Why do I get sick now after even a few drinks (but not every time)?

January 26, 2008 11:29 AM

Over the last year (I am 36) I have experienced some disturbing effects related to my drinking even a small amount of alcohol (two drinks or so). The odd thing is, I am only adversely effected some of the time...

I have been, in my earlier years, an accomplished drinker. Though never one to drink regularly, when I did go out and drink I could keep up with the best of them. At the most, in my twenties, I drank two or three nights a week. Now in my thirties and with a newborn, I have neither the time nor the desire to revisit that lifestyle. That being said, I do enjoy now and again, having a few glasses of wine with dinner or a few beers with friends here and there.

The problem is that sometimes as little as two drinks will leave me waking around two to three hours after I fall asleep. I wake immensely hot, and nausea begins to creep over me. I have horrible gas and eventually my body starts to get rid of everything out both ends. Sometimes this happens, and sometimes it doesn't. It does not seem to matter what type of alcohol I drink.

I am on no medications other than I receive ocular injections of a small amount of Avastin for ocular histoplasmosis about three times a year. I eat well and exercise three to four times a week. I do take a protein shake after each weight lifting session, though I have had these ill effects on days when I don't drink in the extra protein as well.

I am going to the doc this week by the way, but was curious as to what the hive would come up with...

Thanks for any insights!

posted by pazoozoo to health & fitness (20 comments total)

I read somewhere recently (unfortunately I can't remember where) that the metabolites from alcohol can interfere with sleep- a couple of drinks in the evening can make one very sleepy at first but can cause insomnia-like wakefulness a few hours later. I have definitely experienced this after drinking a couple of glasses of wine at night. I can't comment on your nausea and overheating- but this perhaps is also related to how you are metabolizing the alcohol. It probably wouldn't hurt to make sure you drink a couple of tall glasses of water before you retire. Hope that helps....
posted by mistsandrain at 11:37 AM on January 26

I should have added that hopefully your MD will check for proper liver function...
posted by mistsandrain at 11:40 AM on January 26

get checked out for celiac disease. does this happen when you eat bread or pasta? you might have developed some gluten intolerance.
posted by thinkingwoman at 12:00 PM on January 26

I was able to drink like a fish in college, but the older I get the less tolerant I am with booze. Even half a beer now will wake me up at about 4:00 a.m. feeling like I licked an ashtray and I can smell the beer oozing out of every pore. It ain't pretty. Maybe we just grow less tolerant as we age.
posted by 45moore45 at 12:15 PM on January 26

In my earlier twenties I used to drink a lot more than I do now. And I could drink a heck of a lot in a short period of time and not experience near what I do now (late 20's) after just a few beers spread out over several hours. My symptoms aren't as severe as yours, but after a few drinks over the course of an evening (wine or beer, not tequila shots or anything) I definitely wake up a few times in the middle of the night feeling hot and sick to my stomach and the next morning am surprisingly close to hungover for having had, say two and a half glasses of wine between 6:30 and 11. I always assumed this was related to getting a bit older and drinking far less frequently, making my body less tolerant when I do drink. Also, I assume that whatever/how much I've eaten (or haven't eaten) combined with how sleep deprived I am, water intake and hormonal issues (I'm a chick) play some role in this reduced tolerance/increased likelihood of sickness.

That said, I seem to experience a milder version of what you describe. So, obviously YMMV and asking the doctor can't hurt.
posted by sneakin at 12:21 PM on January 26

No real help to offer, but I'm 36 as well and the same thing has started happening to me, and it's REALLY annoying. The good news is that I look at it as having my hangover in the middle of the night, and then I go back to bed, and wake up in the morning feeling relatively normal. Best of luck to you!
posted by jildelicious at 12:26 PM on January 26

The "coming out both ends" portion of your post leads me to think that you may be a member of that small but august community, "those-unable-to-process-alcohol."

Membership often begins in the late twenties or early thirties. Initiation fees waved.

Experiment with different types of booze -- distilled, fermented, scotch, tequila, vodka--to discover if this is truly an accurate description of your problem. Some can cope with "white" spirits (like gin and vodka); others can't.

If, after a year or two of experimentation, you find that your divorce from booze has been finalized, don't despair. Marijuana, for those lucky to live in tolerant countries (or areas, like California, with enlightened medical views) is your friend.
posted by Gordion Knott at 12:33 PM on January 26

I went out with my boyfriend and his father a couple of weeks ago. We split a pitcher of margaritas, and all woke up in the middle of the night feeling extremely sick. We thought it must have been the food but I guess not! This also happened to me after 3 beers last weekend; however, last night I had considerably more to drink, and my hangover was delayed until I woke up at 9 AM.
posted by chelseagirl at 12:40 PM on January 26

Get check for allergies with your doctor. Thinkingwoman's suggestion would be worth looking into.
posted by munchingzombie at 12:59 PM on January 26

I can't shed any clinical light on this, but over the past two years (I'm 33) I've noticed many of these same side effects on sleep, digestion, and general well-being from relatively minimal and well-paced drinking totaling 2-3 beers or glasses of wine. I don't have a name for it except aging.
posted by foxy_hedgehog at 1:01 PM on January 26

I'm in my mid-thirties and definitely don't drink the way I used to (or tolerate excessive alcohol as well as I used to.) However, your experience sounds way more extreme than just the ol' gettin' older thing. And it's hard on your body to be sick like that.

In preparation for your doctor's visit, you should keep a food diary. Maybe your symptoms have something to do with a combination of some food that you're borderline-not-tolerating coupled with alcohol.
posted by desuetude at 1:49 PM on January 26

The sporadic symptoms from drinking alcohol you describe are almost identical to those of an acquaintance of mine who developed them after getting infected with Giardia as a social worker in a nursing home a number of years ago. I think she has chronic giardiasis, but I was unable to convince her she should return to the doctor for further treatment. A quick Googling did not disclose an established connection to alcohol consumption for the periodic intestinal problems associated with chronic Giardia infection (though alcohol is apparently toxic to the parasite), but other than that, your description of what happens to you seems typical of chronic giardiasis.

