Headache. Jitters. Upset stomach. Symptoms of alcohol withdrawal
can be worse than a hangover—but help is available. According to research or other
evidence, the following self-care steps may be helpful:
Seek support
Join a community support group like Alcoholics Anonymous to
support recovery from alcohol abuse
Work with a specialist
When withdrawing from alcohol, don’t risk your health; find
a healthcare provider who is knowledgeable about alcohol detoxification
Diet right
To improve health and reduce alcohol cravings, eat more whole
grains, fruit, and other healthful foods, and limit sugar, caffeine, and junk food
Mix in a multi
Take a daily multivitamin to speed recovery from common
alcohol-related deficiencies
Try milk thistle
420 to 600 mg of an extract from this herb can help the liver
recover from the effects of alcohol
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full alcohol withdrawal article
for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
Alcohol withdrawal is a set of symptoms that occur with the elimination of alcohol when a
person is psychologically and/or physiologically addicted to it.
A majority of people who have been drinking alcohol and decide to stop (often for
health-related reasons) are able to do so without much trouble. Alcohol withdrawal typically
becomes difficult only when problem drinkers—alcoholics—attempt to quit. Almost
inevitably, alcoholics need help in achieving this goal. Sometimes, this help requires medical
intervention in detoxification centers.
Finding doctors who work with alcohol detoxification is often as easy as calling the local
chapter of Alcoholics Anonymous (AA) and asking for referral information. Most programs
successful in getting alcoholics to quit drinking are either part of the AA network or employ
AA techniques. Natural approaches to alcohol withdrawal should not be a substitute for detox
centers or for AA or AA-related programs.
Reliable
and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies
suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal
or no scientific evidence. For a supplement, little scientific support and/or minimal health
benefit.
What are the symptoms?
A person typically has a mild to severe hangover that lasts several days. Symptoms may
include stomach upset; headache; shakes or
jitters; feelings of generalized anxiety or
panic attacks; and insomnia that may be
accompanied by bad dreams. There may be also be increases in heart rate, breathing rate, and
body temperature. In a small proportion of alcoholics, withdrawal may result in severe
symptoms, such as hallucinations, delirium tremens (DTs), or generalized seizures.
Dietary changes that may be helpful
Some of the nutritional deficiencies associated with alcoholism can be caused by a poor
diet—a factor that needs correction on an individual basis. Improving the overall diet
should be done in conjunction with a doctor. Sometimes liver or pancreatic disease associated with alcoholism
also contributes to nutritional deficiencies. These problems require medical assessment and
intervention.
In one trial, a hospital diet was compared with a special diet including fruit and wheat germ and excluding caffeinated coffee, junk food, dairy products, and peanut butter.1 After six months, fewer
than 38% of those on the hospital diet remained sober, compared with over 81% of those eating
the special diet. A review of the research shows that diets loaded with junk food increase
alcohol intake in animals.2 In a human trial, restricting sugar, increasing complex carbohydrates, and
eliminating caffeine also led to a reduction
in alcohol craving.3 While the support for dietary intervention remains somewhat
unclear, some doctors suggest that alcoholics reduce sugar and junk food intake and avoid
caffeine.
Lifestyle changes that may be helpful
Most experts agree that alcoholics must stop drinking completely in order to overcome the
addiction. Moreover, before nutritional supplements can be used, effective treatment of the malabsorption problems requires a complete
avoidance of alcohol.
Other therapies
Further treatment includes adequate nutrition, fluid intake, and rest.
Vitamins that may be helpful
Many alcoholics are deficient in B vitamins, including vitamin B3. John Cleary, M.D., observed that some
alcoholics spontaneously stopped drinking in association with taking niacin supplements
(niacin is a form of vitamin B3). Cleary concluded that alcoholism might be a manifestation of
niacin deficiency in some people and recommended that alcoholics consider supplementation with
500 mg of niacin per day.4 Without specifying the amount of niacin used,
Cleary’s preliminary research findings suggested that niacin supplementation helped wean
some alcoholics away from alcohol.5 Activated vitamin B3 used intravenously has
also helped alcoholics quit drinking.6 Niacinamide—a safer form of the same
vitamin—might have similar actions and has been reported to improve alcohol metabolism
in animals.7
Deficiencies of other B-complex vitamins
are common with chronic alcohol use.8 The situation is exacerbated by the fact that
alcoholics have an increased need for B vitamins.9 It is possible that successful
treatment of B-complex vitamin deficiencies may actually reduce alcohol cravings, because
animals crave alcohol when fed a B-complex-deficient diet.10 Many doctors recommend
100 mg of B-complex vitamins per day.
