Why it’s a bad idea to mix alcohol with some medications

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Anyone who has drunk alcohol will be familiar with how easily it can lower your social inhibitions and let you do things you wouldn’t normally do.

But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk.

When you mix alcohol with medicines, whether prescription or over-the-counter, the medicines can increase the effects of the alcohol or the alcohol can increase the side-effects of the drug. Sometimes it can also result in all new side-effects.

How alcohol and medicines interact

The chemicals in your brain maintain a delicate balance between excitation and inhibition. Too much excitation can lead to convulsions. Too much inhibition and you will experience effects like sedation and depression.

Alcohol works by increasing the amount of inhibition in the brain. You might recognise this as a sense of relaxation and a lowering of social inhibitions when you’ve had a couple of alcoholic drinks.

With even more alcohol, you will notice you can’t coordinate your muscles as well, you might slur your speech, become dizzy, forget things that have happened, and even fall asleep.

Woman collects beer bottles
Alcohol can affect the way a medicine works.
Jonathan Kemper/Unsplash

Medications can interact with alcohol to produce different or increased effects. Alcohol can interfere with the way a medicine works in the body, or it can interfere with the way a medicine is absorbed from the stomach. If your medicine has similar side-effects as being drunk, those effects can be compounded.

Not all the side-effects need to be alcohol-like. Mixing alcohol with the ADHD medicine ritalin, for example, can increase the drug’s effect on the heart, increasing your heart rate and the risk of a heart attack.

Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds.

Alcohol can increase the break-down of certain medicines, such as opioids, cannabis, seizures, and even ritalin. This can make the medicine less effective. Alcohol can also alter the pathway of how a medicine is broken down, potentially creating toxic chemicals that can cause serious liver complications. This is a particular problem with paracetamol.

At its worst, the consequences of mixing alcohol and medicines can be fatal. Combining a medicine that acts on the brain with alcohol may make driving a car or operating heavy machinery difficult and lead to a serious accident.

Who is at most risk?

The effects of mixing alcohol and medicine are not the same for everyone. Those most at risk of an interaction are older people, women and people with a smaller body size.

Older people do not break down medicines as quickly as younger people, and are often on more than one medication.

Older people also are more sensitive to the effects of medications acting on the brain and will experience more side-effects, such as dizziness and falls.

Woman sips red wine
Smaller and older people are often more affected.
Alfonso Scarpa/Unsplash

Women and people with smaller body size tend to have a higher blood alcohol concentration when they consume the same amount of alcohol as someone larger. This is because there is less water in their bodies that can mix with the alcohol.

What drugs can’t you mix with alcohol?

You’ll know if you can’t take alcohol because there will be a prominent warning on the box. Your pharmacist should also counsel you on your medicine when you pick up your script.

The most common alcohol-interacting prescription medicines are benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and some antibiotics, like metronidazole and tinidazole.

Medicines will carry a warning if you shouldn’t take them with alcohol.
Nial Wheate

It’s not just prescription medicines that shouldn’t be mixed with alcohol. Some over-the-counter medicines that you shouldn’t combine with alcohol include medicines for sleeping, travel sickness, cold and flu, allergy, and pain.

Next time you pick up a medicine from your pharmacist or buy one from the local supermarket, check the packaging and ask for advice about whether you can consume alcohol while taking it.

If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.The Conversation

Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney; Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney; Kellie Charles, Associate Professor in Pharmacology, University of Sydney, and Tina Hinton, Associate Professor of Pharmacology, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Women’s Strength Training Anatomy – by Frédéric Delavier

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Fitness guides for women tend to differ from fitness guides for men, in the wrong ways:

    “Do some squats and jumping jacks, and here’s a exercise for your abs; you too can look like our model here”

    In those other books we are left wonder: where’s the underlying information? Where are the explanations that aren’t condescending? Where, dare we ask, is the understanding that a woman might ever lift something heavier than a baby?

    Delavier, in contrast, delivers. With 130 pages of detailed anatomical diagrams for all kinds of exercises to genuinely craft your body the way you want it for you. Bigger here, smaller there, functional strength, you decide.

    And rest assured: no, you won’t end up looking like Arnold Schwarzenegger unless you not only eat like him, but also have his genes (and possibly his, uh, “supplement” regime).

