Does Alcohol Weaken Your Immune System?

Your immune system defends your body against infection and recovers it from injury.1 Many factors affect the immune system, so does alcohol lower your immune system response? Heavy use of alcohol and immune system are, in fact, closely related in negative ways.

How Does Alcohol Weaken Your Immune System?

Alcohol can weaken your immune system a few known ways.

Gut Function

Alcohol affects how the gastrointestinal (GI) tract (aka your gut) functions. Your gut is the first point of contact for many of the foods and drinks you ingest. You primarily absorb nutrients through your gut.1

Alcohol can change the number of GI tract microorganisms. These microorganisms help your gut function normally by processing food into nutrients. Alcohol also disrupts how these microorganisms communicate with each other, which can change how long it takes to digest food and how effective your gut is at absorbing all available nutrients.

Alcohol can also damage other cells in your gut.

These changes to the GI tract can contribute to progressive health conditions of the digestive system, such as alcohol liver disease (ALD).1

Antibodies

Misuse of alcohol and immune system function are linked.Alcohol misuse can lower your immunity by affecting the cells that protect your body from infection. These cells, known as T cells and B cells, originate in your bone marrow and are involved in the release of antibodies in your blood.

Antibodies are proteins that fight against foreign particles, such as bacteria and viruses.

Alcohol use can contribute to lowering T and B cell levels. When your T and B cells are chronically low, your body produces fewer antibodies and is less equipped to combat infection.2

 

Which Health Risks Are Associated with a Weakened Immune System?

A weakened immune system makes it more difficult for your body to fight off infection. As a result, if you are exposed to certain infections, you are more likely to get sick. For example, if you are immunodeficient, you are more likely to be affected by food poisoning (listeriosis), pneumonia, post-surgery complications, and respiratory conditions.

Listeriosis

Food poisoning is a serious infection caused by eating food contaminated with the bacterium Listeria monocytogenes. You are more likely to get sick from this infection if you have a weakened immune system, including if you have alcohol-related immunodeficiency.3

Listeriosis can cause:3

  • Vomiting
  • Diarrhea
  • Headache
  • Stiff neck
  • Confusion
  • Loss of balance
  • Convulsions
  • Fever and muscle aches

If you are pregnant, food poisoning also increases the risk of premature delivery, miscarriage, still-birth, and newborn infection.3

Pneumonia

Pneumonia is an infection in one or both of your lungs. Anyone can get pneumonia, however, heavy alcohol use increases your risk.

Pneumonia symptoms can vary from mild to severe depending on the type of infection. Symptoms include:4

  • Fever
  • Chills
  • Cough usually with phlegm
  • Shortness of breath
  • Chest pain when you breathe or cough
  • Nausea or vomiting
  • Diarrhea

Post-Surgery Complications

Researchers have also found alcohol misuse to be associated with different types of complication after surgery, including: 5, 6, 7, 8

  • Infection
  • Unusual wounds or bleeding
  • Cardiopulmonary complications—Cardiopulmonary effects (i.e., heart-related complications) include high blood pressure, irregular heartbeat, and a higher risk of heart failure.
  • Neurologic complications—Neurologic complications (i.e., nervous system related complications) include a wide range of symptoms and conditions. Some of the most serious potential complications related to alcohol use are:
    • Cognitive decline, or changes in thinking, mental clarity, and mental acuity
    • Delirium, or issues with inattention and disorganized thinking which may be potentially dangerous
    • Stroke, which occurs when the blood supply to the brain is blocked or a blood vessel in the brain bursts causing brain damage
    • Spinal cord ischemia, which occurs when the blood supply to the spinal cord is blocks and is a potentially life-threatening complication

Because alcohol can potentially contribute to a number of surgery complications depending on your level of use and the type of surgery, your surgeon may require that you reduce the amount of alcohol you drink or stop drinking alcohol for a set timeframe before planned surgery.

If you are dependent on or addicted to alcohol and experience withdrawal symptoms when you reduce how much you drink, you may need to complete an addiction treatment program before a planned or non-urgent surgery.

