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Comment by sgt101 | Hacker News Reader

I am no MD - but I am curious, perhaps someone who has a clue can comment on what I am going to say.

I believe that Liver Cirrhosis is caused by scaring due to fat being retained in the liver. I understand that fat is retained when the liver is metabolizing alcohol, and that if this is a short term thing then the liver can expel the fat and no scaring occurs. But if you persistently force your liver to metabolize alcohol scars appear and this is irreversible - the scarred part of the liver cannot recover and provides no function from this point.

My question is, what is the amount of time that you should leave for the liver to have cleared alcohol and how long would it take for fat to be expelled?

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I‘ve heard that 6 weeks without a drop of alcohol should be sufficient for the liver to recover. But it is very important to very strictly not consume alcohol. Just reducing alcohol a little bit will help nothing.

The NHS is of the opinion that 2 weeks suffice.

https://www.nhs.uk/conditions/alcohol-related-liver-disease-...

It's been shown (in rats) that saturated fats are protective against cirrhosis and unsaturated fats (linoleic acid in this case) are required for liver injury.

Might explain why some people can drink like fish and have perfectly healthy livers while others suffer badly.

https://pubmed.ncbi.nlm.nih.gov/2915600/

Just listened to a Revisionist History episode that called out the harms of over-consumption of linoleic acid. Apparently the shift away from animal and towards vegetable oils in the '70s and '80s caused a lot of adverse health effects because we now consume multiples of the amount of linoleic acid that we did in previous generations.

Podcast: https://blog.simonsays.ai/the-basement-tapes-with-malcolm-gl...

(Somewhat biased, but still a good summary of the research) article on linoleic acid: https://theecologist.org/2014/feb/24/linoleic-acid-overwhelm...

Unfortunately, at least according to Wikipedia, linoleic acid is an essential fatty acid so avoiding it is less of an option.

Edit: More info: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3650500/

The example I gave got my dad and me into discussion about what is the effect of choice of alcohol which a person (mis)uses excessively, on the probability and severity of alcoholism related illnesses. To put it bluntly, is getting frequently drunk from beer/wine less harmful long term than getting drunk from spirits?

That’s a great question. As a fellow non-MD I can only speculate too. But my guess would be that assuming you balanced the quantities of alcohol consumed EXACTLY then it’d be better to drink whisky or vodka than beer, since you’d end up consuming fewer calories per “unit” of alcohol overall. However, I think it’s also much easier to go overboard with the whisky given how small each measure is and how quickly it’s possible to drink it if you’re not paying attention. So it’s hard to say.

I think deep down we know when we are at the level of problem-drinking, whether that’s with whisky, vodka, beer, wine or anything else. It’s about facing up to it at that point and not trying to deny or justify it. This is coming from someone who drank more than usual during covid isolation and thankfully scaled it back when I realised I was waking up feeling awful every other day.

Would the damage depend on the pacing ? I recall reading an opinion that spirits are more harmful because they ramp up one's blood alcohol level more quickly, and this in and of itself causes a particular harm.

Not an MD, but in my experience this seems a question that MDs don't like to answer - for good reason. (I.e. if I understood your question correctly)

There is so much individuality involved (genetics, history, liver health in general), and so much "it depends" (amount of alcohol, size of liver, food intake, ...) that you cannot possibly stick a definitive number to that question.

Also, the question seems dangerous: What are you going to do with an answer? Drink to a certain limit, in good conscience?

> What are you going to do with an answer? Drink to a certain limit, in good conscience?

I'm doing that already.

EDIT: I realized that I am maybe a little sensitive, and the question could be read the other way round, giving the liver enough time to recover between two occasional (small) intakes. That is actually an interesting question.

Leaving original answer (but please don't be triggered by me failing to read the question correctly):

And you're free to do so.

But don't expect an absolution from a health professional, in the form of a number that is "always entirely safe, under all circumstances".

