Table of ContentsView AllTable of ContentsAlcohol’s Effect on BonesHeavy DrinkingIs Drinking Safe?Improving Bone HealthFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Alcohol’s Effect on Bones
Heavy Drinking
Is Drinking Safe?
Improving Bone Health
Frequently Asked Questions
This article examines the effects that heavily consuming alcohol can have on your bones over time and how to improve your bone health instead.
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How Does Alcohol Affect Your Bones?
Osteoporosis is abone diseaseof decreased bone strength and an increased risk for bone fractures. Over time, heavy alcohol consumption can interfere with your body’s ability to grow new bones and replace skeletal tissues. This increases the risk of bone fractures andosteoporosisas it reduces bone density.
Research shows that alcohol consumption, particularly in high amounts, negatively impacts bones at all ages. However, it is especially harmful to younger bones that are still growing. This is because alcohol reduces peak bone mass, which can result in weaker adult bones than there would be otherwise.
Defining Alcohol Consumption LevelsThe National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) define the categories of alcohol consumption habits as follows:Moderate drinkingindicates two drinks per day or fewer for men and one drink per day or fewer for women.Binge drinkingis a pattern that raises blood alcohol concentration (BAC) to 0.08% or higher. For many adults, this correlates to five or more drinks for men and four or more for women within two hours.Heavy drinkinggenerally means more than four drinks per day, or 14 drinks per week for men and more than three drinks per day, or seven drinks per week for women. This may also mean binge drinking for five or more days within a month.
Defining Alcohol Consumption Levels
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) define the categories of alcohol consumption habits as follows:Moderate drinkingindicates two drinks per day or fewer for men and one drink per day or fewer for women.Binge drinkingis a pattern that raises blood alcohol concentration (BAC) to 0.08% or higher. For many adults, this correlates to five or more drinks for men and four or more for women within two hours.Heavy drinkinggenerally means more than four drinks per day, or 14 drinks per week for men and more than three drinks per day, or seven drinks per week for women. This may also mean binge drinking for five or more days within a month.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) define the categories of alcohol consumption habits as follows:
Your bones are a major storage center for calcium and other minerals. Calcium is absorbed from food into the small intestines, and the kidneys are responsible for getting rid of excess calcium in the body.
Theright amount of calciumin your bloodstream is necessary for nerves and muscles to function properly. When calcium balance is off, the body uses vitamins, hormones, and other compounds to correct the imbalance. However, alcohol consumption interferes with the body’s ability to do these things as intended.
In addition to interrupting these mechanisms, alcohol may eventually interfere with the immune system in ways that affect bone health.
Interestingly, refraining from alcohol has been shown to improve markers of bone density within two months.
The Impact of Alcohol on Your Body
Vitamin and Mineral Absorption
Drinking alcohol regularly has been associated with a higher risk for nutrient deficiencies because of poor dietary intake and interrupted nutrient absorption.
This often includes vitamin A, zinc, and B vitamins like folate, and nutrients more heavily involved in bone health like calcium,vitamin D, andmagnesium.
Bone Cell Turnover
Bones constantly break down and rebuild—a process called bone remodeling—in small areas all over your bones. Bone cells, called osteoclasts, break down parts of your bones to release more calcium into your bloodstream, a process called resorption. Other bone cells, called osteoblasts, fill these holes with new, stronger bone.
Some studies suggest that alcohol consumption increases bone resorption and reduces the body’s ability to promote new bone formation and repair.This results in impaired bone cell turnover and weaker bones over time.
Hormone Production
Parathyroid hormone(PTH) is produced in response to decreasing amounts of calcium in your bloodstream. It triggers the activity of osteoclasts, which dissolve small areas of bone and release more calcium into your blood.
Having more PTH tells the kidneys to stop eliminating calcium from your body and, instead, to hold on to it. Additionally, PTH activates vitamin D, which boosts calcium absorption from the intestine. When this results in more calcium, further PTH production is prevented.
Drinking alcohol interferes with this process because it causes additional PTH to be released. Over time, this can result in too much calcium leaching from the bones. When there’s not enough calcium present, a reduction in bone density and a higher risk for fractures can result.
