Ethanol & Acetaldehyde

This article has been recorded to audio for convenience. All Podcasts can be heard on: This Website (Podcast Episodes), Podbean, Spotify, Apple Podcast, Amazon Music Podcasts, Google Podcasts, Google Chrome, TuneIn, iHeartRadio, and more.

Hello Sobertown,

Todays article is your body on booze 1.5: Understanding ethanol and acetaldehyde

As we follow alcohol through the human body we will take a moment here to pause the ride and delve into what ethanol is and what it does chemically when the body processes it.

Ever heard of acetaldehyde? “Ass-et-al-de-hide” This is compound which is bad news. This is a substance your body wants nothing to do with and it has nothing but harmful effects on our cells. Acetaldehyde is a carcinogenic substance which results in serious bodily harm and it is exactly what your body has to deal with when you drink alcohol. Acetaldehyde is the first breakdown product of ethanol, so not only is ethanol harmful but the only thing the body can convert ethanol to initially is actually even more harmful than the ethanol itself, so in a way it goes bad for you to worse for you before it gets better as far as the breakdown process is concerned.

Let’s start this journey with ethanol. The aspect of drinking with the “desirable” effects are experienced due to ingestion of ethanol, most people are aware that ethanol is the ingredient within alcohol with the intoxicating effects. Ethanol is an organic chemical compound made up of carbon, hydrogen and oxygen which alone are among the most common elements in our universe and when bonded together in just the right format they form ethanol. Ethanol is a liquid which is volatile, it is colourless, it is flammable with a mild and slight odour, ethanol is also a central nervous system depressant and is psychoactive, and as most of us know, it forms the active ingredient in the recreational drug named alcohol.

Ethanol is either formed by a petrochemical process or by fermentation of sugars, in the case of fermentation to state it in a very simplified form, yeast which is a fungus, believe it or not and a single celled organism has the ability to essentially gobble up any sugars in a liquid such as grape juice for example and crap out ethanol and carbon dioxide, so they eat sugar and as a by product out comes alcohol and gas.

Ethanol is used for many purposes, it can be very helpful, it has a mass of useful applications and one stupid use also which involves putting it internally inside people and gradually killing them and in return it provides them with a short term psychoactive effect. Ethanol is an excellent antiseptic and a fantastic disinfectant. Ethanol is great as a solvent and it can even be used as a great fuel source with its volatility and flammability. Ethanol is also highly effective at damaging human DNA, causing cancers and generally sapping the health of living organisms which consume it for its short lived psychoactive effects, somewhere along the line of history it went from a weak solution consumed as a safe alternative to the potentially deadly sources of water available to people prior to modern sanitation to what it is now, high strength, attractively packaged, aggressively promoted, fully legalised, highly protected and misrepresented poison which is now so deep set industrially that the only option for its removal is mass populations moving away from its consumption regardless of its forceful promotion, we can now no longer rely on good science and health information to regulate how this drug is used or promoted but we can encourage as many as possible to make the decision to remove it from their own lives. Ethanol is great, in the tank of your car, it is great to keep hospitals clean and ethanol is truly great at damaging human health when ingested.

Once you consume ethanol you swallow it, down it goes, down the throat and the esophagus into the stomach and then partly transferring to the early sections of the digestive system and then absorbed through the portal vein it travels to the liver. Here in the liver is where most of our enzymes called “alcohol dehydrogenase” are located. Enzymes and their matching compounds can be thought of like a lock and a key, the ethanol for example could be the lock and the enzyme alcohol dehydrogenase could be considered the key, so the ethanol comes in and the alcohol dehydrogenase enzyme is the correct shape and structure to fit with the ethanol and break it down, now, here is where we meet acetaldehyde. When the enzymes in our liver break down the ethanol molecules they create acetaldehyde. So we go ethanol in, enzyme does its thing in the liver, acetaldehyde out which the body then has to get to work on breaking down further.

Acetaldehyde is highly toxic to the human animal. Acetaldehyde is an unavoidable result of drinking alcohol. This breakdown product is a group 1 carcinogen and is the primary concern for the human body when we discuss alcohol consumption. Most conversion happens in the liver but in fact some metabolism occurs in the pancreas and the brain potentially causing damage in these tissues while acetaldehyde in animal studies also causes memory impairment and poor coordination among other effects. Long story short, acetaldehyde is highly toxic, causes significant damage and cancers in human cells and its production is a natural occurrence in the process of drinking alcohol.