Alcohol is essentially a poison for the body, which he can tolerate quite well in respectable amounts, compared to other toxins (we can actually "buffer" a certain amount AFAIK).

But talking about lesions in liver tissue growing back without scarring or long-lasting consequences is really out of the safe zone if you ask me. So your questions is clearly rubbing me the wrong way.

Also, sometimes your liver can be weakened or inflamed (without you realizing), and then obviously every drop counts.

Thank you for trying to answer in good faith!

I will say that early in my life I saw some extremely healthy and clean living friends killed by events and disease and I learned that we all only have a short time to live, despite the promises and absolutions we might get from doctors or priests. However, there is a difference between taking some risks and risking your life - and I guess that exploiting drugs, and sex, and rock and roll for pleasure can be in either category.

There isn't a safe zone - even complete abstinence isn't safe....

It's interesting to think what change in attitude and advice the existance of a "safe zone" would create - if medicine could really save us (allow us to live reliably much longer), if only we didn't do silly things. I sometimes think that a lot of folks operate as if that were true now, and get shocked when it turns out that it isn't. There are so many stories that start with "he used to run three times a week, never smoked and then..."

There is a saying where my folks are from: "Dying from fear of death will just as well kill you".

But what I learned the last few years is that I don't miss the things that I thought were "living" when I was young. Drinking or "Nights out" is one of them. Also: Everything "Internet" (Netflix, Youtube, News, ...). Especially when it actually hinders me from experiencing life (it will steal your day).

That does not mean I regret anything. I made my experiences, everyone should, I think this is an important part of growing up for a lot of people.

Nowadays, eating healthy/well, exercise, etc. are the things that make me feel more alive and well - these are the things that make life "better".

But also I have two small kids, so there is no time and space for all these "silly things". And for the same reason I eat to much crap and don't exercise nearly enough for my taste. And I watch way too much YouTube.

Moral: Do your best and try to enjoy it. Nobody can tell you if the bus is waiting for you the next corner. But wether it changes anything if you are drunk at the time is up to you.

Another reason is that MD are not simultaneously experts on nutrition and alcohol. What are exacts safe amounts for this or that is not all that large part of their education.

> Also, the question seems dangerous: What are you going to do with an answer? Drink to a certain limit, in good conscience?

That is actually useful question with useful answer.

Not a medical professional either, but I once heard that keeping 2 consecutive days out of every week alcohol free as sufficient for preventing liver cirrhosis.

This is promoted as a minimum, generally the advice here in the UK right now seems to be "leave more alcohol-free days",

The medical establishment here seems to frown on the "glass of wine every night" habit these days, in favour of having a few drinks a couple of times a week (if you must drink).

I honestly lose track of what's good and bad for you on any given day.

You would need to stop less frequently and for a longer interval to see health benefits.

For heavy drinkers stopping and starting every week would cause withdrawals, which is dangerous and often worse than consistent heavy drinking. Weekend Warriors are actually doing a lot of damage to their body for this reason.

What makes withdrawals dangerous?

Alcohol is a very strong depressant, your nervous system will adjust to it and will be over stimulated if you cut it off abruptly. A minor symptom of this would be anxiety... severe symptoms could be psychosis, seizures or death. https://en.wikipedia.org/wiki/Alcohol_withdrawal_syndrome

There is also a positive feedback effect called Kindling, from sudden withdrawals, which makes subsequent ones worse. https://en.wikipedia.org/wiki/Kindling_(sedative%E2%80%93hyp...

This makes little sense. I can drink 6 bottles a day, but as long as I respect the lord on the weekend my liver’ll be ok?

I think that there is another factor - extreme abuse!

It seems pretty obvious from even a casual acquaintance with alcohol that consuming 10 units in a sitting (one or maybe two bottles by the OP's rating depending on the Georgian sizing and strengths) is extremely bad for you. Anything that steals your sleep and leaves you feeling sick with a headache is kinda self evidently bad - right?

Best stick to drinking the contents…

The molten glass really coats the throat.

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