    What you will get though, is a deep understanding of how to tailor your exercise routine to actually deliver the personalized and specific results that you want.

    Pick Up Today’s Book on Amazon!

    Not looking for a feminine figure? You may like the same author’s book for men:

    Check out Strength Training Anatomy (for men) here!

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  • Peanuts vs Macadamias – Which is Healthier?

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    Our Verdict

    When comparing peanuts to macadamias, we picked the peanuts.

    Why?

    In terms of macros, peanuts have more than 3x the protein while macadamias have a lot more fat. It’s mostly healthy monounsaturated fat, but all the same, we’ll prioritize the protein over the fat, which becomes the deciding factor since they are approximately equal on carbs and fiber. So, a subjective win for peanuts in this category.

    In the category of vitamins, peanuts have a lot more of vitamins B3, B5, B6, B9, E, and choline, while macadamias have slightly more of vitamins B1, B2, and C. A clear and convincing win for peanuts.

    When it comes to minerals, peanuts have more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while macadamias have more manganese. An overwhelming win for peanuts.

    Adding up the sections with their various degrees of win for peanuts, makes for an overall absolute win for peanuts, but by all means enjoy either or both; diversity is good!

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

    Enjoy!

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  • How To Reduce Your Alzheimer’s Risk

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Reduce Your Alzheimer’s Risk

    Alzheimer’s is just one cause of dementia, but it’s a very notable one, not least of all because it’s

    • a) the most common cause of dementia, and
    • b) a measurably terminal disease.

    For that reason we’re focusing on Alzheimer’s today, although most of the advice will go for avoiding dementia in general.

    First, some things not everyone knows about Alzheimer’s:

    • Alzheimer’s is a terminal disease.
    • People who get a diagnosis at age 60 are typically given 4–8 years to live.
      • Some soldier on for as many as 20, but those are rare outliers.
    • Alzheimer’s begins 20 years or more before other symptoms start to develop.
      • This makes this information very relevant for younger people approaching 40, for example.
    • Alzheimer’s accounts for 60–80% of dementia, and affects around 6% of people over 60.
      • By the age of 65, that figure is 10%. By the age of 70, however, the percentage is still about the same—this is because of the mortality rate preventing the accumulation of Alzheimer’s patients over time.

    Want to know more? Read: 2023 Alzheimer’s Disease Facts And Figures Special Report ← this is a very comprehensive downloadablereference, by the way, including a lot of information about diagnosis, treatmentpathways, and earlyinterventions.

    Speaking of diagnosis…

    Know what the symptoms are… and aren’t!

    Forgetting your car keys can be frustrating. Forgetting them frequently can be worrying.

    But: there’s a difference between forgetting your car keys, and forgetting what car keys are used for. The latter is the kind of memory loss that’s more of a red flag for Alzheimer’s.

    Similarly: forgetting someone’s name can be embarrassing. Forgetting someone’s name, asking them, forgetting asking them, asking them again, forgetting again (lather rinse repeat) is more of a red flag for Alzheimer’s.

    There are other symptoms too, some of them less commonly known:

    ❝Difficulty remembering recent conversations, names or events; apathy; and depression are often early symptoms. Communication problems, confusion, poor judgment and behavioral changes may occur next. Difficulty walking, speaking, and swallowing are common in the late stages of the disease❞

    ~ Alzheimer’s Association

    If you or a loved one are experiencing worrying symptoms: when it comes to diagnosis and intervention, sooner is a lot better than later, so do talk to your doctor.

    As for reducing your risk? First, the obvious stuff:

    The usual 5 things that go for almost everything:

    How much do lifestyle changes alone make a difference?

    They make a big difference. This 2022 population-based cohort study (so: huge sample size) looked at people who had 4–5 of the healthy lifestyle factors being studied, vs people who had 0–1 of them. They found:

    ❝A healthy lifestyle was associated with a longer life expectancy among men and women, and they lived a larger proportion of their remaining years without Alzheimer’s dementia.❞

    The numbers of years involved by the way ranged between 3 and 20 years, in terms of life expectancy and years without or with Alzheimer’s, with the average increase of healthy life years being approximately the same as the average increase in years. This is important, because:

    A lot of people think “well if I’m going to go senile, I might as well [unhealthy choice that shortens lifespan]”, but they misunderstand a critical factor:

    The unhealthy choices will reduce their healthy life years, and simply bring the unhealthy ones (and subsequent death) sooner. If you’re going to spend your last few years in ill-health, it’s better to do so at 90 than 50.

