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Alcohol and MPNs: Your Guide

Posted on December 01, 2021
Medically reviewed by
Todd Gersten, M.D.
Article written by
Kristopher Bunting, M.D.

If you have received a diagnosis of myeloproliferative neoplasms (MPNs) — a type of blood cancer that includes polycythemia vera, essential thrombocythemia, primary myelofibrosis, and certain leukemias — you may be wondering how alcohol consumption can affect your disease progression and symptoms.

Drinking is common — the 2019 National Survey on Drug Use and Health reported that 85 percent of adults in the United States drank alcohol at some point in their lives, and more than half of the adults surveyed reported drinking in the past month.

However, consuming alcohol can affect various medical conditions and can interact with many medications. Although moderate drinking does not appear to have a significant impact on MPNs, any alcohol consumption (especially heavy drinking) can contribute to several complications.

Before you reach for your next beverage, here’s what to consider.

How Does Alcohol Affect MPNs?

Research has not found a link between drinking and increased risk of developing MPNs. Some research has found a correlation between drinking and reduced risk of developing polycythemia vera and essential thrombocythemia.

However, these results do not imply that drinking alcohol can prevent or improve MPNs, only that drinking is not a risk factor for MPNs. Alcohol does not usually exacerbate symptoms in people with MPNs, but it can contribute to complications such as dehydration and blood clots.

Dehydration

Alcohol acts as a diuretic, increasing urination and contributing to dehydration. MPNs are caused by an overproduction of different types of blood cells, including red blood cells, white blood cells, and platelets, which can lead to increased blood viscosity, or thickness. Dehydration can reduce blood volume, also increasing the thickness of your blood. Dehydration can increase the risk of dangerous blood clots, making it important to stay well hydrated, especially when drinking alcohol.

Blood Clots

People with MPNs have a significantly higher risk of thrombosis (blood clots). Blood clots can lead to heart attack, stroke, and pulmonary embolism. Research has found that low to moderate alcohol consumption may be associated with a lower risk of blood clots, but heavy drinking, including binge drinking, can significantly increase the risk.

Does Alcohol Affect MPN Medications?

Always be honest with your doctor about your drinking habits and discuss any potential interactions with your treatments and medications. Alcohol can interact with some common medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), some antibiotics, and drugs for mood disorders.

Alcohol can increase the risk of gastrointestinal bleeding when taking NSAIDs. When used with certain antibiotics, alcohol can cause nausea, vomiting, stomach pain, headache, flushing, increased heart rate, and sudden changes in blood pressure.

Alcohol can also interact with drugs used to treat depression and anxiety, which can occur more often in people with MPNs and other cancers. Common antidepressants, such as Paxil (paroxetine) or Celexa (citalopram) and anti-anxiety medications, including benzodiazepines such as Xanax (alprazolam), can interact with alcohol. Symptoms of this interaction can include feeling dizzy, drowsy, or depressed. Alcohol can also increase the risk of overdose with certain drugs and may have negative side effects affecting breathing, motor control, and memory.

The National Cancer Institute emphasizes the importance of checking in with your cancer treatment team about the interaction of alcohol with your treatments. Health care professionals and caregivers who know your medical history, risk factors, and typical side effects are the best equipped to advise you on this topic.

When Should You Avoid Alcohol?

There are certain situations when drinking any amount of alcohol is not recommended.

Liver Problems

MPNs can lead to liver problems. Your liver is responsible for metabolizing alcohol. If you have liver damage, avoid drinking alcohol.

Bone Marrow Transplant

Bone marrow transplant (stem cell transplant) is a treatment option for some people with MPNs. Avoid alcohol immediately after a bone marrow transplant due to potential complications involving the liver and immunosuppressive medications. Drinking can interfere with your recovery after a bone marrow transplant.

How Much Alcohol Is Too Much?

Drinking one to two alcoholic drinks per day and no more than 14 drinks per week is considered moderate drinking. Drinking more than four drinks per day or periodically drinking to get drunk is considered heavy drinking.

Even moderate drinking can be too much for some people. More than 14 million adults in the United States have alcohol use disorder (AUD), which affects people from all backgrounds and all walks of life.

AUD does not necessarily involve heavy drinking or binge drinking. Having alcohol cravings, difficulty reducing your alcohol consumption, or experiencing withdrawal when not drinking can all be signs of AUD. If drinking is negatively affecting work, school, or relationships, then you may want to seek help to better control your drinking.

Talk With Others Who Understand

By joining myMPNteam, the social network and online support group for those living with MPNs, you gain a community of people who understand the challenges of living with these rare blood cancers.

On myMPNteam, more than 1,800 members come together to ask questions, give advice, and share their stories with others who understand life with myeloproliferative neoplasms.

Have something to add to the conversation? Share your experience in the comments below, or start a conversation by posting on myMPNteam.

References
  1. Alcohol Facts and Statistics — National Institute on Alcohol Abuse and Alcoholism
  2. Understanding MPNs — MPN Research Foundation
  3. Polycythemia Vera — Mayo Clinic
  4. Essential Thrombocythemia — Mayo Clinic
  5. Myelofibrosis — Mayo Clinic
  6. Drinking Levels Defined — National Institute on Alcohol Abuse and Alcoholism
  7. Alcohol Drinking, Tobacco Smoking and Subtypes of Haematological Malignancy in the UK Million Women Study — British Journal of Cancer
  8. Modifiable Lifestyle and Medical Risk Factors Associated With Myeloproliferative Neoplasms — HemaSphere
  9. Hangovers — National Institute on Alcohol Abuse and Alcoholism
  10. Myeloproliferative Neoplasms — Cleveland Clinic
  11. Understand Your Risk for Excessive Blood Clotting — American Heart Association
  12. Risk of Arterial and Venous Thrombosis in Patients With Myeloproliferative Neoplasms: A Population-Based Cohort Study — Annals of Internal Medicine
  13. Thrombosis — Johns Hopkins Medicine
  14. Alcohol’s Effects on the Cardiovascular System — Alcohol Research
  15. Alcohol Consumption, Types of Alcoholic Beverages and Risk of Venous Thromboembolism — The Tromsø Study — Thrombosis and Haemostasis
  16. Venous Thromboembolism (Deep Venous Thrombosis & Pulmonary Embolism) — Cleveland Clinic
  17. Harmful Interactions — National Institute on Alcohol Abuse and Alcoholism
  18. Anxiety and Depression in Patients With Philadelphia-Negative Myeloproliferative Neoplasms: A Nationwide Population-Based Survey in Denmark — Clinical Epidemiology
  19. Depression in Cancer Patients: Pathogenesis, Implications and Treatment (Review) — Oncology Letters
  20. Bone Marrow Transplant — Cleveland Clinic
  21. Life After Transplant — Cancer Research UK
  22. Treatment for Alcohol Problems: Finding and Getting Help — National Institute on Alcohol Abuse and Alcoholism
All updates must be accompanied by text or a picture.
Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. Review provided by VeriMed Healthcare Network. Learn more about him here.
Kristopher Bunting, M.D. studied chemistry and life sciences at the U.S. Military Academy, West Point, and received his doctor of medicine degree from Tulane University. Learn more about him here.

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