Is Drinking Alcohol Bad for Your Bones?

Medically Reviewed

It’s well known that drinking too much alcohol can be harmful, increasing the risk of accidents and, over time, causing liver damage. What’s less well known is that the effects of drinking too much can harm your bones, too.

Research has shown that the most damaging effects of excessive alcohol consumption on bones occur during adolescence and young adulthood. However, research has also shown that even older adults who drink too much could be sabotaging their bone health.

Also worrisome is that many people don’t realize that they could have a drinking problem. Here’s what you should know to protect your bone health.

How alcohol affects your bones

Heavy alcohol consumption has deleterious effects on bone through its impact on nutrition, disrupting hormonal regulators of bone, and by directly inhibiting bone-forming cells. Heavy drinking leads to deficiencies in nutrients important for skeletal health such as calcium, magnesium, and vitamin D.

In addition, heavy alcohol use disrupts hormones important for bone formation, such as testosterone in men and estrogen in women. However, the most harmful effect of alcohol on the skeleton is due to its ability to inhibit bone-forming cells, thus reducing bone formation.

Last, but not least, alcohol consumption affects balance and gait; people who abuse alcohol tend to fall more frequently than those who don’t. Heavy alcohol consumption has also been linked to an increase in the risk of hip and spine fractures.

Don't believe stereotypes

Many people hold a stereotypical view of problem drinkers: They hide their liquor in a brown paper bag, they can’t hold a job, they’re poor, their personal hygiene is lacking, they drink every day, and so on. But substance abuse experts have long recognized that problem drinking can affect anyone from any background.

That observation is backed up by findings in a BMJ Open study that was published online in 2015. The authors reported that traits associated with an increased risk for alcohol abuse in people ages 50 and older included being active, healthy, and well-off. In addition, being well-educated, in good functional status, socially active, and a smoker also elevated risk.

These findings are based on the investigators’ study of more than 9,000 British people, but the results are consistent with some earlier U.S. study outcomes. The authors couldn’t fully explain why an affluent lifestyle heightened the risk for harmful drinking.

When is drinking a problem?

National dietary guidelines say women should consume no more than one alcoholic drink a day, and men should consume no more than two to avoid health problems. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends that adults over 65 consume no more than three drinks on any given day and no more than seven drinks a week.

According to the NIAAA, one standard drink is 12 ounces of beer; 8–9 ounces of malt liquor; 5 ounces of wine; or 1.5 ounces (a shot) of 80-proof spirits, such as vodka, whiskey, rum, or gin.

Not everyone who drinks daily has a drinking problem, and not all problem drinkers imbibe every day. Light to moderate drinking—such as a glass of wine with dinner—can even be beneficial to your health. However, it’s important to keep in mind that those benefits are negated if you exceed the recommended limits.

Consider the consequences

Besides the immediate consequences of excessive drinking—falls (a risk factor for osteoporotic fractures), injuries, accidents, dangerous interactions with medications—misusing alcohol can have longterm effects.

Over time, too much alcohol can cause health problems, such as cancer, liver damage, brain damage, confusion, and forgetfulness; worsen existing health problems, such as diabetes, high blood pressure, and osteoporosis; and mask symptoms of serious health issues, such as dulling the pain of heart-attack warning signs.

Mixing alcohol—even one drink—with drugs can create a dangerous, even deadly, cocktail. Common drugs that don’t mix with alcohol include aspirin, cold and allergy medicine, sleeping pills, painkillers, and anxiety or depression drugs.

Alcohol can also reduce or exacerbate therapeutic effects of certain drugs, such as warfarin. Ask your doctor or pharmacist whether it’s safe to drink while taking your medication.

When to seek help

Doctors often use a set of four questions called the CAGE test to determine whether someone is misusing alcohol. Answering yes to two or more of the following questions can indicate that you have an alcohol problem for which you should see a healthcare professional:

  • Cut down. Have you ever felt you should cut down on your drinking?

  • Annoyed. Have people annoyed you by criticizing your drinking?

  • Guilty. Have you ever felt bad or guilty about your drinking?

  • Eye-opener. Have you ever taken a drink first thing in the morning to steady your nerves or get rid of a hangover?

You may also want to consider seeking help if you feel compelled to hide your drinking or lie about it, are irritable or tense when you don’t drink, drink to forget your troubles, or have lost interest in food.

Enlist your doctor

The United States Preventive Services Task Force—a federal advisory panel of medical experts that evaluates the scientific evidence for preventive medical protocol—advises primary care doctors to screen all adult patients for unhealthy alcohol use and offer counseling if needed.

If your doctor doesn’t broach the subject, don’t be afraid to bring up your drinking concerns. She or he can help you find local resources, such as counselors trained in treating alcohol problems, support groups for older adults, or programs like Alcoholics Anonymous, to help you stop or cut back on drinking.

Learn more about how alcohol can affect your health, including increasing the risk for atrial fibrillation, and tips for cutting back on drinking.