Can I Drink Alcohol If I Have Rhabdomyolysis?
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A 19-year-old consumed two liters of red wine. Six hours later, he entered the emergency room intoxicated, uneasy, and sore. He hadn’t taken any medications or other substances, and his medical history was completely unremarkable. After running numerous tests, however, the doctors spotted muscle damage and concluded he had alcohol-induced rhabdomyolysis.
Fortunately, he was diagnosed and treated quickly and was able to make a full recovery. But what happens the next time his friends invite him out for drinks? Is it safe to drink alcohol after a rhabdo diagnosis?
Rhabdomyolysis, nicknamed “rhabdo,” is a rare, rapid breakdown of damaged muscle tissue. When our muscles are injured, they deteriorate, releasing a slew of proteins and electrolytes into the bloodstream. This can worsen kidney function and alter the body’s electrolyte balance. If left untreated, rhabdomyolysis can even lead to organ failure.
Any form of muscle damage may cause rhabdo. The most common culprits are physical overexertion, traumatic injury, and excessive heat exposure. More rarely, muscle breakdown occurs due to drug and alcohol use, certain medications, or illnesses.
If left untreated, rhabdo can be deadly. Knowing the signs of this condition helps us seek medical care before it’s too late.
Clinicians identify rhabdomyolysis through a triad of symptoms: myalgia, myoglobinuria, and asthenia. For those of us who aren’t doctors, that translates to muscle pain, tea-colored urine, and weakness.
It’s important to note that experiencing all of these symptoms at once is a bit rare; fewer than 10% of us will have all three. Instead, we’ll probably just notice one common symptom — the dark, discolored urine emblematic of rhabdomyolysis.
The following symptoms are also associated with rhabdo:
Regardless of how your muscle damage manifests, prompt medical care is crucial. If you experience extreme muscle pain, dark urine, swelling, or any of the other symptoms outlined above, head to the hospital. This condition can be life-threatening.
When we have rhabdo, our deteriorating muscles dump a ton of potassium, phosphate, creatine kinase (CK), urate, and myoglobin into our bloodstream. All that gunk eventually reaches our kidneys, which may struggle to filter out those unexpected hemoglobinic pollutants. That’s a fast track to kidney failure and a whole host of other issues.
The consequences of rhabdo are serious. If left untreated, this condition can cause big problems:
Because rhabdomyolysis threatens our lives, we want to take every possible measure to avoid it. In addition to avoiding triggers like prolonged heat exposure and heavy exercise, we may want to consider one other lifestyle change — cutting back on our alcohol intake.
Alcohol is one of the lesser-known causes of rhabdo. Some patients develop this condition after episodes of intoxication or alcohol-induced comas (acute alcoholic myopathy). Others only exhibit symptoms after years of heavy drinking, which we call chronic alcoholic myopathy.
When we consume large amounts of alcohol, we become dehydrated and uninhibited. Both of these changes contribute to our risk of rhabdo. For example, our impaired judgment may lead us to make decisions we usually wouldn’t, resulting in muscle injury from falls or overexertion. These short-term risks may cause us to develop rhabdo.
There’s another facet to alcohol-induced rhabdomyolysis: drinking accelerates the muscle breakdown associated with rhabdo. When our liver metabolizes the ethanol found in beer, wine, or cocktails, it produces carcinogenic acetaldehyde. This substance triggers the formation of free radicals — unstable, reactive molecules that destroy the protective membranes of our cells. Over time, this damage adds up, meaning that those of us who drink heavily in the long term may experience muscle breakdown, weakness, and (you guessed it) rhabdo.
So, what can we do if we have this condition? If your urine is tea-colored after drinking or you notice out-of-control muscle aches, you may need to go to the hospital.
Seek medical care immediately if you experience any symptoms of rhabdo. This potentially fatal condition isn’t one we can treat on our own — it requires expert clinical care.
As in most medical emergencies, prompt intervention for rhabdomyolysis is key. The sooner we get to the hospital, the better our outcome will be. Our medical team will strive to promote muscle healing, stop further muscle damage, and protect our kidney function.
All types of rhabdo, including alcohol-induced rhabdomyolysis, are treated with fluid management. Mild cases may resolve with a combo of rest and lots of water. In moderate to severe instances, we might require “aggressive repletion” in the form of intravenous fluids administered at the hospital. Those typically include saline or a solution of glucose and sodium bicarbonate (commonly known as baking soda). The purpose of this approach is to flush out the muscle proteins that cause arrhythmia and kidney damage.
Because rhabdo is such a dangerous condition, scientists continue searching for more (and better) ways to treat it. At present, there is no standardized second-line treatment for those whose conditions aren’t improved by fluids. Fortunately, it seems like that’s changing.
Researchers from Tulane University found that corticosteroids dramatically improved the condition of an alcohol-induced rhabdomyolysis patient who didn’t respond to fluid management. These drugs have a low toxicity profile, making them potentials option for those who don’t respond to aggressive repletion.
Additionally, medical experts have begun looking into ways to prevent recurrent episodes of rhabdomyolysis.
While we can’t completely eliminate the risk of rhabdo, we can make lifestyle changes that reduce it:
Any small change you make in the right direction will help you avoid rhabdo and improve your overall health.
Rhabdomyolysis and alcohol don’t mix, but can you drink at all after rhabdo? If so, how long should you wait? Is it okay to drink during treatment? Below is a quick reference guide answering the question, “How long after rhabdo can I drink alcohol?”
Abstaining from alcohol entirely is the safest option, but your doctor will have the best recommendations for your particular case.
The connection between alcohol and rhabdomyolysis is complex. Drinking contributes to muscle damage and weakens our immune system — a recipe for rhabdo recurrence. Our best bet is to enjoy some non-alcoholic alternatives while putting our well-being first.
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1. What triggers rhabdomyolysis?
Rhabdomyolysis, or rhabdo, can be triggered by heat exposure, dehydration, overexertion, illness, certain medications, and alcohol, among other causes.
2. Can drinking alcohol cause rhabdomyolysis?
Yes, drinking can cause alcohol-induced rhabdomyolysis. Alcohol’s toxic effects on muscle tissue contribute to the breakdown of muscle cells. It also dehydrates us.
3. How do you treat alcohol-induced rhabdomyolysis?
All types of rhabdo are treated with rest and fluid replacement. In severe cases, patients may require IV fluids to correct electrolyte imbalances and dehydration.
4. What are the key symptoms of rhabdomyolysis?
The “triad” of rhabdomyolysis symptoms are dark urine, severe muscle pain, and weakness. People with rhabdo may also experience swelling of the affected areas, cramping, nausea, infrequent urination, dehydration, or loss of consciousness.
5. Should I go to the ER for rhabdo?
Yes. If you suspect that you have rhabdo or are experiencing dark urine, muscle pain, or weakness, seek immediate medical attention. Prompt treatment can prevent serious complications.
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