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How Your Body Handles Alcohol

Updated: Aug 26, 2023

Tis' the season for parties and celebrating the holidays which probably means drinking more alcohol too. So how does this affect your body? What happens metabolically? How does the body actually break down alcohol? What is a hangover and how can we get rid of it?? And for those that track their calories/macros, how does alcohol affect my tracking and my waistline!?

Alcohol is metabolized/broken down mainly in the liver, but some does occur in the pancreas, brain, and GI tract causing damage to those cells and tissues over time with consistent alcohol consumption.

Constant brain fog anyone?

Because alcohol is a toxin, the body needs to prioritize the breakdown and elimination of it. This can impair the digestion of any food consumed while you're drinking. This can contribute to bloating, indigestion, acid reflux, constipation or diarrhea the next day, and other GI issues.

During moderate consumption:

Ethanol (AKA alcohol), is broken down into acetaldehyde which is highly toxic and carcinogenic for the body so it's quickly metabolized to acetate. This is a less toxic substance that the body further breaks down into acetyl-CoA which can be used for other metabolic processes. Acetyl-CoA can go on to make glucose, fat, or ketone bodies that our bodies use for energy. So, this isn't so bad, but remember this is for MODERATE consumption which the CDC deems as 1 drink per day for women and 2 drinks per day for men.

During excessive consumption:

The body needs to recruit other enzymes to help speed up the breakdown of ethanol. This can result in excessive oxidative damage from the production of NADP+ and NAD+, free radicals. These free radicals needs to be reduced (getting rid of the + charge by adding a hydrogen) quickly back to NADPH and NADH in order to minimize the effects of free radical damage. (This is why chronic alcohol consumption can contribute to cancer.) The body does what it can but the more your drink the more you put yourself at risk for low blood sugar complications, elevated fat, lactic acid, and uric acid in your blood, impaired glucose metabolism, and fatty liver.

So what makes you feel drunk?

That's acetaldehyde, the toxic byproduct of alcohol which doesn't stick around long but it's around long enough to affect various organs including your brain.

Thanks but I already knew that... But let's recap alcohol metabolism using this photo:

  1. Dehydration and electrolyte imbalances- alcohol increases urine output because it's a diuretic. This pulls water out of the body along with sodium and potassium. This can also lead to either diarrhea or constipation depending on if you have food in your system or other fluids you drank.

  2. Alcohol increases acid release in the stomach which causes stomach pain and GI distress.

  3. Exposure to acetaldehyde causes total body inflammation. Ever wake up feeling puffy from drinking too much?

  4. People may fall asleep faster after a night of drinking but overall, sleep is fragmented, meaning you'll wake up frequently, won't hit deep sleep enough, and this contributes to fatigue and awful headaches the next day.

Hangover symptoms peak when the blood alcohol concentration in the body returns to about zero. So, How do we cure a hangover?


  • A person must wait for the body to finish clearing the toxic byproducts of alcohol metabolism, to rehydrate (so drink lots of water), to heal irritated tissue, and to restore immune and brain activity to normal.

  • Drinking coffee, taking a shower, or having another drink the next morning will NOT cure a hangover.

  • Medications like Tylenol and Motrin can help with the headaches but also do contribute to liver toxicity and your liver has already done so much so if you can forego the meds, give your liver a break!

  • Some people turn to electrolyte drinks or even IV therapy which may feel helpful but research has not found a clear correlation between the impact of added electrolytes on hangover severity. The body will restore it's electrolyte balance once the effects of alcohol subside. (Personally I think it can't hurt, right?)

Thanks for the science! Now how is alcohol affecting my caloric intake?! Alcohol is considered the fourth macronutrient coming in at 7 calories per gram. Protein and carbs are 4 cals/gram, Fat is 9 cals/gram. So, yes, alcohol does contribute to fat gain since it has calories and does impact energy production in the body. Because alcohol is not regulated by the FDA, nutrition labels are not required to be on alcoholic beverages. Alcohol is regulated by the Alcohol and Tobacco Tax and Trade Bureau so they would need to mandate the use of nutrition labels but they don’t despite people fighting them on it. Some companies do display the caloric content and brag about how low carb their drinks are. Like Mic Ultra only having 2.6 carb, but we know this isn't true because 2.6 carb = 10.4 calories but a mic ultra has 95 calories so what about the remaining 84.6 calories?? Those calories have to be accounted for when tracking your macros/calories whether or not the FDA or TTB even recognize them. "But why don’t they?!" Well there’s a discrepancy in carb calculations... all alcohol is basically fermented sugars of some sort... Vodka is usually potatoes. Wine is various grapes. Tequila is the agave plant. Gin is juniper berries and botanicals. Whiskey can be barley, corn, rye, and wheat. So the carbs present in the beverage AFTER fermentation are generally counted as the carbs in the beverage. This accounts for the leftover sugars that were not eaten by the yeast but does NOT account for the yeast still present in the beverage. Those are the remaining calories NOT accounted for on the labels. So generally it’s safe to count alcohol as either CARBS or FATS when and if you are tracking you macros, since tracking apps like MFP don't have an alcohol tracking section.

For example, let's say you want to factor in a glass of wine:

5oz glass of white wine = 120cals. 120 / 4 = 30 grams of carbs. 120 / 9 = 13.3 grams of fat. Or you can do a mix of carbs and fats to account for the 120 calories which would look like 7g fat and 15g carbs = 120 calories. It’s a sad reality, I know, and might not be worth it considering how toxic alcohol is to the body. But I definitely indulge in this toxin now and then!

I hope you learned something from this article and I hope it helps you make healthier decisions in the future regarding having a few drinks! No shame in indulging every now and then but I think it's helpful to know the science behind an alcoholic beverage and the implications of it!

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