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Alcohol and Health

Can You Drink Alcohol If You Have an Autoimmune Disease?

June 28, 2023
19 min read
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Reframe Content Team
A team of researchers and psychologists who specialize in behavioral health and neuroscience. This group collaborates to produce insightful and evidence-based content.
June 28, 2023
19 min read
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Certified recovery coach specialized in helping everyone redefine their relationship with alcohol. His approach in coaching focuses on habit formation and addressing the stress in our lives.
June 28, 2023
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Recognized by Fortune and Fast Company as a top innovator shaping the future of health and known for his pivotal role in helping individuals change their relationship with alcohol.
June 28, 2023
19 min read
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Reframe Content Team
June 28, 2023
19 min read

It’s Friday night. Ah, the magical allure of the weekend after a long work week! You're sitting in your cozy home, finally unwinding, staring at that inviting bottle of your favorite cabernet. But there's a tiny voice whispering at the back of your mind: “What about that autoimmune disease?” Can you really partake? While it’s always a good idea to check with a healthcare provider first, there are some common patterns when it comes to alcohol and autoimmune diseases. Let’s find out more!

The Invisible Battle

Let's begin by understanding autoimmune diseases. These conditions flare up when our immune system — usually our trusty guardian against viruses and bacteria — gets a little confused. It mistakes our healthy cells for foreign invaders and attacks them accordingly. It’s as if the trusty guard dog suddenly sees the mail carrier as an intruder!

There are over 80 types of autoimmune diseases. Some, like rheumatoid arthritis and lupus, can affect many parts of the body. Others, such as type 1 diabetes and psoriasis, are more specific. Managing these diseases often requires a careful balancing act of lifestyle, diet, medication, and yes — our Friday night libations.

Alcohol: Friend or Foe?

Autoimmune diseases thrive on inflammation. Here's where it gets tricky. Alcohol, in moderate amounts, can have an anti-inflammatory effect. Sounds good, right? Not so fast! Remember, the key word here is "moderate.” Higher amounts of alcohol consumption can lead to chronic inflammation, exacerbating autoimmune diseases.

It's also important to remember that many autoimmune diseases have organ-specific effects. For example, in autoimmune liver disease, consuming alcohol can cause more harm, accelerating liver damage. Similarly, autoimmune diseases that affect the digestive system — such as Crohn's or celiac disease — don’t mix well with alcohol, which can irritate the digestive tract.

In a nutshell, while a glass of wine might not spell disaster for everyone with an autoimmune disease, the effects of alcohol can vary widely depending on the type and severity of the autoimmune disease, the amount and frequency of alcohol intake, and individual genetic factors.

1: The Rheumatoid Arthritis Rollercoaster

Rheumatoid arthritis (RA) isn’t your average joint pain. In this chronic autoimmune condition, the immune system mistakenly attacks the joints, leading to inflammation, swelling, and pain. Over time, it can damage joints and even cause joint deformity. RA can also affect other parts of the body including the skin, eyes, lungs, heart, and blood vessels.

Here are some common symptoms of RA:

  • Tender, warm, swollen joints
  • Joint stiffness that is often worse in the mornings and after inactivity
  • Fatigue, fever, and weight loss

So, where does alcohol fit into the RA picture? There’s good news here: research shows that moderate alcohol consumption won’t increase symptoms for those who already have the disease. But again, the key word is “moderate” — so no more than one drink in a sitting for women and no more than two drinks for men, according to the CDC’s definition of moderate drinking.

The Verdict: Possible Foe

In spite of the low risk associated with moderate drinking and RA, alcohol can interfere with medications commonly used to treat it, such as methotrexate. Mixing alcohol and RA medications can heighten the risk of liver problems and diminish the medication's effectiveness.

Moreover, while alcohol might be anti-inflammatory, it can also cause dehydration which might exacerbate RA symptoms.

