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Fast heartbeat after drinking alcohol, blood test normal. Is my body dependent on alcohol?

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Psychiatrist
Practicing since : 2004
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My name is Mike. I am a 29 year old and I started drinking 3 years ago. I never drank when I was younger, and the whole time I felt like I was missing out, watching everyone else party and have fun. So once I started and realized how much I enjoyed it, I got really carried away and tried to make up for lost time.

At first, I was drinking 2-3 times a week, and I was drinking a lot when I would drink (around 8-9 drinks per session). This pattern continued for a year, then reduced to around once weekly. Then the following year once every other week. My pattern has been continuously drinking less and less. Drinking has lost most of it's luster, so it's easy for me to only drink on occasion.

In the last year, I've taken many months where I didn't drink at all. However, since I do enjoy it, I've been currently drinking on 2-3 occasions a month lately. A level I don't feel is too concerning and I definitely don't feel "hooked". (Even though I did at first, it just took exercising a little control, which I've been able to do). Also, when I drink now, I typically only have 3-4-5 drinks at most.

I was hoping you could give me a little medical background to a few questions I had:

After the alcohol wears off (about 3-5 hours after my last drink) my hearts starts beating really fast! I can't even sleep because it's beating so fast. It's a really consistent beat, it's just hard and fast. Also, I feel really shaky. I don't physically shake. BUT, I feel like I am shaking on the inside. I just feel really jittery. I've read so many things online, it makes me nervous and confused. Some people said those are signs of hangover, some said those are signs of severe physical dependance, some have said your liver produces a chemical to metabolize alcohol, which increases adrenaline and makes your heart beat fast, etc.

My question is:

1. Is it possible that I feel that way because my body is physically dependent on alcohol? Is it possible for your body to be physically dependent to alcohol if you only drink 2-3 times a month? The primarily reason I am reaching out, is because I've read so much about alcohol giving people seizures or heart failure when their alcohol dependent. Though from what I've read, it seems to apply to people who drink daily, or more often than 2-3 times a month. But, I just feel so bad after drinking sometimes, it makes me worry if it's more severe than just a hang over.

I went to my doctor, he did blood tests including liver and an EKG. He said everything looks great and he said I am "over-thinking it, and go out and have fun, just keep it limited". He also knows me really well and knows I freak out over everything.

2. All that being said, do you think it's safe for me to continue drinking, or am I at high risk for seizures or heart issues?

3. I've noticed my hang overs last longer than they used to. When I first started drinking, I rarely got hung over. Now I just feel out of it for days. The first 24 hours, my heart rate feels really increased and I feel jittery, especially the first 6-8 hours. After the first 24 hours, I feel calm, I just feel tired and a little out of it. But my body feels okay. I've heard this is a sign of getting older, but do you think my extended hang overs are from doing damage to my body?

4. Last question. When I first started drinking, if I had one beer, I barely felt it. Now, if I drink one beer, within 3 sips, I get a huge dopamine rush and a "really euphoric" feeling. Again, my bloodwork and EKG show that I am fine. That being the case, is it more likely that one drink, makes me more really euphoric because I missed the sensation since last time I drank. Or, does it sound like it's affecting me more, because my body is unable to process alcohol like it use to? (reverse tolerance)

I know the right answer is, "if it makes you feel bad, stop". But, I do enjoy it. The worst part of the jittery feeling and rapid heartbeat is my fear that I am physically dependent or that I am in risk of having a seizure. Have you ever heard of someone who drinks 2-3 times a month, a few drinks at a time being physically dependent?

If I had to stop, I can. I went the last few months without drinking and it's not very important to me anymore. It kind of lost it's luster. But, I do enjoy it from time to time and I am going to a wedding tomorrow and was thinking it would be fun to have a few drinks. But not if it puts me at risk of death.

Thank you sooooo much!
MikeMy name is Mike. I am a 29 year old and I started drinking 3 years ago. I never drank when I was younger, and the whole time I felt like I was missing out, watching everyone else party and have fun. So once I started and realized how much I enjoyed it, I got really carried away and tried to make up for lost time.

At first, I was drinking 2-3 times a week, and I was drinking a lot when I would drink (around 8-9 drinks per session). This pattern continued for a year, then reduced to around once weekly. Then the following year once every other week. My pattern has been continuously drinking less and less. Drinking has lost most of it's luster, so it's easy for me to only drink on occasion.

In the last year, I've taken many months where I didn't drink at all. However, since I do enjoy it, I've been currently drinking on 2-3 occasions a month lately. A level I don't feel is too concerning and I definitely don't feel "hooked". (Even though I did at first, it just took exercising a little control, which I've been able to do). Also, when I drink now, I typically only have 3-4-5 drinks at most.

I was hoping you could give me a little medical background to a few questions I had:

After the alcohol wears off (about 3-5 hours after my last drink) my hearts starts beating really fast! I can't even sleep because it's beating so fast. It's a really consistent beat, it's just hard and fast. Also, I feel really shaky. I don't physically shake. BUT, I feel like I am shaking on the inside. I just feel really jittery. I've read so many things online, it makes me nervous and confused. Some people said those are signs of hangover, some said those are signs of severe physical dependance, some have said your liver produces a chemical to metabolize alcohol, which increases adrenaline and makes your heart beat fast, etc.

My question is:

1. Is it possible that I feel that way because my body is physically dependent on alcohol? Is it possible for your body to be physically dependent to alcohol if you only drink 2-3 times a month? The primarily reason I am reaching out, is because I've read so much about alcohol giving people seizures or heart failure when their alcohol dependent. Though from what I've read, it seems to apply to people who drink daily, or more often than 2-3 times a month. But, I just feel so bad after drinking sometimes, it makes me worry if it's more severe than just a hang over.