Alcoholics may be deficient in a substance called prostaglandin E1 (PGE1) and in
gamma-linolenic acid (GLA), a precursor to PGE1.11 In a double-blind study of
alcoholics who were in a detoxification program, supplementation with 4 grams per day of evening primrose oil (containing 360 mg of GLA)
led to greater improvement than did placebo in some, but not all, parameters of liver
function.12
The daily combination of 3 grams of vitamin
C, 3 grams of niacin, 600 mg of vitamin B6, and 600 IU of vitamin E has been used by researchers from the
University of Mississippi Medical Center in an attempt to reduce anxiety and depression in alcoholics.13 Although the
effect of vitamin supplementation was no better than placebo in treating alcohol-associated
depression, the vitamins did result in a significant drop in anxiety within three weeks of
use. Because of possible side effects, anyone taking such high amounts of niacin and vitamin
B6 must do so only under the care of a doctor.
Although the incidence of B-complex deficiencies is known to be high in alcoholics, the
incidence of other vitamin deficiencies remains less clear.14 Nonetheless,
deficiencies of vitamin A, vitamin D, vitamin E, and vitamin C are seen in many alcoholics. While some
reports have suggested it may be safer for alcoholics to supplement with beta-carotene instead of vitamin A,15
potential problems accompany the use of either vitamin A or beta-carotene in correcting the
deficiency induced by alcoholism.16 These problems result in part because the
combinations of alcohol and vitamin A or alcohol and beta-carotene appear to increase
potential damage to the liver. Thus, vitamin A-depleted alcoholics require a doctor’s
intervention, including supplementation with vitamin A and beta-carotene accompanied by
assessment of liver function. Supplementing with vitamin C, on the other hand, appears to help
the body rid itself of alcohol.17 Some doctors recommend 1 to 3 grams per day of
vitamin C.
Kenneth Blum and researchers at the University of Texas have examined neurotransmitter
deficiencies in alcoholics. Neurotransmitters are the chemicals the body makes to allow nerve
cells to pass messages (of pain, touch,
thought, etc.) from cell to cell. Amino acids
are the precursors of these neurotransmitters. In double-blind research, a group of alcoholics
were treated with 1.5 grams of
D,L-phenylalanine (DLPA), 900 mg of
L-tyrosine, 300 mg of L-glutamine, and 400
mg of L-tryptophan (now available only by prescription) per day, plus a multivitamin-mineral supplement.18 This
nutritional supplement regimen led to a significant reduction in withdrawal symptoms and
decreased stress in alcoholics compared to the effects of placebo.
The amino acid, L-glutamine, has also been
used as an isolated supplement. Animal research has shown that glutamine supplementation
reduces alcohol intake, a finding that has been confirmed in double-blind human
research.19 In that trial, 1 gram of glutamine per day given in divided portions
with meals decreased both the desire to drink and anxiety levels.
Alcoholics are sometimes deficient in
magnesium, and some researchers believe that symptoms of withdrawal may result in part
from this deficiency.20 Nonetheless, a double-blind trial reported that magnesium
injections did not reduce symptoms of alcohol withdrawal.21
Because of the multiple nutrient deficiencies associated with alcoholism, most alcoholics
who quit drinking should supplement with a high-potency multivitamin-mineral for at least
several months after the detoxification period. Whether or not the supplement should include
iron should be discussed with a doctor.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Milk thistle extract is commonly
recommended to counteract the harmful effects of alcohol on the liver.22 Milk
thistle extracts have been shown in one double-blind study to reduce death due to
alcohol-induced cirrhosis of the
liver,23 though another double-blind study did not confirm this
finding.24 Milk thistle extract may protect the cells of the liver by both blocking
the entrance of harmful toxins and helping remove these toxins from the liver
cells.2526 Milk thistle has also been reported to regenerate injured
liver cells.27
Kudzu is most famous as a quick-growing
weed in the southern United States. Alcoholic hamsters (one of the few animals to become so
besides humans) were found to have decreased interest in drinking when fed kudzu
extract.28 Traditional Chinese medicine practitioners generally recommend 3 to 5
grams of root three times per day; some herbal practitioners also suggest that 3 to 4 ml of
tincture taken three times per day may also be helpful to reduce alcohol cravings.
Nonetheless, a double-blind trial using 1.2 grams of powdered kudzu root twice per day failed
to show any benefit in helping alcoholics remain abstinent from alcohol.29 On the
other hand, supplementing with a kudzu extract (1,000 mg three times a day for seven days)
significantly reduced the amount of beer consumed by heavy alcohol drinkers in a short-term
experiment.30
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
1. Guenther RM. Role of nutritional therapy in alcoholism treatment.
Int J Biosoc Res 1983;4:5–18.
2. Werbach MR. Alcohol craving. Int J Altern Complementary Med
1993;July:32.
3. Biery JR, Williford JH, McMullen EA. Alcohol craving in
rehabilitation: assessment of nutrition therapy. J Am Diet Assoc
1991;91:463–6.
4. Cleary JP. Etiology and biological treatment of alcohol addiction.
J Neuro Ortho Med Surg 1985;6:75–7.
5. Smith RF. A five-year field trial of massive nicotinic acid therapy of
alcoholics in Michigan. J Orthomolec Psychiatry 1974;3:327–31.
