Monday, November 3, 2008

Love Wine?

Let’s chat about how much you drink. I have lots of patients who are working at demanding jobs, either in the corporate/non-profit sector or at home, and when dinnertime rolls around, a glass of wine just hits the spot. Many of my patients, blessed by proximity to sumptuous wine-growing regions, don’t stop at one glass: they have one while making dinner, one with dinner, and maybe one more after. They don’t see a problem with it. “But I have my liver checked every year, and my internist says I’m fine,” one patient confided.

The problem is the accumulated effect on the body: 2 glasses of wine 7 days per week is excessive. We know that the threshold for a problem is 12+ drinks per week. For every alcoholic, there are 4 problem drinkers. We know that 10% of us or more have a sticky relationship to alcohol. I’m interested in trying to prevent people from becoming problem drinkers, or if you are already, how to reverse the path toward alcoholism and/or over-consumption.
One glass of wine feels good. You’re relaxed -- more calm, open and loving. Two glasses – yum! But some of us get tipsy with more than one glass. When you’re tipsy, you’re at a greater risk of addiction, emotional problems, including irritability and depression, obesity or overweight, gastritis or ulcers, nerve and brain problems, hepatitis, cirrhosis, pancreatitis, hypoglycemia, immune suppression, injury and death. Even if you do not notice the white of your eyeballs turning yellow from hepatitis, you may still be doing some damage. Alcohol is what we call “empty calories” – that is, you are not getting essential vitamins, minerals or other nutrients. It can cause deficiencies over time. Alcohol causes rapid changes in blood sugar, which can cause mood swings, inconsistent energy and very commonly, sleep disruption.

I find that many perimenopausal or menopausal women or andropausal men can no longer tolerate wine on a regular basis – adrenal fatigue or fluctuating sex hormones increase your chances of intolerances or allergies to grains, grapes, sugar and yeast, all of which are contained in wine. And you already know that sulfites are bad for you.

Recently a study showed that the “healthy” limit of alcohol is 80 ounces/month (that’s 20 ounces per week, or 5 servings of 4 ounces – you’d be surprised with our increasing larger wine glass capacities how small a 4 ounce serving really is!). I recommend to my patients who are drinking too much to start measuring their wine (or even better, get your partner to do it for you) and stop at 20 ounces per week or less.

I was taught in medical school that the two ways to raise your good cholesterol or HDL were exercise and alcohol. In our sedentary culture, wine seems a lot easier than regular exercise! The problem is that not all people raise their HDL with alcohol: in 25% of the population with the ApoE4 genotype, moderate alcohol actually lowers HDL and raises the bad type of cholesterol (LDL).

For those of us who are battling the bulge, any excess alcohol gets stored as fat. Not good! Right around the time your liver stores those extra calories as fat, the calming effects of alcohol downslide toward numbness, flatness, delayed reflexes and poor coordination and judgment. If you slur your words – even mildly – you have overconsumed.

How do you know if you have a problem with drinking?
1. Intense craving. This is a sign of alcohol withdrawl.
2. Problems with your blood sugars: either hypoglycemia or pre-diabetes.
3. Difficulty with skipping your alcohol for 10-14 days at a time. I strongly recommend a periodic cleanse at a minimum of twice per year.
4. Drinking alone.
5. Drinking before a social outing or business function.
6. Drinking in the morning or late at night.
7. Drinking in place of meals or real nutrition.
8. Episodes of amnesia or blackouts. These are more common than you think. Do you get into fights with your spouse, and then forget the next day what you fought about?

What helps?
  • Cut back or stop drinking. Keep to the 80 ounce/month limit or less. Have 2 days per week where you do not drink at all, and notice truthfully how you feel on those days versus the morning after you drink.
  • Consider a 1-2 week cleanse. Stopping alcohol consumption for this length of time without difficulty is a good sign that you are not yet in serious trouble.
  • Talk to your practitioner about getting help. We know acupuncture and massage are both helpful. Some people benefit from use of glutamine, topamax or antabuse.
  • Alcoholics Anonymous or one of the moderate drinking groups can be helpful. Check out Moderation Management, a program aimed at helping early-stage problem drinkers and prevention of alcoholism.

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I'm an organic gynecologist, yoga teacher + writer. I earn a living partnering with women to get them vital and self-realized again. We're born that way, but often fall off the path. Let's take your lousy mood and fatigue, and transform it into something sacred and useful.