When I went to Wikipedia, to look up ocular histoplasmosis, I found an interesting article entitled Presumed ocular histoplasmosis syndrome (POHS) which said that

It is thought to be caused by Histoplasma capsulatum, but the fungus has rarely been isolated from cases with POHS.

and that it

is characterized by peripheral atrophic chorioretinal scars...

When I Googled 'ocular giardiasis' I found an article which said

Infection generally manifests as intestinal illness, but ocular findings are being recognized with increasing frequency. G. lamblia is found worldwide and is relatively common in the United States. It is found in contaminated water sources as well as food which has been contaminated by a human carrier.

and that

Interestingly, ocular disease has not been shown to be related to the presence of microorganisms within eye structures. Rather, it appears that ocular disease is allergic in nature (13, 148). The pathogenesis of this is poorly understood.

The ocular manifestations associated with giardiasis include chorioretinitis, iridocyclitis, retinal hemorrhage, retinal arteritis, vitreous hemorrhage, and uveitis. Retinal changes have been described as "salt and pepper" changes (55). Diagnosing ocular giardiasis is a challenge and is generally made by exclusion. Retrospective diagnosis may be made by demonstration of improvement in ocular findings following a course of treatment with antigiardial agents (138). Diagnosing intestinal disease by the identification Giardia antigen may help support the diagnosis of ocular giardiasis.

Note the similarity between peripheral atrophic chorioretinal scars for ocular histoplasmosis, and chorioretinitis for ocular giardiasis.

If your diagnosis is indeed 'presumed ocular histoplasmosis syndrome' meaning that no histoplamosis organisms have been demonstrated in your eye, I think you should insist on an antibody test for Giardia.

One last thing-- if the doctor you are seeing this week made the diagnosis of ocular histoplasmosis in the first place, it would only be human nature for him or her to be quite resistant to exploring the possibility you might be suffering from giardiasis instead.
posted by jamjam at 2:11 PM on January 26

i'm in the same club as you, bro

27 yo, and this past year it has gotten tougher and tougher for me to process booze

a couple of drinks is all it takes to get me shittin' and puking like the dickens, usually starting very late at night/early morning afterword, then i feel mega shitty and hung over t hroughout the morning

drink more, and things really get bad

i quit drinking! sux, but i save money and can drive everyone around now
posted by Salvatorparadise at 2:22 PM on January 26

Your description reminds me of first night I ever got tore up, it also sounds a lot like the second and third time too. Of course, back then, I had a nice young body to deal with it.

My guess is that you are just out of drinking shape. Maybe you are comparing the days gone by to the days of now and things don't add up? Let us know what the doc has to say.
posted by bkeene12 at 2:26 PM on January 26

I'm approaching 40, used to be able to knock back beer at an alarming rate. The hangovers kept getting worse, and then the symptoms you describe started to happen. I've mentioned it to my doc, she thought it was a normal and unhappy part of aging. I don't drink nearly the amount I did even 2 or 3 years ago, and when I do drink I found that 1-2 good whiskeys chased with water works fine with few ill effects.
Welcome to the second half of your life!
posted by kuujjuarapik at 2:45 PM on January 26

If a couple of drinks makes you puke, get to a doctor, and don't take "you're getting old" for an excuse. There has to be a reason for it. There is no normal reason that such a small amount of alcohol should ever cause those effects in someone who used to be able to handle it. Good luck!
posted by gjc at 3:50 PM on January 26

You mention a newborn in the house. In my experience,lack of sleep or interrupted sleep, possibly coupled with erratic eating in your case, can magnify the effects of alcohol.

As I was deeply, unpleasantly reminded this week when I got bombed on one glass of wine and four hours of sleep.
posted by DarlingBri at 4:33 PM on January 26

pazoozoo,

A trip to your doctor will likely serve you well. I can tell you none of the above answers are going to give you a correct diagnosis, but what's ailing you is far more pedestrian and simple. Suffice it to say that one of the more common manifestations of hyper-acidity/acid reflux is a lack of heartburn and instead a full blown bout of top to bottom evacuation. My guess is there are circumstances you sometimes create with the right combination of food/drink/excess weight(?), etc. that results in sporadic symptoms.

Please go see your doc. You may have more of a problem than you think.
posted by docpops at 6:44 PM on January 26

I did go to the doc today and I did indeed get the "you are getting old" and sometimes people develop an intolerance for alcohol bit. I am not satisfied with that and asked to be checked for proper liver function and hepatitis. The doc tried to explain it as like developing an allergy. Not sure what to think at this point. Maybe I am too bogged down in cause and effect, but I have a hard time believing that things like this "just happen".
posted by pazoozoo at 6:07 PM on January 28

pazoozoo, if you a) explained in graphic terms the effect of alcohol on you and b) explained that these are new symptoms from a small amount of alcohol that are waking you up in the middle of the night (!), I think it's reasonable to insist that he take your symptoms more seriously. It will likely be easier to just get a second opinion.

So many people lie to their docs about how much they drink and smoke and do drugs and eat that I think that some doctors automatically do a lot of assuming. And a lot of people who complain to their doc that they puke and have an upset stomach when they drink are, in fact, reporting the elusive "hangover," but that doesn't mean that you are.

(In fact, anecdotally, I have heard that your average GP/internist assumes that you drink twice as much as you disclose. Any MDs wanna 'fess up?)
posted by desuetude at 6:51 PM on January 28