From beer and wine to whiskey and gin, alcohol is one of the largest products consumed throughout the world. According to the World Health Organization, “every person in the world aged 15 years or older drinks 6.2 (liters) of pure alcohol per year.” Since less than half of the world’s population drinks, those who do drink actually consume more like 17 liters of pure alcohol per year. Keep in mind that this is alcohol in its purest form.
Alcoholism is a widespread disease that affects men, women, adolescents and individuals from all over the world. It is widely known that alcohol negatively affects the brain and the liver resulting in cirrhosis, alcohol hepatitis and dementia. A less publicized consequence of alcohol abuse is the negative effects that it has on the bones. Alcohol has direct harmful effects on an individual’s bone structure that could result in many injuries and diseases.
Decrease in bone mass
Osteoporosis usually presents in women over the age of 65 years old due to the lack of estrogen in the body after menopause. However this differs in alcoholics. The “battered alcohol syndrome” was initially described in a study in 1977 as three or more fractures with different stages of healing in an individual. Alcohol itself has harmful effects on both bone buildup and bone breakdown. A decrease in bone mass is the core underlying mechanism of osteoporosis; hence this bone disease is extremely prevalent in chronic alcoholics.
Alcoholism also affects the bone structure by causing a delay in fracture healing, aseptic necrosis (noninfectious dead bone) and osteomalacia (softening of bones). Keep in mind that this has nothing to do with the increased risk of fractures due to physical injuries that are typically seen in alcoholics.
Decrease in bone formation
Osteoblasts are the cells that build bone and osteoclasts are the cells that break down or remodel bone. Evidence has shown that alcohol has a direct effect on osteoblasts and drinkers have less osteoblastic activity than nondrinkers. A decrease in osteoblastic activity leads to a decrease in bone formation and, as a result, creates less dense bones that are more likely to undergo fractures. Interestingly, the same study showed that alcohol had a greater effect on osteoblasts then estrogen did. This shows that alcoholism has a more devastating outcome on bone structure than menopause on bone structure.
Antioxidants are produced from chronic alcoholism and these antioxidants are also known to decrease osteoblastic activity. Although the exact correlation between alcohol and osteoclasts is not yet known, it is believed that an increase in osteoclastic activity results from alcohol due to the pro-inflammatory markers that are released in the body in chronic alcoholics. The pro-inflammatory markers are thought to increase osteoclastic activity resulting in an increased bone breakdown. A decrease in osteoblastic activity and an increase in osteoclastic activity combined result in a tremendous bone breakdown leading to multiple bone diseases that occur in alcoholics.
The condition is reversible
So how do we stop this process? Fortunately, evidence shows that alcoholic bone disease is potentially reversible once an individual stops drinking. Malnutrition and vitamin deficiency are leading causes for bone breakdown in alcoholics. Once an individual stops drinking, bone remodeling goes back to normal and the individual tends to eat a more calorie-sustainable diet. Vitamin D and calcium are the two leading necessary nutrients for bone development and should be supplemented for any individual who has a chronic history of alcoholism, as both of these nutrients can help restore bone formation.
The Sovereign Health Group is a leading treatment group with locations across the United States that treat people struggling with alcohol and drug use, co-occurring conditions and co-occurring conditions. For more information, call our 24/7 helpline.
About the author
Kristen Fuller, M.D., is a senior staff writer at the Sovereign Health Group and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author, who also teaches, practices medicine in the urgent care setting and contributes to medicine board education. She is also an outdoor and dog enthusiast. For more information and other inquiries about this article, contact the author firstname.lastname@example.org.