Autoimmune disease and alcohol: should I drink with vasculitis?

If you know me well, you know I’m a whiskey lover. Strong, mild, spicy, sweet – I like it all. When traveling, a bottle from a local distillery is usually the souvenir I choose to take home.

There has never been a time in my adult life when I haven’t had a drink. For me, it’s not a vice, and I’ve always known how to control my consumption. A delicious drink is a small thing, but it’s one of life’s pleasant indulgences that balances out the tough times.

However, the issue of drinking with a chronic illness is not one that I have ignored. And while it’s okay to imbibe as a patient with vasculitis, some medications may not mix well.

Over the years I’ve had many questions about this, but there still seems to be no consistent answer. Of course, everyone is healthier without alcohol, but what if I decide that abstinence is not necessary in my specific situation?

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I remember a particularly amusing conversation with my doctor during my college years. Recent lab results showed I had increased inflammation, so we switched meds. I hadn’t been very sick, we just needed to try a different tactic to control the disease.

I had spent my time in college in strange limbo as a sick girl who was still able to get an education without too much trouble. As such, I wanted to hang out with friends when the occasion allowed, and often that meant having a drink with them. But the new drug has raised some concerns.

The conversation with my doctor went something like this:

Me: “How many glasses of wine can I drink with this medicine?”

Doc: “How many do you usually have?”

Me: “How much should I have?”

Doc: “How many do you want?”

It felt like a dead end, or like I was being tested. I wasn’t trying to push my limits, but I didn’t know where the cut was and I didn’t want to shock her or worry her. In the end, she said a few drinks once or twice a week wouldn’t hurt me, and we left it at that.

I am blessed or cursed with an incredible tolerance for alcohol, especially whiskey. My body processes it rather than rejecting it or making me sick, which means I can ingest some of it before I feel bad. But that doesn’t mean I should push this ability to the limit.

The question remains: how much alcohol can or should we drink with a chronic illness before it harms our health? Since we don’t know the underlying cause of vasculitis, some patients may choose not to participate at all, thereby avoiding potential triggers.

We already know that alcohol can have negative effects on the body. But when I learned that it dilates blood vessels and causes inflammation, I gained a whole new perspective. Vasculitis involves inflammation of the blood vessels, so it doesn’t seem wise to make this worse.

Certain vasculitis medications certainly do not mix well with alcoholic beverages. In particular, methotrexate – the one my doctor referred me to in college – does not interact directly with alcohol. The problem is that both can damage the liver, so mixing them is not a good idea.

Different drinks also have different effects. A glass or two of wine may not affect someone as much as the same number of shots of tequila. In addition, wine contains antioxidants and other beneficial elements which can help control heart disease and cholesterol.

Then there is the hydration aspect. Usually I pair whiskey with water, which means I never completely dry out. A glass, then a glass of water, and repeat throughout the night. It allows me to enjoy tasting my favorite beverage without the alcohol affecting my skin, stomach, or liver as badly as it might if I were dehydrated.

As with everything, moderation is important. I don’t feel the need to abstain completely, although some may go that route, and that’s respectable. I also do not consider myself in danger of abuse to the point that it affects my condition.

Ultimately, I want to research the details and decide what’s best for me, with the advice of my doctor. Having a good drink is part of the sweetness of life, and I believe I can enjoy it responsibly.

To note: News ANCA Vasculitis is strictly a disease news and information site. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of anything you read on this website. The opinions expressed in this column are not those of News ANCA Vasculitis or its parent company, BioNews, and are intended to spark discussion about vasculitis issues at ANCA.

About Michael Brafford

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