Alcohol and Inherited Metabolic Disorders : University College London Hospitals NHS Foundation Trust

Drinking alcohol can be a part of everyday life and can be associated with celebrations and social activities. If you choose to drink alcohol it is important to do so responsibly.

Alcohol consumption increases the risk of developing a wide range of illnesses including certain cancers, high blood pressure, heart attack and stroke.

The immediate physical affects of alcohol on the body include dehydration and lower blood sugar levels. Reduction in blood sugar levels can cause the body to use alternative sources of energy which may lead to metabolic decompensation.

NHS guidance for the general population is that there is no completely safe level of drinking, but sticking within government guidance for alcohol consumption lowers the risk of harming your health.

Alcohol intake in patients with Inherited Metabolic Disorders (IMD) carries the same risks as the general population in addition to the increased risk of an acute metabolic decompensation, which could result in a hospital admission.

Current general recommendations advise no more than 14 units of alcohol per week, spread across 3 days or more. This is the same for both men and women.

There are no specific recommendations in IMD; however, the advice would be to stay within the current general recommendations.

The current UK recommendations of 14 units per week spread across at least 3 days. Alcohol units are a way of measuring alcohol intake. Each unit of alcohol is equal to 10ml or 8g of pure alcohol. The unit measuring system is a helpful way to keep track of alcohol intake when consuming a variety of drinks as different drinks contain different amounts of alcohol.

For example, 14 units is equal to:

9 bottles of 4.5% beer

5 pints of 4.5% beer

6 glasses (175ml) of 12.5% wine

Percentage refers to the amount of alcohol in a drink. The higher the percentage the more alcohol is in the drink. Units of alcohol depend on the amount of alcohol in a drink and the serving size.

More information about the units in different types of alcoholic drinks can be found on the NHS website: Alcohol units - NHS.

If you consume mixed drinks, “alcopops”, or cocktails it is important to check the ingredients to ensure there are no ingredients that you have been advised to avoid based on your condition.

If you choose to drink alcohol, planning ahead helps to minimise the short-term risk of metabolic decompensation. Avoid drinking on an empty stomach and eat a meal before or alongside any alcoholic drinks. This provides an appropriate energy source for the body which may reduce the risk of lower blood glucose.

If drinking alcohol over an extended period (i.e. over the course of an evening) aim to have regular snacks and ensure you have something to eat before you go to bed.

Long periods of fasting and alcohol intake are both metabolic stressors. Individually fasting or drinking alcohol can lead to metabolic decompensation, when paired together the risk of metabolic decompensation is increased. Try to reduce this risk when drinking alcohol by eating at regular intervals.

Key points:

Eat before alcohol intake.
Frequent regular snacks if drinking alcohol over an extended period.
Keep alcohol intake within recommended limits. Consider alternating alcoholic and non-alcoholic drinks to reduce overall alcohol consumption.
If you are drinking in the evening, ensure you have a snack before bed.

If you start to feel unwell after drinking alcohol and you are unable to eat and drink as you normally would then start your emergency regimen immediately.

If you are not able to manage any prescribed supplements start your emergency regimen immediately.

As with any other illness, start your emergency regimen and contact your medical team and dietetic team.

Some ideas to support you in staying safe if you choose to drink alcohol:

Make sure you have a copy of your emergency regimen.
Make sure any prescribed products for your emergency regimen are in-date.
Consider letting someone you are with know about your condition and what to do if you become unwell.
Fill in the medical ID information on your phone with relevant information and contact details.

Emergency Contact details

9-5pm Monday to Friday:

0203 448 4778 (Dr Murphy or Dr Lachmann)

Out of hours:

Hospital switchboard 0845 155 5000 or 020 3456 7890

Ask to be put through to the Adult Inherited Metabolic Disease Consultant on-call

Emergency guides

Can be found on the British Inherited Metabolic Disease Group website

BIMDG: British Inherited Metabolic Disease Group

Metabolic Dietitians

Charles Dent Metabolic Unit, Box 92, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG

Direct line: 020 3448 4332, 020 3448 3602, 020 3448 3604 or 020 3448 3605