    The other thing you may already know… And a thing about it that not everyone considers:

    Keeping cognitively active is important. This much is broadly known by the general public, and to clinicians, this was the fourth “healthy factor” in the list of five (instead of the sleep that we put there, because we were listing the 5 things that go for most preventable health issues).

    Everyone leaps to mention sudoku at this point, so if that’s your thing, great, enjoy it! (This writer personally enjoys chess, which isn’t everyone’s cup of tea; if it yours though, you can come join her on Chess.com and we’ll keep sharp together)

    But the more parts of your mental faculties you keep active, the better. Remember, brainpower (as with many things in health and life) is a matter of “use it or lose it” and this is on a “per skill” basis!

    What this means: doing sudoku (a number-based puzzle game) or chess (great as it may be) won’t help as much for keeping your language skills intact, for example. Given that language skills are one of the most impactful and key faculties to get lost to Alzheimer’s disease, neglecting such would be quite an oversight!

    Some good ways to keep your language skills tip-top:

    • Read—but read something challenging, if possible. It doesn’t have to be Thomas Scanlon’s What We Owe To Each Other, but it should be more challenging than a tabloid, for example. In fact, on the topic of examples:
      • This newsletter is written to be easy to read, while not shying away from complex ideas or hard science. Our mission is literally to “make [well-sourced, science-based] health and productivity crazy simple”.
      • But the academic papers that we link? Those aren’t written to be easy to read. Go read them, or at least the abstracts (in academia, an abstract is essentially an up-front summary, and is usually the first thing you’ll see when you click a link to a study or such). Challenge yourself!
    • Write—compared to reading/listening, producing language is a (related, but) somewhat separate skill. Just ask any foreign language learner which is more challenging: reading or writing!
      • Journaling is great, but writing for others is better (as then you’ll be forced to think more about it)
    • Learn a foreign language—in this case, what matters it that you’re practicing and learning, so in the scale of easy to hard, or doesn’t matter if it’s Esperanto or Arabic. Duolingo is a great free resource that we recommend for this, and they have a wide range of extensive courses these days.

    Now for the least obvious things…

    Social contact is important.

    Especially in older age, it’s easy to find oneself with fewer remaining friends and family, and getting out and about can be harder for everyone. Whatever our personal inclinations (some people being more introverted or less social than others), we are fundamentally a social species, and hundreds of thousands of years of evolution have built us around the idea that we will live our lives alongside others of our kind. And when we don’t, we don’t do as well.

    See for example: Associations of Social Isolation and Loneliness With Later Dementia

    If you can’t get out and about easily:

    • Online socialising is still socializing.
    • Online community is still community.
    • Online conversations between friends are still conversations between friends.

    If you don’t have much (or anyone) in the category of friends and family, join Facebook groups related to your interests, for example.

    Berries are surprisingly good

    ^This may read like a headline from 200,000 BCE, but it’s relevant here!

    Particularly recommended are:

    • blueberries
    • blackberries
    • raspberries
    • strawberries
    • cranberries

    We know that many of these berries seem to have a shelf-life of something like 30 minutes from time of purchase, but… Frozen and dried are perfectly good nutritionally, and in many cases, even better nutritionally than fresh.

    Read: Effect of berry-based supplements and foods on cognitive function: a systematic review

    Turmeric’s health benefits appear to include protecting against Alzheimer’s

    Again, this is about risk reduction, and turmeric (also called curcumin, which is not the same as cumin) significantly reduces the build-up of amyloid plaques in the brain. Amyloid plaques are part of the progression of Alzheimer’s.

    See for yourself: Protective Effects of Indian Spice Curcumin Against Amyloid Beta in Alzheimer’s Disease

    If you don’t like it as a spice (and even if you do, you probably don’t want to put it in your food every day), you can easily get it as a supplement in capsule form.

    Lower your homocysteine levels

    Lower our what now? Homocysteine is an amino acid used for making certain proteins, and it’s a risk factor for Alzheimer’s.