Respiratory Conditions

Alcohol and immune system are connected.In addition to increased risk of pneumonia, alcohol misuse and addiction is associated with increased risk of other respiratory conditions affecting the lungs. These include tuberculosis, respiratory syncytial virus infection, and acute respiratory distress syndrome.9

Tuberculosis

Tuberculosis (TB) is caused by germs spread through the air from person to person. Globally, TB is the leading cause of death by infectious disease. 10

While TB is less common in the U.S. than the global average—the CDC reported approximately 28 cases per million people in 2017—an immunodeficient person has an increased risk of contracting TB regardless of where they live.11

Symptoms of TB include:10

  • Feeling sick or weak
  • Losing weight
  • Having a fever
  • Having night sweats
  • Coughing
  • Having chest pain
  • Coughing up blood

Respiratory Syncytial Virus Infection

You can get a respiratory syncytial virus (RSV) infection from someone who has it when they cough or sneeze. You can also contract the virus if you touch a surface that has the virus on it.

Symptoms of RSV infection include:12

  • Runny nose
  • Decrease in appetite
  • Coughing
  • Sneezing
  • Fever
  • Wheezing or breathing with difficulty

Acute Respiratory Distress Syndrome

Acute Respiratory Distress Syndrome (ARDS) is a serious condition that causes low levels of oxygen in your blood. Fluid builds up inside the air sacs in your lungs. This keeps your lungs from being properly filled with air and moving enough oxygen into the bloodstream.

Signs and symptoms that you are developing ARDS or are at risk for it include:13

  • Shortness of breath
  • Fast, shallow breathing
  • Fast heart rate
  • Coughing that produces phlegm
  • Blue fingernails, skin, or lips
  • Fatigue
  • Fever
  • Crackling sound in the lungs
  • Chest pain, especially when trying to breathe deeply
  • Low blood pressure
  • Confusion

Alcoholic Liver Disease

A weakened immune system can also make it hard for your body to repair tissue damage and may even worsen it. Research indicates that alcoholic liver disease (ALD) could be partly explained by alcohol’s impact on the immune system.14

Recent studies show the possibility that, in some cases, damage to the liver may continue to worsen after alcohol is no longer present in your body. This suggests that your weakened immune system could cause ongoing injury to your liver even after you stop drinking.15

The greatest degree of tissue injury in the body due to alcohol misuse occurs in the liver because the liver is the main organ that metabolizes, or breaks down, alcohol. The risk for ALD increases the longer period of time that you drink heavily.16

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ALD occurs in three stages:16

  1. Steatosis—Steatosis occurs in more than 90% of those who consume 4 to 5 standard drinks per day over decades. (A standard drink is one that has about 0.5 fluid ounces, or 14 grams, of pure alcohol.) Steatosis can also develop after an episode of binge drinking, which is having 4 to 5 standard drinks in 2 hours or less. Steatosis is largely reversible if you stop drinking.
  2. Alcoholic Hepatitis—The second stage is a more severe injury that involves liver inflammation.
  3. Cirrhosis—Late-stage ALD, called cirrhosis, is characterized by scarring of the liver and can potentially lead to liver failure.

Is Any Amount of Alcohol Good for the Immune System?

Research has conflicting findings on whether drinking in moderation has health benefits. Some studies have found this link whereas more recent studies have not.

Moreover, the studies that have found that drinking in moderation has health benefits, they cannot conclusively claim that the health benefits are due to alcohol; other possible factors include genetics and other dietary choices.17

The impact that alcohol has on your immune system can also vary based on how much you drink, what you drink, and other factors like age, gender, and body composition. Some studies indicate that small amounts of alcohol might potentially enhance your immune response. Other studies have found preliminary support for the idea that red wine and beer might strengthen your immune system because of their antioxidant properties.18

It is important to note that only some early research studies find a positive relationship between alcohol use and health. Whether or not moderate alcohol consumption has health benefits is not conclusive.
If you have found yourself using these purported benefits to justify having a drink every day or “just one more drink,” this may actually be a sign of problematic alcohol misuse that can cause harm even if it did boost your immune system.

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What Can I Do to Minimize Damage to My Immune System?

Though heavy alcohol use has long-term impacts on your immune system and overall health, it is never too late to seek treatment.