2: Lupus and Alcohol: Navigating the Waters

First things first, what is lupus? Like other autoimmune diseases, lupus develops when the immune system turns against parts of the body it's designed to protect, leading to inflammation and damage to various body tissues. Lupus can affect the joints, skin, kidneys, blood cells, brain, heart, and lungs. Think of it like an overeager security system that's a bit too enthusiastic, mistaking friendly visitors (the body's cells) for intruders.

Lupus can be a bit of a chameleon, presenting a range of symptoms that often mimic other ailments. Lupus has some common indicators:

  • Fatigue and fever
  • Joint pain, stiffness, and swelling
  • A butterfly-shaped rash on the face that covers the cheeks and the bridge of the nose
  • Skin lesions that worsen with sun exposure
  • Shortness of breath
  • Chest pain
  • Dry eyes

How does alcohol play with lupus? Can you drink with lupus? Alcohol and lupus together is kind of a mixed bag. The main concern is that alcohol can interact negatively with medications that are often prescribed to treat lupus, such as non-steroidal anti-inflammatory drugs (NSAIDs), antimalarials, and corticosteroids. Combining alcohol with these medications can increase the risk of liver complications and stomach bleeding. Alcohol can also amplify the side effects of these meds, making us feel more tired or dizzy.

Does alcohol cause joint inflammation? Alcohol can exacerbate lupus-related skin flares, especially for someone who is sensitive. Plus, alcohol may exacerbate symptoms such as fatigue and joint pain, adding fuel to the lupus fire.

The Verdict: Possible Foe

The lupus-alcohol equation isn't one-size-fits-all. It's about knowledge, understanding your body, and making choices that support your well-being.

3. Multiple Sclerosis and Alcohol: Decoding the Connection

Multiple sclerosis, commonly known as MS, is a chronic autoimmune disease that affects the central nervous system. Once again, the body's defense system gets a bit too overzealous. In this case, it starts damaging the protective covering of nerve fibers (called myelin), leading to communication issues between the brain and the rest of the body.

MS can also lead to a range of symptoms that differ from person to person, but these are some common signs:

  • Fatigue
  • Numbness or weakness in one or more limbs
  • Electric-shock sensations with neck movement
  • Tremors, unsteady gait
  • Vision problems, including double vision or partial vision loss
  • Slurred speech
  • Dizziness

When it comes to MS and alcohol, things can get tricky. MS already stirs up issues with balance and coordination, and — as we all know — alcohol does, too. Plus, alcohol may not play nice with certain MS medications, so that's another hurdle to watch out for.

The Verdict: More Foe Than Friend

Moderate alcohol consumption does not appear to increase the risk of developing MS, nor does it seem to influence disease progression. However, the keyword here, once again, is "moderate." Binge drinking or consistent heavy drinking can have adverse effects on anyone's health, and with MS, the risks might be even more pronounced.

4. Psoriasis and Alcohol: Peeling Back the Layers

Psoriasis is an autoimmune condition caused by accelerated skin cell growth, which causes thick, red, scaly patches to form on the skin. These patches can be itchy and sometimes painful. Imagine the skin's production line going into overdrive, causing a pile-up of cells on the surface. That is psoriasis in action.

Psoriasis can manifest in various forms, but here are some common signs:

  • Red patches covered with thick, silvery scales
  • Itchy, burning, or sore skin
  • Cracked, possibly bleeding skin
  • Thickened, pitted, or ridged nails
  • Swollen, stiff joints (a sign of psoriatic arthritis)

Alcohol and psoriasis can be a tricky combination. Excessive alcohol consumption is known to trigger psoriasis outbreaks for some people. It can also interfere with the body's ability to process and eliminate medications used to treat psoriasis, rendering them less effective.

Moreover, alcohol can dehydrate the body, including the skin, possibly making psoriasis symptoms worse. And, in some cases, alcohol has been known to have an inflammatory effect which may potentially flare up psoriasis patches.

The Verdict: Mostly Foe

Alcohol consumption, especially in excess, can trigger psoriasis flares and worsen symptoms. That’s why it’s essential for those living with this condition to drink mindfully and consider healthier options such as mocktails.

