This post is the sixth in a series on non-pharmacologic approaches for managing symptoms related to alcohol and drug abuse and withdrawal and decreasing the risk of relapse. Previous posts commented on evidence for natural supplements, weak electrical current and mindfulness for reducing drug and alcohol use and treating symptoms of withdrawal. This post is offered as a concise review of the evidence for certain B-vitamins, vitamin C, magnesium and zinc for reducing alcohol craving.
Chronic drinking leads to deficiencies in several B vitamins
Chronic drinkers are often deficient in several B vitamins including thiamin, folate, B-6 and B-12 because of toxic effects of alcohol on the mucosal lining of the stomach and small intestine that interfere with normal absorption. The conventional Western medical treatment of Wernicke’s encephalopathy, a condition of acute confusion and delirium sometimes seen in chronic heavy alcohol abuse, is intravenous administration of thiamin followed by oral thiamin supplementation 500mg per day.
Some B-vitamins and Vitamin C may decrease craving, increase alcohol clearance from the blood and reduce the severity of hangovers
Animal studies suggest that low serum thiamin levels are associated with increased alcohol craving (Zimatkin 1996). There is evidence that the B vitamin niacin in the form of nicotinamide dosed at 1.25 grams taken with a meal before drinking may protect the liver against the acute toxic effects of alcohol in individuals who have relapsed or are unable to abstain (Volpi 1997). Niacin in the form of nicotinic acid may reduce the risk of developing alcohol dependence by interfering with the synthesis of a morphine-like substance that is formed when acetaldehyde—a metabolite of alcohol—condenses with dopamine (Davis 1970).
For individuals who are unable to stop drinking, taking anti-oxidant vitamins close to the time of alcohol consumption may reduce or prevent hangover symptoms by neutralizing metabolites of alcohol that cause oxidative damage to the body and brain (Altura 1999; Marotta 2001). Findings of a small open study that enrolled 13 healthy males suggest that taking vitamin C before drinking may increase the rate at which alcohol is cleared from the blood. Taking 2 grams of vitamin C one hour before alcohol consumption increases the rate at which alcohol is cleared from the blood, and may reduce acute toxic effects on the liver (Chen 1990). This significance of this finding is limited by small study size and the absence of blinding and a control group.
Magnesium and zinc supplementation may improve neuropsychological deficits caused by chronic drinking
Magnesium supplementation 500 to 1500mg per day, may improve cognitive deficits associated with chronic alcohol abuse by improving cerebral blood flow which is often diminished in chronic alcoholics (Thomson 1988). Deficiencies in Zinc, copper, manganese and iron are common in alcoholics and worsen with continued heavy use. The diffuse nerve cell damage that is frequently associated with chronic alcohol use is probably caused by low serum Zinc levels which promote increased formation of damaging free radicals (Menzano 1994).
Most research findings on B vitamins, vitamin C, and other supplements for reducing drinking, controlling craving, and mitigating the toxic effects of alcohol on the body and brain come from small studies done many years ago that have not been replicated by large placebo-controlled studies. Despite the paucity of evidence for these supplements, select B vitamins and vitamin C have well established general beneficial effects at many levels of the body and brain, have no associated risks, and may mitigate the toxic effects of alcohol abuse in some cases.
Anyone who is struggling with a serious drinking problem should seek professional care. However, heavy drinkers who are unable to stop drinking or moderate drinking behavior, may benefit from supplementation with select B vitamins, vitamin C, magnesium and zinc because of their neuroprotective and antioxidant effects on the body and brain.