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Widely accepted across the world as a pleasurable drink, alcohol is a toxin that greatly distresses the body and can activate a defensive reaction as soon as the first sip hits the tongue. It can also lower the natural defenses, and despite being strongly associated with relaxation, the beverage can wreak havoc on the overall functionality. Even a person with an excellent immune system finds it difficult to escape the effects of drink. For someone battling an autoimmune disease, the impact is not only more intense but also prolonged, typically lasting days and even weeks after a drink.
So far, scientists have discovered more than 80 different types of autoimmune diseases. Some, such as lupus and rheumatoid arthritis, can have widespread effects on the body, whereas others, like psoriasis and diabetes type 1, are more specific. Carefully balancing diet, lifestyle, and medication is crucial for such people to keep the disease in check and lead a healthy life. The relationship between alcohol and autoimmune disease is critical to understand, as alcohol carries the potential to trigger these illnesses, some more than others.
What is an Autoimmune Disease?
An autoimmune disease is when the body mistakenly attacks its own tissue by confusing it with a foreign body, such as germs. There are different types of autoimmune diseases, such as lupus, rheumatoid arthritis, multiple sclerosis, and inflammatory bowel disease. People struggling with any one or more of such illnesses have a weak immune system, and drinking can cause further impairment of the immune cells. The toxins in various alcoholic drinks can also cause the autoimmune disease to become more severe.
National surveys suggest that more than 23.5 million, or approximately 7 percent of the U.S. population, struggle with an autoimmune disease. More than 80 percent of those diagnosed with this illness are women. The prevalence of autoimmune disease is greatly determined by genetics, as one-third of the risk is hereditary. In some people, autoimmune disease may occur based on the ability of their immune system to handle stress. Regardless of what causes an autoimmune disease, a person who has developed it must be cautious about their everyday dietary consumption as it plays a significant role in controlling the symptoms.
Can Alcohol Cause Autoimmune Disease? The Role of Alcohol and Autoimmunity
Many people are confused about whether or not alcohol can affect autoimmune diseases or not. Experts are now convinced that drinking can serve as a factor for autoimmunity that not only contributes to the development of an autoimmune disease but also triggers it.
One of the worst possible effects of drinking in someone with an autoimmune disorder is a heightened inflammatory response. Alcohol acts as a systemic pro-inflammatory agent, especially when consumed in excess. The body produces reactive oxygen species as soon as it detects alcohol in the system, which can be highly unstable and can damage the RNA, DNA, and vital proteins while stimulating an inflammatory response.  This inflammatory response triggers hypoxia, a condition where the oxygen levels drop in the blood, depriving the body’s vital organs and tissues of oxygen. Once hypoxia sets in, the following symptoms may occur:
- Shortness of breath
- Bluish discoloration of skin and lips
Damaged Immune Cells
As mentioned before, an inflammatory response is the earliest response to alcohol consumption. Consequently, the inflammation can significantly damage the body’s immune cells and quickly become chronic, further triggering immune system issues.  Repeated exposure of a body with an autoimmune disease to alcohol can cause permanent dysregulation, setting the foundation for an autoimmune disorder. In people with a diagnosed but controlled autoimmune disease, drinking can cause the body to lose its control over the immune cells and responses, leading to an overreaction.
Lowered Quality of Sleep
Alcohol detrimentally affects the quality of sleep. Research confirms that drinking close to bedtime has been linked to disruption in regular sleep patterns despite the initial sedation it brings. This disruption is because as the body starts metabolizing alcohol, it loses its soothing effects. Moreover, the liver enzymes the body uses to break down alcohol can further interfere with sleep. In the long run, a lack of sleep can impair immunity and negatively affect an immune system’s overall strength and function, which can be highly damaging to a person with an autoimmune disorder. 
How Does Alcohol Affect Autoimmune Disease?
The relationship between alcohol and autoimmune disease can differ based on a person’s current health status, type of autoimmune disorder, and general drinking habits.
Irritable Bowel Syndrome
Also known as IBS, irritable bowel syndrome is one of the most common autoimmune diseases across the United States, with up to 15% of people suffering from it. Due to its high prevalence, the relationship between alcohol consumption and IBS is well-documented. Research shows that heavy drinking can worsen the symptoms associated with IBS, mainly due to alcohol’s effects on the digestive system. Alcohol is known to tamper with the natural microbiome in the gut, which triggers inflammation and causes a flare-up.
Type One Diabetes
Affecting up to 1.6 million individuals in the United States, type one diabetes is characterized by the destruction of the pancreatic cells responsible for synthesizing insulin. Insulin is a natural hormone that controls sugar levels in the blood and prevents them from becoming too high. As people with type one diabetes are unable to secrete insulin, consuming excessive alcohol can be particularly dangerous.
When consumed in moderation, alcohol can increase blood sugar levels, which a person with type one diabetes may struggle to control even with their regular synthetic insulin dose. However, this surge is usually temporary as, in the long run, heavy alcohol consumption often leads to a drop in sugar levels. These fluctuations can be hazardous and potentially deadly if not caught and treated in time.