5. Type 1 Diabetes and Alcohol: Playing With Fire

Type 1 diabetes is an autoimmune condition caused by the immune system mistakenly attacking and destroying the insulin-producing beta cells in the pancreas. Insulin allows glucose (sugar) from our food to enter our cells and provide energy. Without enough insulin, glucose builds up in the bloodstream, leading to high blood sugar levels.

Type 1 diabetes has some hallmark symptoms:

  • Frequent urination and excessive thirst
  • Unexpected weight loss
  • Extreme hunger
  • Blurry vision
  • Fatigue and weakness
  • Mood swings

What happens when type 1 diabetes and alcohol mix? This is a pairing that needs careful attention.

Alcohol can interfere with the liver's ability to release glucose, increasing the risk of low blood sugar (hypoglycemia) for those with type 1 diabetes. While it might initially elevate blood sugar, it can drop later on, especially if we’re taking insulin or other diabetes medications.

Additionally, many alcoholic beverages, especially cocktails, contain sugars and carbs that can spike blood sugar levels. It's essential to factor in these carbs as part of our overall daily intake.

Symptoms of hypoglycemia can sometimes mirror the effects of too much alcohol: dizziness, disorientation, and sleepiness. This can make it challenging for those around us to distinguish between intoxication and a medical emergency.

When navigating the alcohol-diabetes combo, keep these points in mind:

  • Stay informed. Know how alcohol affects your blood sugar levels. Monitor it before drinking, while you drink, and for up to 24 hours after drinking.
  • Count your carbs. If your drink has carbohydrates, ensure you account for them in your daily carb count.
  • Avoid drinking on an empty stomach. This can increase the risk of hypoglycemia. Opt for a balanced meal or snack beforehand.
  • Keep your company informed. Make sure someone you're with knows you have diabetes and understands the risk of hypoglycemia.
The Verdict: Foe

Alcohol consumption, especially in excess, can mess with blood sugar and be potentially dangerous for those living with type 1 diabetes. Always consult with a healthcare provider, such as an endocrinologist, before imbibing when living with this condition.

6. Celiac Disease and Alcohol: Sifting Through the Details

Finally, celiac disease is an autoimmune condition triggered by gluten — a protein found in wheat, barley, and rye — that leads to damage in the small intestine when ingested by those who are sensitive to it. The body misinterprets gluten as a harmful invader and prompts the immune system to attack the inner lining of the small intestine, disrupting the absorption of vital nutrients.

Celiac can be a bit sneaky, presenting a wide array of symptoms. These are some of the common signs to look out for:

  • Diarrhea or constipation
  • Abdominal pain and bloating
  • Fatigue and weakness
  • Skin rashes
  • Anemia
  • Joint pain
  • Headaches and migraines

Where does alcohol stand in the world of celiac disease? Here’s the scoop.

The primary concern with celiac disease and alcohol is the source of the alcohol. Many alcoholic beverages, including beers, ales, lagers, malt beverages, and even some hard ciders, contain gluten. Consuming these would be a no-go for someone with celiac disease.

However, pure distilled spirits, even if they're made from wheat, barley, or rye, are considered gluten-free due to the distillation process. This means spirits like vodka, gin, and whiskey might be safe. Similarly, wines and some ciders are naturally gluten-free and safe for most people with celiac disease. But always read labels or check with manufacturers when in doubt.

The Verdict: Not Necessarily a Friend, But Not a Serious Foe

Considering a drink and living with celiac disease? Here's the mantra: be informed and vigilant. Not all alcoholic beverages will label their gluten content, so doing a bit of homework might be necessary. Additionally, always listen to your body; even gluten-free options might not sit well with everyone.

Diagram about the common autoimmune diseases

So … Can You Drink Alcohol With an Autoimmune Disease?

Well, as you can see, there's really no one-size-fits-all answer here. It all depends on the specific autoimmune disease, your overall health, and the type and amount of alcohol consumed. It’s essential to talk to professionals and take all these factors into consideration to make an informed decision.