Heavy Drinking and Osteoporosis
When someone drinks heavily, their risk for bone fractures andosteoporosiscan significantly increase.In one systematic review and meta-analysis of six studies, researchers concluded that there is a positive association between alcohol consumption and osteoporosis risk.
Increased Fall and Fracture Risk
Consuming alcohol regularly or in excess can also increase the risk of falls. If bone density is already impaired, this also comes with a higher risk of breaking a bone if you fall. Not surprisingly, research shows that light to moderate drinking is associated with fewer falls among older adults than heavy drinking is.
Is It Safe to Drink After Being Diagnosed With Osteoporosis?
Because alcohol is associated with worsened bone density, it’s a good idea to evaluate your drinking habits if you arediagnosed with osteoporosis. Continued drinking, especially heavy drinking, can worsen osteoporosis and increase your risk for bone fractures. If it’s not possible to refrain from alcohol altogether, the National Institutes of Health (NIH) recommends no more than one drink per day for women and two drinks per day for men.
How to Treat Osteoporosis
How to Improve Bone Health
In addition to reducing or stopping your alcohol intake, there are several ways you can help support optimalbone health.
First, make sure your diet includes a variety of bone health-promoting nutrients, like calcium, vitamin D, and vitamin K; these are found in foods like leafy greens, dairy products, fortified plant milk, ultraviolet (UV)-treated mushrooms, and soy products.
Your body also produces vitamin D when exposed to regular direct sunlight. However, many of us are vitamin D deficient and don’t produce enough of the nutrient this way alone.It’s a good idea to check your vitamin D levels to determine whether avitamin D supplementwould be helpful to maintain your levels or correct a deficiency.
Next, be sure to get regularweight-bearing exercise. This includes activities like running, playing sports, and strength training. Try a combination of exercises to help prevent further bone loss and promote bone density improvement.
Finally, if you smoke, stop. Research shows that people who smoke have a higher risk for osteoporosis.
Sex Differences in Skeletons and Bone Health
Summary
The evidence clearly shows an association between heavy alcohol consumption and the risk of osteoporosis. Alcohol can impair nutrient absorption and interfere with the body’s ability to repair bones and regulate calcium. To best support your bone health, it’s a good idea to reduce or refrain from alcohol and practice other healthy lifestyle habits that support bone density.
A Word From Verywell
There’s no question that alcohol consumption can negatively influence your bone health, especially if you drink regularly or have other risk factors for osteoporosis. However, if you are concerned about your bone health or have already been diagnosed with osteoporosis, there are things you can do to better support your bones. It’s never too late to make changes to improve your bone health.
Frequently Asked QuestionsAll alcoholic beverages can negatively affect bone health, regardless of type.Some commonly prescribed osteoporosis medications, including bisphosphonates, hormone-related medications, and monoclonal antibodies, are used to help prevent the development of osteoclasts that erode bone. There are no known significant interactions between any of these medications and alcohol.However, it’s always best to speak with your healthcare provider before combining the two, as alcohol is known to reduce bone density.In addition to regular alcohol consumption, other factors that can increase the incidence of osteoporosis include a diet lacking in calcium, vitamin D, and vitamin K, an inactive lifestyle, and smoking. Additionally, being female, older, having a small or thin body frame, being White or of Asian descent, and having a family history of the disease, can also play a role.Learn MoreCauses and Risk Factors of Osteoporosis
All alcoholic beverages can negatively affect bone health, regardless of type.
Some commonly prescribed osteoporosis medications, including bisphosphonates, hormone-related medications, and monoclonal antibodies, are used to help prevent the development of osteoclasts that erode bone. There are no known significant interactions between any of these medications and alcohol.However, it’s always best to speak with your healthcare provider before combining the two, as alcohol is known to reduce bone density.
