoholics.

Fourth, alcohol-induced mucosal injuries—especially in the upper small intestine—allow large molecules, such as endotoxin and other bacterial toxins, to pass more easily into the blood or lymph. These toxic substances can have deleterious effectson the liver and other organs.

Over the past three decades, researchers have made major progress toward understanding alcohol’s manyacute and chronic effects on GI-tract function and structure.


Difficulty walking, blurred vision, slurred speech, slowed reaction times, impaired memory: Clearly, alcohol affects the brain. Some of these impairments are detectable after only one or two drinks and quickly resolve when drinking stops.

On the other hand, a person who drinks heavily over a long period of time may have brain deficits that persist well after he or she achieves sobriety. Exactly how alcohol affects the brain and the likelihood of reversing the impact of heavy drinking on the brain remain hot topics in alcohol research today.

We do know that heavy drinking may have extensive and far–reaching effects on the brain, ranging from simple “slips” in memory to permanent and debilitating conditions that require lifetime custodial care. And even moderate drinking leads to short–term impairment, as shown by extensive research on the impact of drinking on driving.

A number of factors influence how and to what extent alcohol affects the brain (1), including

  • how much and how often a person drinks;
  • the age at which he or she first began drinking, and how long he or she has been drinking;
  • the person’s age, level of education, gender, genetic background, and family history of alcoholism;
  • whether he or she is at risk as a result of prenatal alcohol exposure; and
  • his or her general health status.

This Alcohol Alert reviews some common disorders associated with alcohol–related brain damage and the people at greatest risk for impairment. It looks at traditional as well as emerging therapies for the treatment and prevention of alcohol–related disorders and includes a brief look at the high–tech tools that are helping scientists to better understand the effects of alcohol on the brain.


Alcohol can produce detectable impairments in memory after only a few drinks and, as the amount of alcohol increases, so does the degree of impairment. Large quantities of alcohol, especially when consumed quickly and on an empty stomach, can produce a blackout, or an interval of time for which the intoxicated person cannot recall key details of events, or even entire events.

Blackouts are much more common among social drinkers than previously assumed and should be viewed as a potential consequence of acute intoxication regardless of age or whether the drinker is clinically dependent on alcohol (2). White and colleagues (3) surveyed 772 college undergraduates about their experiences with blackouts and asked, “Have you ever awoken after a night of drinking not able to remember things that you did or places that you went?”

Of the students who had ever consumed alcohol, 51 percent reported blacking out at some point in their lives, and 40 percent reported experiencing a blackout in the year before the survey. Of those who reported drinking in the 2 weeks before the survey, 9.4 percent said they blacked out during that time.

The students reported learning later that they had participated in a wide range of potentially dangerous events they could not remember, including vandalism, unprotected sex, and driving.


The pancreas

Alcohol causes the pancreas to produce toxic substances that can lead to:

  • pancreatitis
  • inflammation of the pancreas
  • swelling of the blood vessels in the pancreas

Pancreatitis can be very painful.

There are 2 types of pancreatitis:

  • acute pancreatitis
  • chronic pancreatitis

Acute pancreatitis

Acute pancreatitis comes on suddenly. It can cause severe pain and can be life-threatening.

Acute pancreatitis can cause pain in the stomach area (abdomen), behind the ribs. It can spread through the back and cause nausea, vomiting and fever.

Chronic pancreatitis

Chronic (long-lasting) pancreatitis is when the pancreas becomes inflamed and stays that way. This causes it to stop working properly.

Symptoms of chronic pancreatitis include:

  • recurring, severe pain behind the ribs and through the back
  • weight loss
  • greasy, foul-smelling poo and loose bowel movements

It may cause complications that can be life-threatening, such as pancreatic cancer.

Treatment for chronic pancreatitis

Chronic pancreatitis is hard to treat. The main advice is to not drink alcohol. 

The pancreas produces enzymes that digest your food. When the pancreas does not function, these enzymes come in tablet form.

A third of people with pancreatitis develop type 2 diabetes.

Blood pressure and the heart

A lot of alcohol over a long time – or too much on a single occasion – can damage the heart or interfere with the way it works.

This can cause different problems, including:

  • high blood pressure (hypertension)
  • increased risk of strokes
  • cardiomyopathy (stretching and drooping of the heart muscle)
  • arrhythmias (irregular heartbeat)

High blood pressure (hypertension)

High blood pressure is the most common alcohol-related health problem. Many people don’t realise they have it.

Drinking a lot of alcohol can affect the muscles in your blood vessels. This can cause them to become narrower.

The more alcohol you drink the higher the risk of developing hypertension. If you drink regularly you are at risk, especially if you’re over the age of 35. One drink a day can increase the risk.

When your blood vessels are narrower, the heart has to work harder to push blood around your body. This makes your blood pressure go up.

High blood pressure can significantly increase your risk of:

  • stroke
  • heart disease
  • vascular dementia – caused by not enough blood being able to get to the brain
  • chronic kidney disease


Sex life and fertility

Drinking alcohol can increase your:

  • confidence with sexual partners
  • sexual desire

But it can have a bad effect on what happens in bed.

Alcohol can also cause long-term problems with sex and fertility.

How alcohol can affect sex and fertility

Problems with erections

Drinking large amounts of alcohol can make it hard to get or keep an erection. This is called erectile dysfunction (ED).

Alcohol interferes with the messengers in the brain that tell the penis to fill with blood.

It can also happen because alcohol can reduce the production of testosterone. Testosterone is the hormone that controls male sexual functions.

ED is normally a temporary problem.

Problems with orgasms

Alcohol interferes with your ability to feel sexual stimulation. It does this by interfering with the signals between the brain and the genitals.

After heavy drinking:

  • men may find it hard to ejaculate (come) or may ejaculate too quickly
  • women may find it harder to orgasm or their orgasms may feel less intense

Sex drive (libido)

Drinking heavily over a long period of time can lead to a lower sex drive (libido). This is because it reduces your levels of testosterone.

Shrinking of sex organs

High-risk drinking over a long time can cause a man’s testes and penis to shrink.


Lowered testosterone can affect sperm production. This can reduce fertility.

Women who drink heavily for a long time may find they stop ovulating.

Even small amounts of alcohol can affect fertility.

Sexually transmitted infections (STIs)

Alcohol lowers your inhibitions and affects your judgement. This increases your chances of having unprotected sex. This puts you at risk of sexually transmitted infections


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