The bottom line of laboratory research studying the use of fish oil for preventing liver damage caused by high alcohol consumption is that taking large amounts of fish oil slows down, but does not eliminate, alcohol-induced changes induced by heavy consumption of alcohol. It is especially beneficial for people who are also exposed to:
- Solvents, especially acetone and toluene,
- Anesthetics, especially enflurane, halothane, and isoflurane,
- Muscle relaxants,
- Asthma inhalers, and
- Medications for gastroesophageal reflux disease, heartburn, and tuberculosis.
Fish oil helps the liver preserve an enzyme that is especially vulnerable to side effects from the combination of alcohol and any of these substances. Anyone with a history of alcoholism should take 2 to 5 grams of fish oil (2 to 5 capsules) every day.
But fish oil is not the only nutritional intervention available for alcoholics in recovery. In fact, I would suggest that the first nutritional change for alcoholics in recovery should be eating more of the nightshade vegetables such as tomatoes, potatoes, and peppers.
Nightshades for Recovery
If you read the literature of holistic nutrition, you'll probably come across a lot of references to vegetables in the nightshade family as being somehow evil and poisonous. Actually, tomatoes were once known as "love apples," and not in a good way. A tomato was thought to deliver just enough of a poison to make its eater vulnerable to romantic seduction. Peppers, potatoes, and eggplants were not associated with romantic seduction or poisoning a rival, but most holistic health experts don't recommend them for most conditions. Recovery from alcoholism is an exception to the holistic rule.
The way these vegetables amplify the disease process in some conditions is through their content of solanine. Found in tiny amounts in eggplant, peppers, tomatoes, potatoes, and tobacco products, this plant chemical can cause inflammation. In active alcoholics and alcoholics in recovery, however, solanine activates some of the enzymes needed to detoxify alcohol and that are depleted by long-term heavy drinking. Moreover, these vegetables concentrate a mood-stabilizing mineral known as lithium.
Just how important is lithium in recovery from alcoholism? It turns out that regions that have the highest concentrations of lithium in tap water and local vegetables have the lowest rates of alcoholism and alcohol-related psychiatric disease. It is more important to control drinking than it is to start eating more pico de gallo and ratatouille, but eating these vegetables daily often makes an observable difference in the ability to deal with psychological issues surrounding alcoholism.
Healing the Liver by Eating Less Sugar and Fat
Another generally overlooked method of healing liver damage after years of heavy drinking is simply eating less sugar and fat. If you can avoid the Twinkies, Ding Dongs, and cellophane-packaged sweet treats that many people with alcohol issues make the mainstay of their diet, you will also avoid the inflammatory fatty acids found in the soybean oil, corn oil, and shortening used to make them. Your liver will be able to use the anti-inflammatory fatty acids provided by fish oil and healthy fats in your diet (if you actually eat any) greatly reducing liver damage caused by alcohol.
Nutritional Supplements That Help You Take Back Control Over Drinking
When people who have alcohol issues are getting at least some vegetables in the form of peppers, tomatoes, potatoes, and eggplant every day, and preferably a whole more than just these nightshade vegetables, and they have cut back on junk food, then there is a combination of supplements that help most alcoholics stay in control over their drinking. The combination is:
- 5-HTP: 400 mg daily.
- L-glutamine: 500-600 mg daily. (This is the minimum dose that is commercially available in the United States. A smaller dose would be sufficient.)
- DL-phenylalanine (a mixture of D- and L-phenylalanine): 1,500 mg daily.
- Pyridoxal-5'-phosphate (activated vitamin B6): 200 mg extended-release tablet.
Why do I recommend these supplements?
- 5-HTP is a source of a form of the amino acid tryptophan that can easily enter the brain. The brain converts tryptophan into serotonin, which reduces carbohydrate craving and improves the quality of sleep.
- L-glutamine helps the brain produce a chemical known as gamma-aminobutyric acid (GABA), which induces sleep.
- D-phenylalanine, a component of DL-phenylalanine, decreases alcohol craving by increasing the production of the reward chemical enkephalin in the brain. L-phenylalanine increases production of another reward chemical, dopamine, as well as a stimulant hormone, noradrenaline. This reduces depression.
- Pyridoxal-5'-phosphate, the activated form of vitamin B6, helps the gastrointestinal tract absorb amino acids. Alcoholics usually have a vitamin B6 deficiency.
Compared to the long-term effects of heavy drinking, any potential side effects of these five supplements are quite mild, but people who take prescription drugs must use caution.
Avoid 5-HTP if you take antidepressants or St. John’s wort. The combination can cause an unhealthy elation or euphoria known as serotonin syndrome.
L-glutamine does not react in any detrimental ways with prescription drugs, although people with bipolar disorder should only use it under supervision of a physician who is knowledgeable of nutritional supplements (such as a naturopathic physician). In very rare cases, L-glutamine has been associated with "switching" from depression to mania.
Phenylketonurics and people taking one of the older-style MAOI antidepressants such as imipramine (Tofranil) should not take phenylalanine. The combination can also cause elation or euphoria with impaired judgment. If you have high blood pressure, check your blood pressure every day when taking phenylalanine. Discontinue the supplement if your blood pressure is unusually elevated (by more than 10 mm/Hg for either the higher or lower number).
Pyridoxal-5'-phosphate can interact with prescription drugs for arrhythmia, asthma, epilepsy, Parkinson’s disease, and tuberculosis, increasing their toxicity. So can vitamin B6.
Once you have gotten off a junk food diet, started taking the supplements that change your brain so you won't feel as great a need to drink, then you should take supplements to help repair the damage done by long-term heavy drinking.