In addition to regular alcohol consumption, other factors that can increase the incidence of osteoporosis include a diet lacking in calcium, vitamin D, and vitamin K, an inactive lifestyle, and smoking. Additionally, being female, older, having a small or thin body frame, being White or of Asian descent, and having a family history of the disease, can also play a role.Learn MoreCauses and Risk Factors of Osteoporosis
In addition to regular alcohol consumption, other factors that can increase the incidence of osteoporosis include a diet lacking in calcium, vitamin D, and vitamin K, an inactive lifestyle, and smoking. Additionally, being female, older, having a small or thin body frame, being White or of Asian descent, and having a family history of the disease, can also play a role.
Learn MoreCauses and Risk Factors of Osteoporosis
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Godos J, Giampieri F, Chisari E, et al.Alcohol consumption, bone mineral density, and risk of osteoporotic fractures: a dose-response meta-analysis.Int J Environ Res Public Health. 2022;19(3):1515. doi:10.3390/ijerph19031515Sampson HW.Alcohol’s harmful effects on bone.Alcohol Health Res World. 1998;22(3):190-194.National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.Wang X, Chen X, Lu L,et al.Alcoholism and osteoimmunology.Curr Med Chem. 2021;28(9):1815-1828. doi:10.2174/1567201816666190514101303Kelly KN, Kelly C.Pattern and cause of fractures in patients who abuse alcohol: what should we do about it?.Postgrad Med J. 2013;89(1056):578-583. doi:10.1136/postgradmedj-2013-131990Lewis MJ.Alcoholism and nutrition: a review of vitamin supplementation and treatment.Curr Opin Clin Nutr Metab Care. 2020;23(2):138-144. doi:10.1097/MCO.0000000000000622Gaddini GW, Turner RT, Grant KA, et al.Alcohol: a simple nutrient with complex actions on bone in the adult skeleton.Alcohol Clin Exp Res. 2016;40(4):657-671. doi:10.1111/acer.13000Tardelli VS, Lago MPPD, Silveira DXD, et al.Vitamin D and alcohol: a review of the current literature.Psychiatry Res. 2017;248:83-86. doi:10.1016/j.psychres.2016.10.051Luo Z, Liu Y, Chen H, et al.Cellular and molecular mechanisms of alcohol-induced osteopenia.Cell Mol Life Sci. 2017;74(24):4443-4453. doi:10.1007/s00018-017-2585-yMikosch P.Alcohol and bone.Wien Med Wochenschr. 2014;164(1-2):15-24. doi:10.1007/s10354-013-0258-5Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, et al.The effect of alcohol on osteoporosis: a systematic review and meta-analysis.Drug Alcohol Depend. 2019;197:197-202. doi:10.1016/j.drugalcdep.2019.01.025Ortolá R, García-Esquinas E, Galán I, et al.Patterns of alcohol consumption and risk of falls in older adults: a prospective cohort study.Osteoporos Int. 2017;28(11):3143-3152. doi:10.1007/s00198-017-4157-2National Institute of Arthritis and Musculoskeletal and Skin Diseases.Osteoporosis: diagnosis, treatment, and steps to take.Nair R, Maseeh A.Vitamin D: the “sunshine” vitamin.J Pharmacol Pharmacother. 2012;3(2):118-126. doi:10.4103/0976-500X.95506Benedetti MG, Furlini G, Zati A, et al.The effectiveness of physical exercise on bone density in osteoporotic patients.Biomed Res Int. 2018;2018:4840531. doi:10.1155/2018/4840531National Institutes of Health.Smoking and bone health.Harvard Health Publishing.Osteoporosis drugs: which one is right for you?
