Here’s What Happens to Your Alcohol Tolerance as You Age

Well + Good
By Sharon Feiereisen
May 11, 2022

There are some folks who can seemingly drink and drink without feeling any consequences (well, at least in the short term), but as our college days grow further and further out of sight, that actually gets to be increasingly rare.

“As we get older, our body’s ability to process alcohol decreases due to a combination of changes,” says Erika Schwartz, MD, an integrative medicine doctor who founded Evolved Science. “This is due to both natural aging, the buildup of exposure to toxins throughout life, as well as deterioration of enzymatic processes necessary to detoxify alcohol from our system.”

Dr. Schwartz goes on to explain that as we age, muscle is replaced by fat and fat cells hold less water than muscle cells, largely diminishing the positive effect that muscles can have on the processing of alcohol. “Not only does this mean your body can’t metabolize alcohol as quickly as it did when you were younger, it also increases the direct damage to your liver from alcohol,” she says.

That said… everyone is different.

Some people–including those who are elderly–may get wobbly after one alcoholic beverage, while others need a few drinks to feel any impact. “Body size and composition are significant factors in alcohol detoxification and tolerance regardless of age,” says Dr. Schwartz. “Many [people who identify as] men tend to have larger bodies, which indicates more area to distribute alcohol in lowering the overall alcohol content. They also tend to have more muscle, which in turn leads to a higher water content, helping to dilute and diminish the effect of alcohol on the body. Also, some [people who identify as] women have less alcohol dehydrogenase, the enzyme that breaks down alcohol, leaving more alcohol in the bloodstream for longer periods of time.” This is why the U.S. Dietary Guidelines recommend keeping drinking habits to a minimum, which they define as no more than two drinks per day for men and one per day for women.

“Moderate to heavy drinking over an extended period of time may increase the risk of a dangerous type of irregular heartbeat in adults over 40 years of age, too” cardiologist Suzanne Steinbaum, MD, DO, medical expert for American Heart Association’s Go Red for Women movement previously told Well+Good. “Atrial fibrillation, or AFib, occurs when the heart’s upper chambers beat irregularly and can increase stroke risk fivefold if left untreated. The condition is estimated to affect 12.1 million people in the United States by 2030. Studies have linked higher alcohol consumption to increased risk of AFib. If you have been diagnosed with high blood pressure, your doctor may [also] advise you to reduce the amount of alcohol you drink.”

If you’re going to drink, keep these expert-recommended tips in mind

Having progressively more and more trouble tolerating a glass of pinot is no fun, but there are a few things that can be done to mitigate the negative effects of alcohol. Dr. Schwartz suggests limiting sugar-laden mixed cocktails, which can increase the inflammatory effects of alcohol further and may cause you to drink in excess. “Outside of that, studies on effects of alcohol in the body show that the kind of alcohol isn’t as important as the amount over time.” Again, she suggests limiting yourself to one, but preferably none (she is a doctor after all!).

Frequent physical activity may also help thwart the negative effects of alcohol. “As we age, our bodies metabolize alcohol less efficiently and blood alcohol levels remain high in people who are less active and ill-prepared to detoxify its untoward side-effects,” says Dr. Schwartz.

That said, rewinding to the part about cutting back on drinking, it’s worth noting that alcohol speeds up the aging process because regular drinking can result in a loss of skin elasticity, which may mean an increase in fine lines and wrinkles. “Alcohol also decreases cellular efficiency throughout the entire body, making our vital organs function less efficiently, leading to chronic disease. Plus, it’s a depressant affecting behavior and making it difficult to think clearly and make executive functions,” Dr. Schwartz explains.

And that’s not all. While an occasional drink is fine, consuming more than what is considered a moderate amount of alcohol has been shown to have a significant effect on hormonal levels, particularly testosterone. “Many studies of adults over the years have shown that consuming two to three drinks per week had a significant decrease in testosterone after three weeks, while others show alcohol intake may increase intestinal inflammation,” says Brigid Titgemeier, RD.

Bottom line? It’s always important to be mindful and honest with yourself about how many glasses you are consuming and how often. With that in mind, like most doctors, Dr. Schwartz would suggest working on cutting out alcohol versus working on getting your body to better tolerate it. Thinking about the price of getting sick can certainly help meet Dr. Schwartz’s recommendation. If not, flavored sparkling water or a good ‘ol mocktail can ease the transition.

Other alternatives? Try one of the new-to-market alcohol-free wines(which are shockingly delicious), a booze-free spirit, or sign up for Raising the Bar, a monthly subscription box that delivers alcohol-free craft cocktail ingredients to make zero-proof drinks at home.