For instance, depending on your level of alcohol misuse, abstinence can resolve steatosis, the first stage of alcoholic liver disease (ALD). Abstinence can also improve your prognosis if you have late-stage ALD (i.e., cirrhosis of the liver).16

Some of the treatments that researchers recommend for ALD also apply to treating alcohol use disorder (AUD). These recommendations include:16

Making changes to diet or taking nutritional supplements may be a part of treatment because alcohol makes it hard for your body to absorb the nutrients it needs. Note that these changes should be made with supervision by a registered dietician (RD), registered dietician nutritionist (RDN), gastroenterologist/hepatologist, or specializing doctor.16

Becoming abstinent from alcohol should also occur in the context of treatment from health providers. If you are physically dependent on alcohol and abruptly quit drinking, you may experience painful or even dangerous withdrawal symptoms. Withdrawal management services, or “detox,” can help you manage your symptoms.19

Seeking treatment sooner rather than later can reduce the impact of alcohol misuse on your immune system.

Help is available. For assistance with locating treatment programs or providers, please call 800-948-8417 Who Answers? to speak with one of our specialists.

Resources

  1. Sarkar, D., Jung, M.K., & Wang, H.J. (2015). Alcohol and the Immune System. Alcohol Research: Current Reviews, 37(2), 153-155.
  2. Pasala, S., Barr, T., & Messaoudi, I. (2015). Impact of Alcohol Abuse on the Adaptive Immune System. Alcohol Research: Current Reviews, 37(2), 185-197.
  3. Centers for Disease Control and Prevention. (2016, December 12). Listeria (Listeriosis).
  4. U.S. National Library of Medicina. (2021, September 15). Pneumonia. MedlinePlus.
  5. Bradley, K.A., Rubinsky, A.D., Sun, H., Bryson, C.L., Bishop, M.J., Blough, D.K., Henderson, W.G., Maynard, C., Hawn, M.T., Tonnesen, H., Hughes, G., Beste, L.A., Harris, A.H.S., Hwkins, E.J., Houstong, T.K, & Kivlahan, D.R. (2011). Alcohol Screening and Risk of Postoperative Complications in Male VA Patients Undergoing Major Non-cardiac Surgery. Journal of General Internal Medicine, 26(2), 162-169.
  6. Goldman, L. (1983). Cardiac Risks and Complications of Noncardiac Surgery. Annals of Internal Medicine, 98(4), 504-513.
  7. Mashour, G.A., Woodrum, D.T., & Avidan, M.S. (2015). Neurological Complications of Surgery and Anesthesia. British Journal of Anaesthesia, 114(2), 194-203.
  8. Centers for Disease Control and Prevention. (2021, May 25). Stroke.
  9. Simet, S.M., & Sisson, J.H. (2015). Alcohol’s Effects on Lung Health and Immunity. Alcohol Research: Current Reviews, 37(2), 199-208.
  10. Centers for Disease Control and Prevention. (2011, October 28). Tuberculosis.
  11. Centers for Disease Control and Prevention. (September). TB in the United States: A Snapshot.
  12. Centers for Disease Control and Prevention. (2021, September 24). Respiratory Syncytial Virus Infection (RSV).
  13. National Heart, Lung, and Blood Institute. (2019, September 17). Acute Respiratory Distress Syndrome.
  14. Gao, B., Seiki, E., Brenner, D.A., Friedman, S., Cohen, J.I., Nagy, L., Szabo, G., & Zakhari, S. (2011). Innate Immunity in Alcoholic Liver Disease. American Journal of Physiology Gastrointestinal and Liver Physiology, 300, G516-G525.
  15. U.S. Department of Health and Human Services. (2000, June). 10th Special Report to the U.S. Congress on Alcohol and Health. National Institutes of Health.
  16. Osna, N.A., Donohue Jr., T.M., & Kharbanda, K.K. (2017). Alcoholic Liver Disease: Pathogenesis and Current Management. Alcohol Research: Current Reviews, 38(2), 147-161.
  17. Centers for Disease Control and Prevention. (2020, December 29). Alcohol and Public Health.
  18. Romeo, J., Warnberg, J., Nova, E., Diaz, L.E., Gomez-Martinez, S., & Marcos, A. (2007). Moderate Alcohol Consumption and the Immune System: A Review. British Journal of Nutrition, 98, S111-S115.
  19. Das, S.K. (2020). Detoxification of Drug and Substance Abuse. Medical toxicology. Lippincott Williams & Wilkins.
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