HI MY NAME’S ALCOHOL AND I’M READY TO GET METABOLISED

alcohol-metabolismDRAFT_blog_ak

On a night out alcohol is most people’s best friend, being a depressant it slows down our inhibitions and causes those euphoric feelings that make you love it more and more through the night. Affecting your lightweight friend much harder than your heavyweight friend even though they consumed a similar amount. But how come every single time and I mean every single time you wake up from a night out with a hangover, you curse that so called best friend and swear you are never drinking again? Which let’s face it we’ve all heard before and know you are lying.

And why is it that you and a friend can be drinking the same amount of alcohol but they are passed out and you feel “fine”? It all comes down to the fact that alcohol is a chemical that like everything we ingest needs to be metabolised.

So, how does alcohol metabolism work?

How each person experiences the effects of alcohol is dependent on the speed at which your body metabolises and eliminates it from your system. There most common pathway is the metabolism of ethanol in no other than our liver involving two enzymes alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH).

Initially ADH breaks ethanol down, metabolising it to make acetaldehyde, which is a substance more toxic than alcohol, but due to further metabolism, it has a short life span in the liver. However, as you consume more and more alcohol on a night out your metabolism can’t keep up, causing a build-up of acetaldehyde. Which in turn causes all the symptoms associated with a hangover. This substance is the true catalyst for everyone’s love/hate relationship with alcohol.

This toxic substance needs to be further metabolised into a substance less toxic allowing for elimination from the body. This is where ALDH comes into the mixture, metabolising acetaldehyde into acetate. Acetate is then converted into carbon dioxide and water in other important body tissues for elimination.

How efficiently a person metabolises alcohol is dependent on a number of factors like age, weight, and gender. However, it is also largely dependent on a person’s genetic make-up.

What influence does genetics have on the expression on ethanol metabolites?

Differences in the rate of alcohol metabolism can genetically be determined the gene variations of ADH and ALDH, which in turn affect the rate at which acetaldehyde and acetate are metabolised.

Genetic variations of ADH and ALDH are common in individuals of Asian ethnicity. A genetic variation in Asians, is known as a protective gene variation, lowering alcohol dependency. This variation allows ADH to metabolise ethanol into acetaldehyde at a much faster rate. This therefore, leads to a build-up of acetaldehyde leaving the individual experiencing those unpleasant hangover symptoms like nausea. Similarly, ALDH2*2 is another variation seen in Eastern Asians which involves inactivity of ALDH causing a build-up of acetaldehyde.

Individuals with these variations a being genetically protected against the dependency of alcohol, however not all genetic variations have this protective effect. A genetic variation in alcohol dehydrogenase (ADH1B or ADH2) has the opposite effect and is known to cause a predisposition of alcoholism in the individuals with this variation. Alcoholism is a chronic disease that can cause extreme detriment to not only an individual’s health but also those around them, and is unfortunately hard to overcome.

Are there pharmaceuticals available to help reformed alcoholics?

Individuals rehabilitating from alcohol dependency can go through withdrawal symptoms that can range from mild to severe. This withdrawal process is the time where are large amount of alcoholics regress back to drinking to stop these symptoms. However, there are a number of pharmaceutical products aimed to help an individual through this process.

But once an alcohol dependent individual is reformed, other than willpower and support networks there is a drug called Antabuse used to make the consumption of alcohol unattractive. This is a controversial drug, that inhibits the enzyme Aldehyde dehydrogenase, hence causing a build-up of acetaldehyde when the individual consumes alcohol. Within a small time frame the individual will present symptoms of nausea, vomiting, sweating, headaches, anxiety and others which wear off within an hour. These unpleasant symptoms aim to keep the reformed alcoholic away from alcohol, linking a once enjoyable substance with unpleasant consequences.