    Foods high in folate (and possible other B-vitamins) seem to lower homocysteine levels. Top choices include:

    • Leafy greens
    • Cruciferous vegetables
    • Tomatoes

    Get plenty of lutein

    We did a main feature about specifically this a little while ago, so we’ll not repeat our work here, but lutein is found in, well, the same things we just listed above, and lower levels of lutein are associated with Alzheimer’s disease. It’s not a proven causative factor—we don’t know entirely what causes Alzheimer’s, just a lot of factors that have a high enough correlation that it’d be remiss to ignore them.

    Catch up on our previous article: Brain Food? The Eyes Have It

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  • Broccoli Sprouts & Sulforaphane

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝How much science is there behind sulforaphane / broccoli spirits and its health claims??❞

    So, first of all, what it is: sulforaphane is a compound found in Brassica oleracea, of which species broccoli is a cultivar. It’s found in the other Brassica oleracea cultivars too (e.g. cauliflower, various cabbages, Brussels sprouts, kale, etc), but for whatever reason*, most research has been on broccoli and broccoli sprouts.

    *Likely the reason is: research begets research—it’s easier to get funding to expand upon previous research, than it is to break ground on researching a different plant, where for the first third of your paper you have almost no existing scientific literature to cite. So once they got started on broccoli sprouts, everything else has been broccoli sprouts too.

    And for clarity on what broccoli sprouts are: this means that when broccoli seeds have been germinated and just begun to sprout, they are harvested and eaten. That’s the one-line explanation, anyway; there’s a little more to it than that, so anyone interested should check out our previous main feature:

    Good Things Come In Small Packages: Sprout Your Seeds, Grains, Beans, Etc

    …and for more depth than we have room for in a one-page article, check out this book we reviewed:

    The Sprout Book: Tap Into The Power Of The Planet’s Most Nutritious Food – by Doug Evans

    One thing that the science is clear on: sprouts of a given plant indeed have much higher general nutritional density than their “adult” siblings. And in the case of sulforaphane specifically, it’s about 100x higher in broccoli sprouts than in adult broccoli:

    Broccoli or Sulforaphane: Is It the Source or Dose That Matters? ← we suggest skipping down to the section “broccoli-based clinical trials”

    So, that prompts the next question: do we care?

    In other words: is sulforaphane really particularly important?

    Sulforaphane vs cancer

    The most well-evidenced health-giving property of sulforaphane is its anticancer activity:

    Brassicaceae-Derived Anticancer Agents: Towards a Green Approach to Beat Cancer

    A lot of the research there is epidemiological rather than RCTs, and where there are RCTs, they are mostly small ones, like this 10-person broccoli soup study about bioavailability (rather than the effects themselves):

    Bioavailability of Glucoraphanin and Sulforaphane from High-Glucoraphanin Broccoli

    To get into sulforaphane’s anticancer potential in seriousness, we have to look at a lot of in-vitro studies trialling it to limit carcinogenesis, or to shrink tumors with it, or specifically targetting cancer stem cells with it, which make for quite compelling reading:

    Dietary Sulforaphane in Cancer Chemoprevention: The Role of Epigenetic Regulation and HDAC Inhibition

    A quick aside: if you’re reading that and thinking “Why is sonic the hedgehog in here?” it’s because after the observation of the influence of certain genes that influence cuticular denticles (the growth of spikes) on fruit fly larvae (bearing in mind the fruit fly Drosophila melanogaster is used for so much first- or second-line genetic research, being either the go-to or the go-to after the nematode C. elegans) caused the whole group of genes to get called “hedgehog genes” and then it became scientific convention to name each newly researched gene in that set after a different kind of hedgehog. One of them, instead of being named after a real-world hedgehog species like the others, got named after the videogame character.

    Unfortunately, this now means that because the gene is associated with a certain congenital brain disorder, sometimes a doctor has to explain to a family that the reason their baby has a brain defect is because of a mutated sonic hedgehog.

    Ok, back to talking about cancer. Let’s just quickly drop a few more papers so it’s clear that this is well-established:

    However, that’s not the only established benefit:

    ❝SFN has other beneficial effects in addition to cancer protection. SFN exhibits neuroprotective effects and is implemented in treating conditions such as traumatic brain injury, Alzheimer’s disease and Parkinson’s disease.❞

    Source: Sulforaphane in broccoli: The green chemoprevention!! Role in cancer prevention and therapy

    Now, after the extract we quoted above, the rest of the section “other health benefits of sulforaphane” includes a lot of speculation, weak science, and/or things attributable to other phytochemicals in broccoli, including various polyphenols, vitamins, and minerals.