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Godos J, Giampieri F, Chisari E, et al.Alcohol consumption, bone mineral density, and risk of osteoporotic fractures: a dose-response meta-analysis.Int J Environ Res Public Health. 2022;19(3):1515. doi:10.3390/ijerph19031515Sampson HW.Alcohol’s harmful effects on bone.Alcohol Health Res World. 1998;22(3):190-194.National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.Wang X, Chen X, Lu L,et al.Alcoholism and osteoimmunology.Curr Med Chem. 2021;28(9):1815-1828. doi:10.2174/1567201816666190514101303Kelly KN, Kelly C.Pattern and cause of fractures in patients who abuse alcohol: what should we do about it?.Postgrad Med J. 2013;89(1056):578-583. doi:10.1136/postgradmedj-2013-131990Lewis MJ.Alcoholism and nutrition: a review of vitamin supplementation and treatment.Curr Opin Clin Nutr Metab Care. 2020;23(2):138-144. doi:10.1097/MCO.0000000000000622Gaddini GW, Turner RT, Grant KA, et al.Alcohol: a simple nutrient with complex actions on bone in the adult skeleton.Alcohol Clin Exp Res. 2016;40(4):657-671. doi:10.1111/acer.13000Tardelli VS, Lago MPPD, Silveira DXD, et al.Vitamin D and alcohol: a review of the current literature.Psychiatry Res. 2017;248:83-86. doi:10.1016/j.psychres.2016.10.051Luo Z, Liu Y, Chen H, et al.Cellular and molecular mechanisms of alcohol-induced osteopenia.Cell Mol Life Sci. 2017;74(24):4443-4453. doi:10.1007/s00018-017-2585-yMikosch P.Alcohol and bone.Wien Med Wochenschr. 2014;164(1-2):15-24. doi:10.1007/s10354-013-0258-5Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, et al.The effect of alcohol on osteoporosis: a systematic review and meta-analysis.Drug Alcohol Depend. 2019;197:197-202. doi:10.1016/j.drugalcdep.2019.01.025Ortolá R, García-Esquinas E, Galán I, et al.Patterns of alcohol consumption and risk of falls in older adults: a prospective cohort study.Osteoporos Int. 2017;28(11):3143-3152. doi:10.1007/s00198-017-4157-2National Institute of Arthritis and Musculoskeletal and Skin Diseases.Osteoporosis: diagnosis, treatment, and steps to take.Nair R, Maseeh A.Vitamin D: the “sunshine” vitamin.J Pharmacol Pharmacother. 2012;3(2):118-126. doi:10.4103/0976-500X.95506Benedetti MG, Furlini G, Zati A, et al.The effectiveness of physical exercise on bone density in osteoporotic patients.Biomed Res Int. 2018;2018:4840531. doi:10.1155/2018/4840531National Institutes of Health.Smoking and bone health.Harvard Health Publishing.Osteoporosis drugs: which one is right for you?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Godos J, Giampieri F, Chisari E, et al.Alcohol consumption, bone mineral density, and risk of osteoporotic fractures: a dose-response meta-analysis.Int J Environ Res Public Health. 2022;19(3):1515. doi:10.3390/ijerph19031515Sampson HW.Alcohol’s harmful effects on bone.Alcohol Health Res World. 1998;22(3):190-194.National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.Wang X, Chen X, Lu L,et al.Alcoholism and osteoimmunology.Curr Med Chem. 2021;28(9):1815-1828. doi:10.2174/1567201816666190514101303Kelly KN, Kelly C.Pattern and cause of fractures in patients who abuse alcohol: what should we do about it?.Postgrad Med J. 2013;89(1056):578-583. doi:10.1136/postgradmedj-2013-131990Lewis MJ.Alcoholism and nutrition: a review of vitamin supplementation and treatment.Curr Opin Clin Nutr Metab Care. 2020;23(2):138-144. doi:10.1097/MCO.0000000000000622Gaddini GW, Turner RT, Grant KA, et al.Alcohol: a simple nutrient with complex actions on bone in the adult skeleton.Alcohol Clin Exp Res. 2016;40(4):657-671. doi:10.1111/acer.13000Tardelli VS, Lago MPPD, Silveira DXD, et al.Vitamin D and alcohol: a review of the current literature.Psychiatry Res. 2017;248:83-86. doi:10.1016/j.psychres.2016.10.051Luo Z, Liu Y, Chen H, et al.Cellular and molecular mechanisms of alcohol-induced osteopenia.Cell Mol Life Sci. 2017;74(24):4443-4453. doi:10.1007/s00018-017-2585-yMikosch P.Alcohol and bone.Wien Med Wochenschr. 2014;164(1-2):15-24. doi:10.1007/s10354-013-0258-5Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, et al.The effect of alcohol on osteoporosis: a systematic review and meta-analysis.Drug Alcohol Depend. 2019;197:197-202. doi:10.1016/j.drugalcdep.2019.01.025Ortolá R, García-Esquinas E, Galán I, et al.Patterns of alcohol consumption and risk of falls in older adults: a prospective cohort study.Osteoporos Int. 2017;28(11):3143-3152. doi:10.1007/s00198-017-4157-2National Institute of Arthritis and Musculoskeletal and Skin Diseases.Osteoporosis: diagnosis, treatment, and steps to take.Nair R, Maseeh A.Vitamin D: the “sunshine” vitamin.J Pharmacol Pharmacother. 2012;3(2):118-126. doi:10.4103/0976-500X.95506Benedetti MG, Furlini G, Zati A, et al.The effectiveness of physical exercise on bone density in osteoporotic patients.Biomed Res Int. 2018;2018:4840531. doi:10.1155/2018/4840531National Institutes of Health.Smoking and bone health.Harvard Health Publishing.Osteoporosis drugs: which one is right for you?
