The liver is the organ hardest hit by excessive drinking. When you drink, your liver metabolizes alcohol into acetaldehyde, which is highly toxic to cells and a potent carcinogen. Acetaldehyde is then metabolized into the less toxic acetate, which is then broken down into water and carbon dioxide.
How fast alcohol is metabolized into acetaldehyde and then into acetate is determined by what enzymes you happen to have, which is genetic. If your liver metabolizes acetaldehyde slowly, you are more likely to suffer when you drink, but you are also less likely to consume alcohol and damage your liver.
Alcoholism and Liver Enzymes
Alcohol use increases your risk of abnormal enzyme production in the liver. Your body has naturally occurring liver enzymes, including alkaline phosphatase (ALP), alanine transaminase (ALT), aspartate transaminase (AST), and gamma-glutamyl transferase (GGT).
If your AST levels are twice as high as your ALT, you will likely be diagnosed with liver disease. An elevated level of GGT is another indicator of heavy alcohol use and liver injury.
Regardless of which enzymes are affected, there is a direct correlation between alcohol and liver damage. The more you drink, the more damage you do to your liver.
Will Cutting Back on Drinking Lower Liver Enzymes?
When you quit drinking, liver enzymes return to normal activity levels, allowing your liver to metabolize fat normally and, in some cases, begin to heal.
Unfortunately, fatty liver disease is typically asymptomatic, so you probably won’t know you have it unless it’s accidentally caught.
Will Your Liver Heal When You Stop Drinking?
The extent to which your liver can heal depends on your stage of alcohol-induced liver damage.
Fatty liver disease
The first stage of alcohol and liver damage is fatty liver disease. This happens when five to ten percent of the liver’s weight is fat. The increased activity of alcohol metabolizing enzymes makes it more difficult for your liver to metabolize fat, which therefore begins to accumulate.
Alcoholic hepatitis
The next stage of liver damage is alcoholic hepatitis, which typically has symptoms you would see a doctor about. Mild hepatitis might cause weight loss, abdominal pain, nausea, and vomiting. More severe symptoms include brain damage, kidney failure, jaundice, enlarged liver, abdominal swelling, fever, spider angiomas, or swollen blood vessels. Alcoholic hepatitis may progress gradually or come on suddenly after binge drinking. It is typically reversible unless it’s extremely severe.
Cirrhosis
Cirrhosis is the worst stage of alcoholic liver disease. Normally, the liver regenerates living tissue, but when cirrhosis occurs, damaged tissue is replaced with non-living scar tissue. This scar tissue doesn’t perform the necessary functions of the liver and may impede the living parts of the liver from functioning normally as well.
It typically takes ten years of heavy drinking to develop cirrhosis, and about 10 to 20 percent of heavy drinkers develop it. Symptoms include accumulation of fluid in the abdomen, high blood pressure in the liver, bleeding in the esophagus, confusion, and an enlarged spleen. Cirrhosis is sometimes reversible, but it often requires a liver transplant.
Quit Alcohol, and Liver Disease Will Improve
Whatever state your liver is in, it will absolutely improve if you quit drinking. Most people, those with fatty liver disease or mild alcoholic hepatitis, will recover normal liver function in a matter of months, assuming continued abstinence and some healthy lifestyle changes.
The liver is a resilient organ and typically does fine if you stop actively damaging it.