Sobering signs - how do you know when to address your drinking?

David Ellis | August 2019 | 10 minutes

In this blog, retired doctor David discusses some of the physical signs to look out for that suggest alcohol may be having a negative effect on your health.

I see red when '-ic' is added to the end of a word – 'diabetic', 'schizophrenic' and 'alcoholic', for example. It's too easy to let the problem label the person. I believe that those of us drinking too much aren't '-ics'. We just have a problem. But how can you tell your drinking has gotten to a point when you should consider doing something about it? In this blog, I’ll take you through some of the sobering signs that it’s time to address your drinking.

Feeling liverish

Playing a role in over 500 vital processes, the liver has its work cut out, so the last thing it needs is alcohol on a daily basis. Amazingly, it does this largely uncomplainingly until a brick wall of fibrosis has built up that stops it dead in its tracks. The warning signs of the whites of your eyes turning yellow with jaundice and a tummy bloated with fluid need immediate attention from your GP or the nearest A&E department.

Thankfully, cirrhosis will only happen to the minority of drinkers. Loss of appetite, nausea, tiredness and tummy pain could be the early stages of your liver playing up, but feeling 'liverish' can cover a multitude of ills. The bottom line is that if it persists, you should see your GP and they'll arrange some liver function blood tests.

Battling weight

TV diet programmes are stuffed to the gills with participants complaining that they can't lose weight. Calories expended minus calories consumed equals weight loss. Simples! But somehow the calories in glasses of white wine or a few G&Ts often get forgotten. If you find yourself gaining weight or unable to lose it despite dieting and exercising, make sure you’ve taken into account whatever you bought at the off license. You might be shocked by the re-calculation. And that might be the nudge you need to get your drinking under control, which will benefit you in ways that go far beyond your waistline.

Counting sheep

"To sleep, perchance to dream." That's unfortunately unlikely if you've been drinking before bed. Alcohol is terrific for bludgeoning you into a deep sleep, but it shoots the restorative REM sleep to pieces, so you're more likely to have nightmares and feel shattered in the morning. Curb the alcohol and you'll be back in the happier land of Nod in no time. If you’re feeling lethargic in the mornings, think back: what did you have to drink the night before? It may be worth cutting the booze and seeing if that makes an impact.

Having skinfuls

Alcohol is an excellent dehydrator. That's why it can be used for preserving biological specimens. The skin is particularly vulnerable to this and flaking and dryness results. Alcohol also causes small blood vessels in the skin to widen, allowing more blood to flow to the surface. This produces a flushed colour and a feeling of warmth, which can lead to broken capillaries on the face. Even if you're not too fussed about appearances, taking care of the largest organ in the body is still important. So if your skin isn’t peachy, now might be the time to take stock of your drinking.


Alcohol's impact on the brain is just as insidious as on the body. Bathe any organ in ethanol and it'll give up the ghost soon enough. There's a direct toxic effect of alcohol on the chemicals and pathways that your brain cells use to send messages, so forgetting things should make you sit up and think. It can even cause brains to shrink. Some doctors refer to this as the "pickled walnut" effect. Charming. But like the liver, it's potentially reversible if caught early enough.

And while a glass of something may seem the ideal antidote for stress, the after-work drink can rapidly become a habit, followed by the short-term emotional anaesthesia switching to a state of low mood and anxiety, which can have you reaching for a glass of something day after day. Try ‘the mindful pause’ for dealing with stress: pause, breathe for 15 seconds, question yourself and then take action with a character strength. That can be applied when you’re considering drinking, too.

Knowing vitals

Alcohol can raise your blood pressure, so a finger on your pulse should be in any health check. Raised cholesterol is another hidden consequence of drinking. Online retailers like Amazon have easy-to-use blood pressure monitors for as little as £20. Some high street pharmacies will measure your blood pressure and do a cholesterol check at the same time. If you don't mind an at-home, finger-prick blood test, online company Medichecks offers a Health and Lifestyle Check that covers the liver, kidney, heart health and key nutrients, with GP advice thrown in for good measure, and all for £59. Your GP might even thank you for doing some of the hard work. Of course, many of us won’t want or be able to spend this money – and you don’t have to. Pop along to your GP and they can check much of this for you, and give advice on whether there’s anything for you to worry about.

If any of the signs above have given you pause for thought, there are a few actions you can take. First off, you might choose to cut down on the booze by yourself. Go you! But you might want to get some tips and tricks, as cutting down will be tricky. Here’s a good place to start.

A good way of seeing whether alcohol is at the root of some of your health complaints is taking on a month alcohol-free. Lots of people choose Dry January® as their time to shine, but you can do it at any time of year. There are lots of resources and a free app to help you – find out about them here. It can be dangerous to stop drinking suddenly if you’re drinking very heavily or regularly – if you think this could be you go and see your GP before attempting the challenge. There’s more about how to decide if a dry month is right for you here.

If you think you’ll need some more support, there’s lots of information here on the help available. A good place to start is often a visit to your GP.

It's all about making sure that you’re in control of what you’re drinking, not the other way around – and who can argue with that?

Want to know more about alcohol and your body?

Explore the body map to find out more.

David Ellis is a retired doctor with 25 years’ experience of helping people with mental health problems, including alcohol dependence and substance misuse. His own zero alcohol journey may be found here.