It was the smashed-up chin that did it. The bruise that spread from my ear; the right hand side of my face black, blue and dotted with red from where the skin had broken. I’d fallen on my face while attempting an ambitious dance move at a hen do. And while it would have been easy to tell myself that it was a one-off, everyone was drinking more than normal and the dance moves were ones I’d learned in an exercise class (see! I am healthy!) the facial injury was a clear indication that alcohol was causing harm to my health.
Plus, the bruise was visible… what damage had my years of binge drinking done to my insides? The parts I couldn't see? It was time for a break. So I took a month off alcohol – and saw a myriad of benefits, from better sleep to my well-crafted make-up staying on all night. But did it actually make a difference to my insides? As more of us go sober, or try events like Dry January or Sober October, what are the health benefits we don’t know about? Can a month off booze have any impact on our longterm health? I decided to undergo some tests to find out.
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“Until you’ve got advanced liver disease, you wouldn’t shows any sign of it,” explains Dr Michael Huw Chapman, MBBS PhD MRCP, consultant gastroenterologist and hepatologist. “Heavy binge drinking can cause significant injuries [to the liver] and the process of regeneration inevitably leads to scarring.” Scarring is what leads to the condition cirrhosis – where the scar tissue stops your liver from functioning properly. It’s not just caused by excess alcohol or drug use, but infections such as hepatitis and glandular fever can damage the liver. As can a high fat, high sugar diet. Genetics can also influence your propensity to liver damage.
Usually, if a doctor suspects your liver isn’t functioning normally, they will send you for tests – ranging from blood tests to a MRI scan. But this tends to be much later down the line, when you’ve already significantly done damage to your liver. I had a FibroScan, a specialised ultrasound machine for your liver that investigates fibrosis (scarring) and steatosis (fat build up in your liver cells). Essentially it’s a non-invasive way to see how healthy your liver is, so it can catch early scarring and allow you to change your drinking habits before it’s too late.
The scan is available privately across the country, but I go to the London Digestive Centre, where I meet Dr Chapman. We begin by taking a simple test (which anyone can do online) where he asks me a series of questions to gauge how problematic my drinking is. It’s tempting to lie, in the same way I’ll tell my GP that yes, I always stick to my five a day, and no, I never go above the recommended weekly alcohol allowance of 14 units per week. But I decide in this instance, it's probably best to be honest.
I tell him that I first started drinking a decade ago. When he questions this, I do the maths and figure out it was about 16 years ago (I am still in denial that the year 2000 wasn’t ten years ago) as I first started going out in my late teens. Then it was university, where I made the Fresher’s Week spirit last three years, before moving to London, becoming a journalist and really embracing the fact that work events meant I could drink for free. I am now 34 and my job intensifying means I can’t be hungover at work, so I rarely drink on a weeknight and I don’t really drink at home. But when I go out, I go for it.
When I share with Dr Chapman what an average night out would involve (bottle of wine, four double gin and tonics, espresso martini… maybe a few tequilas) he kindly tells me a binge like that does fall into the dangerous drinking category. And, even worse, after 'yes' to questions such as ‘have you had an alcoholic drink in the morning? (it was a couple of Strongbows at a festival) it seems I fall into the high risk category. As a result, the doctor believes that there is a high likelihood that my liver could show some form of scarring.
Thankfully, if your liver is only showing the early stages of liver scarring this can be reversed. The liver is an “active organ” with a strong healing ability, and even after a sustained period of drinking (like, say a festival or Christmas) a month off alcohol can reverse damage.
If you have low level scarring it has no impact on your day to day health at all. “Apart from the fact that you’re on a pathway to more damage,” the doctor warns. “This is the point of measuring scarring with a machine like the FibroScan – it puts people in different risk categories as to whether they are likely to run into trouble in the future or not.” That damage – most of the time – can be reversed by quitting alcohol, ideally for three months if not longer.
The FibroScan works a little bit like an ultrasound – cold jelly is applied to the skin over where my liver is (the upper right part of the abdomen, FYI) and then there’s a quick jab (a bit like someone had just poked me) and my results appear on the screen. Over my shoulder, Dr Chapman sounds amazed – my liver is “very, very good.” I have an elastrography figure of 3.7kPa which means significant fibrosis (scarring) of my liver unlikely. I also have “very mild” fatty deposition in the liver. All of this means that I am in the best category possible and scarring of my liver in the future is very unlikely. And this is before I’ve even begun dry January.
But, instead of celebrating with a Tequila (or two) Dr Chapman is keen to point out that your liver isn’t the only thing alcohol damages. And because there’s so much focus on alcohol and the liver, many people forget about the impact on other parts of the body.
“Alcohol inhibits vitamin absorbency,” he says. “Particularly the absorption of B vitamins which can lead to dementia. It also changes the amount of fat in your blood, which increases your risk of high blood pressure, heart disease, becoming diabetic and creates problems with your pancreas so you don’t produce the enzymes that help you digest food.” These are all slow build conditions that, like liver scarring, you wouldn’t show any outward symptoms until much later on.
Before I start Googling “where can I get an all-over body scan?” and “am I going to die?”, Dr Michael Chapman points out that doing Dry January or Sober October can help with these things too. “It makes people think about their alcohol use and the other health implications,” he says. “There’s good evidence now that people who do Dry January drink less throughout the year.” That is true – I never go back full throttle after a month off, and having strengthened my willpower over time, find it fairly easy to ask for a soft drink. It's also been backed up by science.
Apart from taking a break from alcohol I wonder if there’s anything else I can do to help our bodies process alcohol better? If it inhibits B vitamins, should we all be taking a supplement? It seems those who are drinking high levels of alcohol are advised to, but if you’re not drinking that heavily there’s little benefit to it. Milk Thistle is also very commonly used by people with liver disease. “There’s very little evidence that it’s helpful though,” says Dr Chapman.
As for whether some alcohol is better for your liver than others? This just isn’t true. “Ten units of vodka versus ten units of wine have the same impact on the body,” he says.
Unfortunately, it seems there is no miracle cure for the impact alcohol has on your body, apart from… drink less. And, even though I’ve been given the all-clear, I am still going to do just that. After all, when I told my friends the results, their main response was “are you sure?!” If that’s not a sign to cut back… then I am not sure what is.
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