6. O’Halloren P. Pyridine nucleotides in the prevention, diagnosis
and treatment of problem drinkers. West J Surg Obstet Gynecol
1961;69:101–4.
7. Eriksson CJP. Increase in hepatic NAD level—its effect on the
redox state and on ethanol and acetaldehyde metabolism. Fed Eur Biochem Soc
1974;40:3117–20.
8. Baker H. A vitamin profile of alcoholism. Int J Vitam Nutr
Res 1983;(suppl 24):179.
9. Schuckit MA. Alcohol and Alcoholism. In: Fauci AS, Braunwald E,
Isselbacher KJ, et al, eds, Harrison’s Principles of Internal Medicine, 14th
ed. New York: McGraw-Hill, 1998, 2503–8.
10. Norton VP. Interrelationships of nutrition and voluntary alcohol
consumption in experimental animals. Br J Addiction 1977;72:205–12.
11. Horrobin DF. Essential fatty acids, prostaglandins, and alcoholism:
an overview. Alcohol Clin Exp Res 1987;11:2–9.
12. Glen I, Skinner F, Glen E, MacDonell L. The role of essential fatty
acids in alcohol dependence and tissue damage. Alcohol Clin Exp Res
1987;11:37–41.
13. Replogle WH, Eicke FJ. Megavitamin therapy in the reduction of
anxiety and depression among alcoholics. J Orthomolec Med 1988;4:221–4.
14. Morgan MY, Levine JA. Alcohol and nutrition. Proc Natl Acad
Sci 1988;47:85–98.
15. Chapman K, Prabhudesai M, Erdman JW. Vitamin A status of alcoholics
upon admission and after two weeks of hospitalization. J Am Coll Nutr
1993;12:77–83.
16. Leo MA, Lieber CS. Alcohol, vitamin A, and beta-carotene: adverse
interactions, including hepatotoxicity and carcinogenicity. Am J Clin Nutr
1999;69:1071–85 [review].
17. Chen M, Boyce W, Hsu JM. Effect of ascorbic acid on plasma alcohol
clearance. J Am Coll Nutr 1990;9:185–9.
18. Blum K. A commentary on neurotransmitter restoration as a common mode
of treatment for alcohol, cocaine and opiate abuse. Integr Psychiatr
1986;6:199–204.
19. Rogers LL, Pelton RB. Glutamine in the treatment of alcoholism. Q
J Stud Alcohol 1957;18:581–7.
20. Embry CK, Lippmann S. Use of magnesium sulfate in alcohol withdrawal.
Am Fam Phys 1987;35:167–70.
21. Wilson A, Vulcano B. A double-blind, placebo-controlled trial of
magnesium sulfate in the ethanol withdrawal syndrome. Alcohol Clin Exp Res
1984;8:542–5.
22. Leng-Peschlowe. Alchohol-related liver diseases-use of Legalon®.
Z Klin Med 1994;2:22–7.
23. Ferenci P, Dragosics B, Dittrich H, et al. Randomized controlled
trial of silymarin treatment in patients with cirrhosis of the liver. J Hepatol
1989;9:105–13.
24. Parés A, Planas R, Torres M, et al. Effects of silymarin in
alcoholic patients with cirrhosis of the liver: results of a controlled, double-blind,
randomized and multicenter trial. J Hepatol 1998;28:615–21.
25. Faulstich H, Jahn W, Wieland T. Silibinin inhibition of amatoxin
uptake in the perfused rat liver. Arzneimittelforschung 1980;30:452–4.
26. Tuchweber B, Sieck R, Trost W. Prevention by silibinin of phalloidin
induced hepatotoxicity. Toxicol Appl Pharmacol 1979;51:265–75.
27. Sonnenbichler J, Zetl I. Stimulating influence of a flavonolignan
derivative on proliferation, RNA synthesis and protein synthesis in liver cells. In:
Okolicsanyi L, Csomos G, Crepaldi G eds, Assessment and Management of Hepatobiliary
Disease. Berlin: Springer-Verlag, 1987, 265–72.
28. Keung W, Vallee B. Daidzin and daidzein suppress free-choice ethanol
intake by Syrian golden hamsters. Proc Natl Acad Sci USA 1993;90:10,008–12.
29. Shebek J, Rindone JP. A pilot study exploring the effect of kudzu
root on the drinking habits of patients with chronic alcoholism. J Alt Compl Med
2000;6:45–8.
30. Lukas SE, Penetar D, Berko J, et al. An extract of the Chinese herbal
root kudzu reduces alcohol drinking by heavy drinkers in a naturalistic setting. Alcohol
Clin Exp Res 2005;29:756–62.
The information presented in Aisle7 is for informational purposes only.
It is based on scientific studies (human, animal, or in vitro), clinical experience,
or traditional usage as cited in each article. The results reported may not necessarily occur
in all individuals. For many of the conditions discussed, treatment with prescription or over
the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist
for any health problem and before using any supplements or before making any changes in
prescribed medications.
Contradictory, insufficient, or preliminary studies
suggesting a health benefit or minimal health benefit.