- L-carnitine: 500 mg twice a day.
- Magnesium: 250 mg with breakfast and in the afternoon.
- Selenium: 200 micrograms per day.
- Vitamin A: Only 5,000 IU per day.
- Vitamin B: Any complete supplement (providing the RDA of all B vitamins), 3 times a day.
- Vitamin C: 1,000 mg twice a day with meals.
- Vitamin E: 400 IU per day.
- Zinc picolinate: 30 mg per day.
You won't need to take these supplements forever. You will probably correct any long-term nutritioal deficiencies in six months to a year. Why is each of these supplements important?
L-carnitine: Excessive alcohol consumption impairs the liver’s ability to synthesize the amino acid L-carnitine. This amino acid is critical for the ability of the heart and the skeletal muscles to make energy from fatty acids during times of oxygen deprivation or other kinds of stress.
L-carnitine helps protect the brain from tissue degeneration similar to that in Alzheimer’s disease. L-carnitine helps protect against alcohol-induced fatty liver disease. It helps your liver process dietary fat, increases the production of HDL (“good”) cholesterol, and lowers triglycerides.
Magnesium: Some researchers believe that magnesium deficiencies are what cause the withdrawal symptom known as delirium tremens (DT), a terrifying combination of uncontrollable shaking and hallucinations. Magnesium deficiency is likely to be the major reason heavy drinkers are a high risk for heart disease.
Chances are that you need magnesium, but you don't want to overdose it. In addition to its role as a dietary supplement, magnesium is part of the active ingredient in milk of magnesia, the laxative.
You should also avoid taking magnesium while you are on any antibiotic. Magnesium reduces the body’s absorption of most antibiotics. Eating green beans, rhubarb, spinach, or sweet potatoes within 2 hours of taking magnesium keeps your body from absorbing the supplement, so my suggestions is that unless you eat green beans, rhubarb, spinach, or sweet potatoes for breakfast or on your coffee break, take magnesium with breakfast and in the afternoon.
Selenium, vitamin C, and vitamin E. Selenium, vitamin C, and vitamin E are antioxidants that prevent destruction of liver cells. Taking these antioxidants before you drink moderates the toxic effects of alcohol on the liver and helps prevent fatty liver. Selenium is better absorbed if it is not taken at the same time as vitamin C.
Vitamin A and Zinc. Vitamin A and zinc deficiencies produce the major complications of alcohol abuse: poor night vision, slow healing of wounds to the skin, depressed production of testosterone and estrogen, and poor immune function. Alcohol interferes with the ability of the intestine to absorb vitamin A and zinc, and the liver’s constant need to manufacture the detoxifying enzymes alcohol dehydrogenase and acetaldehyde dehydrogenase depletes the vitamin A and zinc that make it through the intestines.
Tissue damage makes it impossible for the liver to store these nutrients or to process them in large quantities. Only consistent, low-dose supplementation can correct this problem as long as you drink.
And What Else Can Help You Control Your Urges to Drink?
Many alcoholics in recovery do just great until they get some kind of muscle injury or they have a flare-up of arthritis. Any kind of steroid drug can increase the urge to drink.
Many alcoholics do well until they try to stop smoking, too. The nicotine in tobacco smoke slows down the transit of food through the stomach and small intestines, giving the gut more opportunities to absorb nutrients. When alcoholics give up smoking, they suffer temporarily nutritional shortages.
The solution is not to keep on smoking. You can compensate for the withdrawal of nicotine by (1) avoiding bitter foods and (2) eating sour foods, like a vinegar and dressing on a salad or pickles, at the beginning of a meal. This slows down digestion so you absorb more nutrients, and you experience less nutritional stress.
If you get the "munchies" all the time, and you don't smoke pot, the problem may be that your brain is not absorbing tryptophan. Higher sugar levels help the brain absorb this amino acid used to make the feel-good brain chemical serotonin. Another way to help your brain get more tryptophan so it can make more serotonin is to take 5-HTP. If you find yourself craving chips, cookies, sugar-sweetened beverages, and packaged sweet treats, try 5-HTP.
Recapping the Program
This is a lot of information. Nobody puts it all into operation in just one day. Here is a quick review of the steps.
Step 1. Start taking 3 to 5 capsules of fish oil every day to help your liver deal with toxic overload.
Step 2. Start eating vegetables, at least hot peppers, tomatoes, and potatoes. It helps not to eat your potatoes as French fries, not just because of the fat fries absorb, but also because high heat breaks down the solanine, which in some cases, is paradoxically helpful for liver health.
Step 3. Take the five supplements that help you get control over your drinking. If you can't find pyridoxal-5'-phosphate, take 400 mg of a regular vitamin B6 supplement. You may benefit from these supplements over the long term.
Step 4. Replace the nutrients that alcohol has taken from your system. You will probably only need these supplements for six months to a year.
Frequently Asked Questions
Q. If someone can only make only one change in diet and take only one supplement, what would you recommend?
A. If you are an American, I would say at least eat chips and salsa or chips and pico de gallo (chopped tomatoes, onions, and peppers) instead of cellophane-packaged snack treats and candy bars. If you live in another part of the world, I would suggest finding one vegetable that you enjoy.
If you can only take one supplement....well, how about two really inexpensive supplements? Fish oil and vitamin B make the biggest difference. The complete nutritional program can make a huge difference.
Q. Are there any brands of fish oil that are better than others?
A. If you have bipolar disorder or schizophrenia, take a supplement that is higher in the EPA component of fish oil rather than the DHA component, such as Omega-Brite. If you have cardiovascular concerns, then I would recommend a brand of fish oil that contains more DHA than EPA, such as Xtend-Life.