Godos J, Giampieri F, Chisari E, et al.Alcohol consumption, bone mineral density, and risk of osteoporotic fractures: a dose-response meta-analysis.Int J Environ Res Public Health. 2022;19(3):1515. doi:10.3390/ijerph19031515
Sampson HW.Alcohol’s harmful effects on bone.Alcohol Health Res World. 1998;22(3):190-194.
National Institute on Alcohol Abuse and Alcoholism.Drinking levels defined.
Wang X, Chen X, Lu L,et al.Alcoholism and osteoimmunology.Curr Med Chem. 2021;28(9):1815-1828. doi:10.2174/1567201816666190514101303
Kelly KN, Kelly C.Pattern and cause of fractures in patients who abuse alcohol: what should we do about it?.Postgrad Med J. 2013;89(1056):578-583. doi:10.1136/postgradmedj-2013-131990
Lewis MJ.Alcoholism and nutrition: a review of vitamin supplementation and treatment.Curr Opin Clin Nutr Metab Care. 2020;23(2):138-144. doi:10.1097/MCO.0000000000000622
Gaddini GW, Turner RT, Grant KA, et al.Alcohol: a simple nutrient with complex actions on bone in the adult skeleton.Alcohol Clin Exp Res. 2016;40(4):657-671. doi:10.1111/acer.13000
Tardelli VS, Lago MPPD, Silveira DXD, et al.Vitamin D and alcohol: a review of the current literature.Psychiatry Res. 2017;248:83-86. doi:10.1016/j.psychres.2016.10.051
Luo Z, Liu Y, Chen H, et al.Cellular and molecular mechanisms of alcohol-induced osteopenia.Cell Mol Life Sci. 2017;74(24):4443-4453. doi:10.1007/s00018-017-2585-y
Mikosch P.Alcohol and bone.Wien Med Wochenschr. 2014;164(1-2):15-24. doi:10.1007/s10354-013-0258-5
Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, et al.The effect of alcohol on osteoporosis: a systematic review and meta-analysis.Drug Alcohol Depend. 2019;197:197-202. doi:10.1016/j.drugalcdep.2019.01.025
Ortolá R, García-Esquinas E, Galán I, et al.Patterns of alcohol consumption and risk of falls in older adults: a prospective cohort study.Osteoporos Int. 2017;28(11):3143-3152. doi:10.1007/s00198-017-4157-2
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Osteoporosis: diagnosis, treatment, and steps to take.
Nair R, Maseeh A.Vitamin D: the “sunshine” vitamin.J Pharmacol Pharmacother. 2012;3(2):118-126. doi:10.4103/0976-500X.95506
Benedetti MG, Furlini G, Zati A, et al.The effectiveness of physical exercise on bone density in osteoporotic patients.Biomed Res Int. 2018;2018:4840531. doi:10.1155/2018/4840531
National Institutes of Health.Smoking and bone health.
Harvard Health Publishing.Osteoporosis drugs: which one is right for you?
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