Now, where we vary person to person is in the breakdown process. Each of us break down ethanol slightly differently, that is some of us far more efficiently than others. To clarify, what I am not arguing is that if you can demonstrate that you are highly effective at breaking down ethanol and more importantly acetaldehyde that you are good to go and you don’t need to worry about your drinking habits, no that it not what I am saying because regardless of this aspect of alcohol metabolism there remain large risks in multiple aspects of health through drinking. However, the faster we can convert from ethanol to the non harmful state, the less damage we will do to our body. The order of processing ethanol in our body is this. Ethanol (Harmful) to Acetaldehyde (VERY Harmful) to Acetic Acid (Basically vinegar/Fairly safe) and Acetyl-Coenzyme A (Safe) and then eventually the Acetyl-Coenzyme contributes to the production of energy in cells and becomes water and carbon dioxide (Safe). The harmful substances are the ethanol and then the next breakdown product especially which is the acetaldehyde. When we drink, the body can only metabolise a certain amount of alcohol per hour and this amount varies depending on many variables such as gender, size of liver, body mass, fluid levels and a lot more however one other factor is that different people carry different variations of the enzymes which break down ethanol to acetaldehyde and then acetaldehyde to its safer breakdown products after that, these can be traced back to variations in our genetic makeup. What this causes is a variability where some of us can break down ethanol to acetaldehyde fast but then break down acetaldehyde to acetate slowly which is bad news as it means prolonged damage our body by acetaldehyde. Then some people break down ethanol to acetaldehyde slowly but acetaldehyde to acetate quickly which is more desirable, then some people do both fast and some do both slowly. Some people actually have minimal enzyme present which converts acetaldehyde to acetate and these individuals really can’t drink, they end up nauseated, red and inflamed soon after a drink or two. The point, well the point is that it is genetic pot luck as to how effectively each individual breaks down ethanol and acetaldehyde. So in this, yeah we are not all created equal when it comes to alcohol breakdown, but just to be clear there are no superhuman safe drinkers, just some who break down sections of the process faster than others. This quote encapsulates the article drawn from in my blog today. Quote: “Researchers continue to investigate the reasons why some people drink more than others and why some develop serious health problems because of their drinking. Variations in the way the body breaks down and eliminates alcohol may hold the key to explaining these differences”. (3)

Here however is an interesting point. Studies show that people who are genetically less likely to drink large quantities of alcohol, we call these people “normal drinkers” are sometimes actually more likely to develop alcohol related cancers as a result of lower levels of alcohol consumption. Some heavy drinkers do not develop cancer, though more likely heavy drinkers will develop cancer. On the other hand, some people who drink moderately do develop alcohol related cancers, there really is no safe option, heavy, moderate, all habits are potentially risky as far as cancer is concerned, the only safe option regarding alcohol is truly to not drink, you simply can not eliminate risk, you can not do it safely, there are no safe levels and the decision to drink is one which should be made with the knowledge that you do so knowing the habit will increase your chances of cancers and potentially this may even apply if you drink quite moderately so the research suggests. The notion of well, my grandpa drank like a fish and he made it to 80, well, yeah, no, you can justify it this way and take the risk based on grandpa and his lifespan but the statistics are that you just don’t know, you are gambling with your health if you drink at all and especially to excess. (3)

Acetaldehyde is bad news. The substance causes cancer in several ways, two of these involve action with our DNA whereby it interferes with the process of copying DNA or alternatively it can cause cancer by inhibiting a process where our cells and DNA repair, either way bad, either way can cause cancers. This is how I picture the process, ethanol moseys on in to liver and then gets blindsided by an enzyme which latches on and chews it up and spits out acetaldehyde which is a little hyperactive gremlin bastard with big fangs that immediately starts running around biting things, kicking things making a huge mess and destroying everything it can and getting as far from the lived as it can to do damage while the enzymes chase it around and around until they catch it an crush it, munching it up and converting it to a docile puppy dog called acetate which just trots around until its needed, that how I picture it anyway.