    About those broccoli spirits

    Ok, we know it was a typo, but… Actually, there is something worth mentioning here, and that’s that sulforaphane is only activated when glucoraphanin (its inactive form) comes into contact with myrosinase (an enzyme that’s only released when the plant is damaged).

    In other words, it’s necessary to injure the broccoli before consuming it, in order to release the spirits myrosinase. Now, while very few people are out there swallowing adult broccoli plants whole, it could well happen that people might wolf down uncut broccoli sprouts, since they are only small, after all.

    For this reason, it’s best that broccoli, even if it’s broccoli sprouts, be cut while raw before consumption.

    In terms of cooking, heat in excess of 140℃ / 284℉ will destroy the glucoraphanin, and less/no glucoraphanin means less/no sulforaphane.

    So, enjoying them raw or lightly steaming them seems to be best for this purpose:

    Impact of thermal processing on sulforaphane yield from broccoli (Brassica oleracea L. ssp. italica)

    Just want a supplement?

    Many studies (including some cited by the research reviews we cited above) deal with sulforaphane in extract form, rather than whole plants, so there’s no shame in taking it that way if you’re not a fan of broccoli.

    We don’t sell it, but here for your convenience is an example product on Amazon 😎

    Enjoy!

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  • Cabbage vs Carrots – Which is Healthier?

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    Our Verdict

    When comparing cabbage to carrots, we picked the carrots.

    Why?

    Both are top-tier vegetables! But as the Highlander said, “there can be only one”, and we say carrots get a marginal victory;

    In terms of macros, nominally cabbage has slightly more protein (but it’s a tiny amount, and thus an even tinier difference) while carrots have slightly more fiber and carbs (but again, not big differences), as well as the lower glycemic index (but nobody is getting metabolic disease from eating cabbage). We could call this category a tie because it’s all so close, but by the numbers, it’s a slender victory for carrots.

    In the category of vitamins, carrots have more of vitamins A, B1, B2, B3, B5, B6, and E, while cabbage has more of vitamins B9, C, K, and choline. Thus, a win for carrots, especially as carrots’ vitamin A is 167x what cabbage has.

    When it comes to minerals, cabbage has more calcium, iron, manganese, and selenium, while carrots have more copper, phosphorus, potassium, and zinc. They’re both equal on magnesium, and their respective margins of difference for the other minerals were not big, so this round’s a clear tie.

    Adding up the sections makes for an overall win for carrots, but by all means enjoy either or both (together, even, if you like!); diversity is good!

    Want to learn more?

    You might like:

    12 Most Powerful Supplements and Foods to Increase Energy & Slow Down Aging

    Enjoy!

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  • Play Bold – by Magnus Penker

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    This book is very different to what you might expect, from the title.

    We often see: “play bold, believe in yourself, the universe rewards action” etc… Instead, this one is more: “play bold, pay attention to the data, use these metrics, learn from what these businesses did and what their results were”, etc.

    We often see: “here’s an anecdote about a historical figure and/or celebrity who made a tremendous bluff and it worked out well so you should too” etc… Instead, this one is more: “see how what we think of as safety is actually anything but! And how by embracing change quickly (or ideally: proactively), we can stay ahead of disaster that may otherwise hit us”.

    Penker’s background is also relevant here. He has decades of experience, having “launched 10 start-ups and acquired, turned around, and sold over 30 SMEs all over Europe”. Importantly, he’s also “still in the game”… So, unlike many authors whose last experience in the industry was in the 1970s and who wonder why people aren’t reaping the same rewards today!

    Penker is the therefore opposite of many who advocate to “play bold” but simply mean “fail fast, fail often”… While quietly relying on their family’s capital and privilege to leave a trail of financial destruction behind them, and simultaneously gloating about their imagined business expertise.

    In short: boldness does not equate to foolhardiness, and foolhardiness does not equate to boldness.

    As for telling the difference? Well, for that we recommend reading the book—It’s a highly instructive one.

    Take The First Bold Step Of Checking Out This Book On Amazon!

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