Stepping Towards a Healthier Lifestyle

As you figure out how alcohol fits into your life — and whether or not it’s ultimately a no-go because of your autoimmune disease — here are some practical steps to navigate this journey:

  • Dialogue with your doctor. Discuss your questions with your healthcare provider, who can provide tailored advice based on your specific condition and treatment plan.
  • Mindful moderation. If given the green light, remember that moderation is key. The CDC defines moderate drinking as up to one drink per day for women and up to two drinks per day for men.
  • Healthy substitutes. Explore non-alcoholic beverages that can still make your evening special. Herbal tea, fruit-infused water, or fancy mocktails can be refreshing alternatives.
  • Support system. Connect with friends, family, or support groups who understand your journey. Shared experiences and understanding make our lives sparkle.
  • Holistic health. Incorporate a balanced diet, regular exercise, and stress management into your routine. Health is all about balance and teamwork: there are lots of moving parts, and it’s up to us to figure out how to best fit them together.

Listening to the Body

All in all, understanding the interaction between autoimmune diseases and alcohol can be tricky, but ultimately it comes down to understanding your body’s unique needs. It requires patience, discernment, and an appreciation for the nuances. And remember —you're not alone!

Whether we're raising a glass of bubbly or a cup of herbal tea, let's toast to knowledge, health, and the confidence to make the best choices for our wellness.

Summary FAQs

1. What are autoimmune diseases?

Autoimmune diseases arise when the immune system mistakenly attacks healthy cells in the body. Examples include rheumatoid arthritis, lupus, type 1 diabetes, psoriasis, and celiac disease.

2. How does alcohol affect autoimmune diseases in general?

Alcohol can have both anti-inflammatory and pro-inflammatory effects, depending on the amount consumed. Moderate alcohol consumption may offer some anti-inflammatory benefits, while excessive drinking can exacerbate inflammation, often worsening autoimmune conditions.

3. Can someone with an autoimmune liver disease drink alcohol?

It's generally advisable for those with autoimmune liver diseases to avoid alcohol, as it can accelerate liver damage.

4. Is it safe for someone with celiac disease to consume alcoholic beverages?

People with celiac disease should steer clear of alcoholic beverages containing gluten, such as most beers and some ciders. However, distilled spirits, even those made from gluten-containing grains, and most wines are considered safe due to the distillation and fermentation processes.

5. How does alcohol interact with type 1 diabetes?

Alcohol can impact blood sugar levels, potentially causing hypoglycemia (low blood sugar). It's vital for individuals with type 1 diabetes to monitor their blood sugar, factor in the carbohydrates from alcoholic drinks, and be cautious about alcohol-induced hypoglycemia symptoms.

6. What should someone with psoriasis consider when thinking about alcohol?

Excessive alcohol consumption can trigger psoriasis flare-ups in some individuals. Additionally, alcohol can interfere with some psoriasis medications and dehydrate the skin, potentially worsening symptoms.

7. How does alcohol affect those with MS (multiple sclerosis)?

While moderate alcohol consumption might not directly impact MS progression, alcohol can intensify certain MS symptoms, such as balance and coordination issues. Moreover, alcohol can interact with medications prescribed for MS.

Take Care of Your Mind and Body With Reframe!

Although it isn’t a treatment for alcohol use disorder (AUD), the Reframe app can help you cut back on drinking gradually, with the science-backed knowledge to empower you 100% of the way. Our proven program has helped millions of people around the world drink less and live more. And we want to help you get there, too!

The Reframe app equips you with the knowledge and skills you need to not only survive drinking less, but to thrive while you navigate the journey. Our daily research-backed readings teach you the neuroscience of alcohol, and our in-app Toolkit provides the resources and activities you need to navigate each challenge.

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The Reframe app is free for 7 days, so you don’t have anything to lose by trying it. Are you ready to feel empowered and discover life beyond alcohol? Then download our app today! 

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At Reframe, we do science, not stigma. We base our articles on the latest peer-reviewed research in psychology, neuroscience, and behavioral science. We follow the Reframe Content Creation Guidelines, to ensure that we share accurate and actionable information with our readers. This aids them in making informed decisions on their wellness journey.
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