Surprising Ways The Body Reacts to Alcohol | Horizon: Is Binge Drinking Really That Bad?| Earth Lab

We're looking at inflammatory markers called cytokines. A cytokine is a small chemical released by cells of the body to signal inflammation or infection somewhere. So these might be things that might occur when you have an infection, like a cold, but also when some of the organs of the body are damaged. Liver expert Professor Rajiv Jalan has the results. Hi, how are you doing? Thank you so much for seeing us. It's wonderful to meet you guys finally. So this is what happens to you, OK? The left-hand graph shows our results as the test began, after four weeks being teetotal. The graph on the right illustrates before and after our final drinking session. I mean, that is very dramatic. That's very dramatic. So this is Chris here. It is same for Zand. Your body is manifesting systemic inflammation, which is significantly worse than a healthy individual. Here, we're looking at tumour necrosis factor alpha. This is a cytokine that signals inflammation in the body. It's commonly elevated in patients who are extremely unwell. And just to be clear, this has changed from week zero to week four. Our levels are massively elevated. Absolutely. You've both got increased systemic inflammation by a similar amount. This is all over our body. This is all over your body. These are big changes in pro-inflammatory cytokines for both of you. I think that's really, really interesting. So, just to summarise, so far... What you don't want is to hear the liver doctor saying, I think that's really interesting, meaning, I think you're really ill in an interesting way. You never want anyone like these guys going, I think it's really interesting. It's fascinating, and we must study you more. Would you mind seeing some medical students? In 2014, a study at the University of Massachusetts showed an increase in these same inflammatory markers in healthy volunteers after just a single binge. The same tests are yet to be performed on daily moderate drinkers like me, but three units affected me too. And we saw this surprising result in a further five inflammatory markers. It seems both of our bodies were responding to alcohol as if to injury or infection. It's surprising, I mean, all those are on these... It does seem to be having a bigger change in his inflammatory markers. I do seem to be quite inflamed at the end of this, you know? I haven't got away from this scot-free. I feel like we've both lost this argument. So far, we're both losing, which is what I said at the beginning. OK, so, let me show you now. Ah, OK, OK, OK. So, this is looking at the endotoxin methods. Ooh! OK. Endotoxin is a part of many of the bacteria that are resident in our gut. The presence of endotoxin in our blood samples indicates that pieces of bacteria have somehow escaped from the gut. In your case, Zan, as you can see, the levels of endotoxin is very different to the endotoxin levels that we see in Chris's blood. When you're drinking large amounts of alcohol, it produces a particularly deleterious effect on the gut. At binge drinking levels, acid aldehyde damages the gut lining, which leads to bacteria leaking into the blood and being circulated around the body. It's this that causes an increase in inflammatory cytokines, which are trying to fight what they perceive to be a bacterial infection. So, ordinarily, my gut wall, my intestines, are keeping all these bacteria out of my bloodstream. And the problem with the alcohol is it gets broken down into this nasty chemical, the acid aldehyde, and that makes my gut leak. It separates the cells and it means the bacterial poisons, effectively, are getting into my bloodstream. And that gets my whole immune system going, creates inflammation everywhere, it's damaging my organs. So, I'm literally being poisoned by the bacteria in my own intestine. Absolutely right. The scientists in Massachusetts also found these elevated endotoxin levels in the blood of their binge volunteers, confirming the link between systemic inflammation and endotoxin leakage from the gut at binge levels. By week four, Zahn's bloods show that his immune system was already hugely inflamed, even before he'd started the final binge. That's maybe the most terrifying bit of this graph for me, is that on week four, I've had seven days off, I haven't had a drink for seven days, and before I have that first drink, I've got double the concentration of endotoxin that Chris has got in his blood. So, what you're seeing there is the damage to my gut from the previous binges. Yes. With that sort of level of binging, six days is not enough to get you back to a healthy baseline. Probably takes a month or two. So, it seems like a slam dunk for me, doesn't it? I think we have to call it. Well, it doesn't, actually. Oh, there you go. Listen to the professor, OK? Binging is significantly worse than drinking sensibly 21 units. But I think it's very clear that, with the data that we've seen, 21 units is certainly not safe for either of you, because these tests are changing to levels that we see in cirrhotic patients after a month of drinking to what's called sensible limits. I'm completely flabbergasted, because this is completely beyond my expectation. So, when I saw these results, we went and rechecked them to make sure that these are correct. Whether 14 units is safe or not, I cannot tell. Or whether the safe limit for you is 10 units, I cannot tell. But I think probably in the future, we will reset the sensible drinking limit to perhaps a little bit lower.