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Clinician’s Corner: Alcoholic Vitamins

Alcoholics often eat poorly, limiting their supply of essential nutrients and affecting both energy supply as well as cell and organ system structure maintenance. In general, moderate drinkers (two drinks or less per day) seem to be at little risk for nutritional deficiencies.  Furthermore, alcohol affects all the pharmacokinetic parameters:

Digestion: decreasing secretion of digestive enzymes from the pancreas, as well as damaging the absorptive surface of the stomach.

Storage: a damaged liver doesn’t store the Vitamins A and Vitamin E

Kidney Damage: alcohol consumption, especially binge drinking can lead to dehydration, affecting kidney function. Liquor selectively increases blood flow to the kidneys and basal metabolic rates of kidney tubes hence causing an increase in urine output, leading to massive dehydration. Elevations in blood pressure from alcohol can cause direct kidney damage.

Excretion of nutrients: improper digestion of fats might cause a decrease in the fat soluble vitamins  A, D ,E, & K.

Vitamin Supplementation in the Alcoholic Patient:

  • Vitamins A, D, E, and K — Vitamin A, D, E, and K levels are often deficient in patients with chronic pancreatitis or alcoholic liver disease.
  • Thiamine (B-1) deficiency is found in up to 80 percent of adults with chronic alcohol use.
  • Pyridoxine (B-6) deficiency occurs in over 50 percent of alcoholic patients and is caused by reduced intake and increased breakdown of pyridoxine during ethanol metabolism.
  • Folic Acid (B-9) Two-thirds of binge drinkers will have folate deficiency caused by malabsorption, reduced intake, and increased urinary excretion.
  • Zinc: Alcoholics up to half of that population need zinc supplementation due to poor diet.

Your Thompson Pharmacist is a valuable resource for patients suffering from alcoholism.  We can help you select the best vitamin therapy, as well as guide you through drug therapy to help stay sober.  We have acamprosate, naltrexone and disulfram that can be useful in maintain sobriety.  Through our association with Value Specialty we can get Vivitrol® (naltrexone sustained release), which is a once a month injection to help manage cravings.  Go Ahead and ASK… at Thompson Pharmacy it’s All for YOU!!!