If you read fact based articles and research you will read things like “alcohol causes cancer”, you will read alcohol referred to as a recreational drug and a psychoactive substance as though it were common knowledge which is so detached from the strange false manner in which we view the bottled depressant and drug in real life, we need to re-establish the connection to what ethanol actually is, what it does once ingested and what health risks it is linked to. The choice is only a choice when we all have the understanding of these facts. Then it might seem odd to observe drinking it while parenting as a positive or normal act while it would seem from the outside strange to do a low dose little sniff of cocaine while in the same situation, both might have comparably mind altering effects but one would be viewed with horror and the other, the alcohol not so much, we need to simply view it for what it is, an addictive psychoactive drug.

Acetaldehyde, you don’t want it. It comes from ethanol and there is no way around it.

This is a quote from authors of a 2016 research article titled Neuropathology of Drug Addictions and Substance Misuse: “Acetaldehyde (ethanal) is an aldehyde that is highly reactive and toxic. Acetaldehyde causes damage at the cellular and genomic levels. The sheer number of enzymes involved in the metabolism and detoxication of acetaldehyde and other aldehyde species is a testament to the impact of its reactivity. Metabolic or autoxidation pathways lead to the formation of endogenous acetaldehyde, and a large number of genes function in the metabolic detoxication of acetaldehyde. The World Health Organization considers acetaldehyde to be a Class 1 toxin (human carcinogen). The main source of acetaldehyde is the consumption of alcohol. In vivo, ethanol is predominantly metabolized to acetaldehyde”. “Understanding of the potential adverse effects and the pathogenesis of acetaldehyde is a pressing need. More toxicological studies and risk assessment on acetaldehyde are required. Acetaldehyde is ubiquitously present and increased levels are associated with neurological pathologies such as stroke, Wernike encephalopathy, and Alzheimer disease, as well as alcohol-induced impairment of brain structure and function”. (1)

Lastly this is a quote from a paper from 2014 titled Fatty Liver, NASH, and Alcoholic Liver Disease: “Acetaldehyde is highly reactive and toxic. It binds to phospholipids, amino acid residues, and sulfhydryl groups. As a result, acetaldehyde leads to the failure of DNA repair, mitochondrial abnormalities, impairment of microtubular function, and failure of the cell membrane. Furthermore, acetaldehyde increases lipid peroxidation with concomitant production of oxygen free radicals and reduces glutathione. A defect in the regulation of neutrophil chemotaxis can also occur due to aldehyde production resulting in the reduction of the body’s biological defense”. (2) Wowsers ok so the easiest way for me to explain that quote in lamens terms would be this. That acetaldehyde fucks you up in all sorts of ways, in-fact that article basically says acetaldehyde screws up most major aspects of cell function.

So in summary Sobertown, where you may have thought the process of breaking down alcohol/ethanol was simpler or more of a single step process, it is not, ethanol to the liver, liver enzymes convert ethanol to acetaldehyde, more enzymes convert acetaldehyde to acetate and acetate to safe products such as water and gas. The ethanol is harmful, the acetaldehyde is very harmful and each of us possess varying abilities to break these products down based on our genetics and none of us have the ability to undertake this process with any degree of safety. Basically that encapsulates the article for today.

I am annoyed I did not more deeply understand these very well understood facts earlier since I do live my life in the pursuit of good health and function and I am suspicious of the level of concealment based on our societies desire to turn a blind eye to its favourite daily drug. I mean how many of us have been desperate for a professional such as a doctor to tell us the harms and encourage us to stop, but when we hint at our problems were likely to be met with reinforcement or even admission that the professional themselves consumes unsafe levels of alcohol, I have heard reports of this exact occurrence more times than I can count. Fact is, alcohol and its breakdown products are arguably the worst choice regarding human health as far which drugs should be legal and which should not.

REFERENCE

(1): Roshanna Rajendram, Rajkumar Rajendram, Victor R. Preedy. 2016: Neuropathology of Drug Addictions and Substance Misuse. Chapter 51 - Acetaldehyde: A Reactive Metabolite. Volume 1: Foundations of Understanding, Tobacco, Alcohol, Cannabinoids and Opioids. Pages 552-562.

(2): M. Shimada, J.Cheng, A.Sanyal. 2014: Fatty Liver, NASH, and Alcoholic Liver Disease. Pathobiology of Human Disease. Pages 1817-1824.

(3) Alcohol Metabolism: An Update. 2007: US Department of Health and Human Services. National Institutes of Health. Taken from: https://pubs.niaaa.nih.gov/publications/aa72/aa72.htm. On July 15th 2021.