Rheumatoid arthritis is another autoimmune disorder that targets the joints, leading to warm, tender, and swollen joints and other symptoms like fever, fatigue, joint stiffness, and weight loss. Research shows that drinking moderately is not likely to exacerbate the symptoms of rheumatoid arthritis. However, heavy consumption may overrule this observation and lead to unpredictable flare-ups.
Like other types of autoimmune disorders, lupus develops when the immune cells turn against different body parts they are designed to protect. This disease targets various body parts, including the heart, brain, blood cells, lungs, skin, joints, and kidneys. For people with lupus and alcohol habits, experts advise caution as drinking can negatively interact with the lupus medications, increasing the risk of developing liver complications and internal bleeding. Moreover, drinking can also exacerbate the risk of side effects due to these medications. Some people may also experience flare-ups, particularly in terms of their skin symptoms, due to increased alcohol intake.
Commonly known as MS, multiple sclerosis is a chronic autoimmune disorder that targets the central nervous system through overactivation of the immune system. In this particular disease, the overactivated immune cells target and damage the protective layers of the nerve fibers, known as myelin, causing communication issues between the brain and other body parts. MS can lead to various symptoms that differ from one person to another but generally include fatigue, weakness, numbness in limbs, unsteady gait, tremors, vision problems, etc.
When it comes to alcohol and MS, things can be a bit tricky to navigate. Multiple sclerosis is known to cause issues with coordination and balance, and adding alcohol to the picture exacerbates these problems. Moreover, the combination of alcohol with certain MS medications may also not play nice, and a person using them needs to be cautious to avoid interactions.
Alcohol and Autoimmune Disease: Stepping Toward a Healthier Lifestyle
As you understand the relationship between alcohol and autoimmune disease while navigating how drinking can fit into your life, the following are some tips to achieve and maintain a healthy lifestyle:
Discussion with a doctor
Discuss all questions you have with your healthcare provider and seek tailored advice regarding alcohol consumption based on your specific autoimmune disease and the ongoing treatment plan.
If you receive a green light for drinking, always remember to observe the rule of moderation. National guidelines define moderate drinking as one and two drinks per day for women and men, respectively.
Consider finding non-alcoholic beverages to make your evenings memorable without risking your health. Some examples include fruit-infused water, herbal tea, or non-alcoholic fancy mocktails.
Incorporate regular exercise, a balanced diet, and good stress management into your daily routine. Remember that health combines balance and teamwork; it is up to you to find out how to fit them together perfectly.
Remember that autoimmune disease does not only have physical manifestations but can also negatively impact mental health. Connect with family. Members, friends, or local support groups to find people who understand and support your journey. Finding shared experiences and understanding can make life easier and more manageable.
Can you drink alcohol if you have an autoimmune disease?
There is no one-size-fits-all answer to this question, as it depends on the type of autoimmune disorder, the overall health status, the type and amount of alcohol consumed, etc. The best way to find an answer is by contacting a healthcare professional and seeking tailored advice so that you can make an informed decision.
How can alcohol impact autoimmune disorders in general?
Alcohol can lead to both pro-inflammatory and anti-inflammatory effects, depending on how much a person consumes. Moderate consumption may offer some anti-inflammatory effects, but heavy sessions can exacerbate inflammation and worsen the underlying autoimmune conditions.
Should a person with an autoimmune liver disease drink?
Experts generally recommend people with an autoimmune liver disease to abstain from drinking as their liver is already prone to damage, and alcohol can accelerate this damage.
Is it safe for a person struggling with celiac disease to consume alcohol?
People with celiac disease are generally advised to avoid alcoholic beverages with gluten. Gluten is a common ingredient in many beers and ciders, but some distilled spirits and wines may be safer options. Because gluten is a trigger for celiac disease, be mindful about the type of alcohol you drink.
What should I remember when drinking if I have psoriasis?
Remember that alcohol consumption may cause a flare-up in some people. In others, it may interact with their regular psoriasis medications while dehydrating the skin and worsening symptoms.
How does alcohol affect people with multiple sclerosis?
While alcohol may not directly impact the progression of MS, it can intensify the symptoms, such as issues with coordination and balance. Moreover, it can cross-react with certain medications used to manage MS.
What is the best alcohol for autoimmune disease?
So far, there is no drink perfectly safe for people with autoimmune disorders. However, experts generally consider clear liquors mixed with soda water and polyphenol-rich dry red wine as more favorable options. However, a doctor must be consulted before consuming any of these alcoholic drinks, as their effects may vary from one person to another.
1 Wang HJ, Zakhari S, Jung MK. Alcohol, inflammation, and gut-liver-brain interactions in tissue damage and disease development. World journal of gastroenterology: WJG. 2010 Mar 3;16(11):1304.
2 Iddir M, Brito A, Dingeo G, Fernandez Del Campo SS, Samouda H, La Frano MR, Bohn T. Strengthening the immune system and reducing inflammation and oxidative stress through diet and nutrition: considerations during the COVID-19 crisis. Nutrients. 2020 May 27;12(6):1562.
3 Besedovsky L, Lange T, Born J. Sleep and immune function. Pflügers Archiv-European Journal of Physiology. 2012 Jan;463(1):121-37.