I went to my doctor, he did blood tests including liver and an EKG. He said everything looks great and he said I am "over-thinking it, and go out and have fun, just keep it limited". He also knows me really well and knows I freak out over everything.

2. All that being said, do you think it's safe for me to continue drinking, or am I at high risk for seizures or heart issues?

3. I've noticed my hang overs last longer than they used to. When I first started drinking, I rarely got hung over. Now I just feel out of it for days. The first 24 hours, my heart rate feels really increased and I feel jittery, especially the first 6-8 hours. After the first 24 hours, I feel calm, I just feel tired and a little out of it. But my body feels okay. I've heard this is a sign of getting older, but do you think my extended hang overs are from doing damage to my body?

4. Last question. When I first started drinking, if I had one beer, I barely felt it. Now, if I drink one beer, within 3 sips, I get a huge dopamine rush and a "really euphoric" feeling. Again, my bloodwork and EKG show that I am fine. That being the case, is it more likely that one drink, makes me more really euphoric because I missed the sensation since last time I drank. Or, does it sound like it's affecting me more, because my body is unable to process alcohol like it use to? (reverse tolerance)

I know the right answer is, "if it makes you feel bad, stop". But, I do enjoy it. The worst part of the jittery feeling and rapid heartbeat is my fear that I am physically dependent or that I am in risk of having a seizure. Have you ever heard of someone who drinks 2-3 times a month, a few drinks at a time being physically dependent?

If I had to stop, I can. I went the last few months without drinking and it's not very important to me anymore. It kind of lost it's luster. But, I do enjoy it from time to time and I am going to a wedding tomorrow and was thinking it would be fun to have a few drinks. But not if it puts me at risk of death.

Thank you sooooo much!
Mike
Posted Sat, 28 Apr 2012 in Smoking and Alcohol Addiction
 
 
Answered by Dr. Ashish Mittal 9 hours later
Hello,
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     29 year old male
•     Drinking alcohol for 3 year
•     Progressive reduction in alcohol intake in amount and frequency
•     Reduce tolerance to alcohol
•     Current pattern of alcohol use: 3-5 pegs around 2-3 times per month
•     Complaints of: increase heart rate (?palpitation), anxiety and shakiness.

You case is interesting and but difficult too. Even your attending physician is facing to solve it. I will try to give my best effort to help you in this problem.

Reverse tolerance occur in patient with alcohol dependence in the presence of severe liver dysfunction so that body found difficulty in metabolising alcohol leading to alcohol intoxication in fewer doses. I would like know your liver function test report if it has already done to help you better.

In your case there are multiple points against it:
•     Normal investigations
•     You were never physically dependent on alcohol (clear from your history), even now also you are not dependent.

About withdrawal symptoms: you are having severe hangover with alcohol. Hangover is defined as acute withdrawal from alcohol and its severity person to person. Hangover symptoms can also change over a period of time and with quality of liquor. Hangover occur most of alcohol using persons and there is no need to fulfill alcohol dependence criteria to experience hangover.

Why is your tolerance decreasing? It is surprising to me also. But I also suspect that you may have some anxiety disorder (recent onset). Alcohol is having short anxiety relieving action so your anxiety reduced on its use even with fewer doses and you feel good. That may be reason for exacerbation of hangover.

About alcohol use: I never advise patient to drink alcohol even it is not harmful in your current pattern use. It is nice and admirable that you have decreased its use significantly.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,
Above answer was peer-reviewed by
 
Follow-up: Fast heartbeat after drinking alcohol, blood test normal. Is my body dependent on alcohol? 1 hour later
Thank you SO much Dr. Mittal. That was great information.

I wish I had my liver test results to give you, but I never got a copy.

Your awnser really helped clear up a few things for me. And you REALLY hit the nail on the head regarding anxiety. I do bad have anxiety!

Just a few other questions:

1. Is it common to hear of hangovers causing rapid heartbeat and shakiness? Most people say hang overs seem more like being under the weather, where my symptoms seem like severe withdrawl. I am nervous because of how much I used to drink, my body became dependant.

2. Just to confirm, it's unlikey I could have any form of physical dependence to alcohol if I am just drinking a few times a month? I am just worried that the amount I used to drink caused me to become dependant. I worry so much that it could cause seizures or a heart attack.

3. I read about drinking causing Arterial Fibrillation. Is it likely this occurred do to drinking over time and that's what makes my heart beat so fast after drinking?

I am hoping this is all just normal signs of hang over and that your right, the anxiety is what is making it most concerning.

Thank you for everything!
Mike
Follow-up: Fast heartbeat after drinking alcohol, blood test normal. Is my body dependent on alcohol? 14 minutes later
Hey Doctor, sorry one other thing I just thought of.

Last month, I had one beer. After it wore off in about 2 hours, I also still had that shaky feeling and a really rapid heart beat.

If these symptoms were normal for hangover after having several drinks, I would understand. But it doesn't seem right that even 1 beer made me feel like that. (at the time I was really calm and couldn't have been anxiety). Literally just the one beer made my heart pound after drinking it and feeling a little shaky.

Do you think that is a sign that there is physical dependace present?

I feel like I should be able have more than 1 drink without having symptoms, as 1 drink never used to make me feel like that.

I am just so nervous. If my symptoms are just hangovers, I can brush it off and live with that. I do really enjoying drinking the few times a
month I now do it. But if there is any physical dependace there, I'll never drink again. I am just so nervous about physical dependence and having a seizure or heart attack.

Thanks a million for everything!
 
 
Answered by Dr. Ashish Mittal 5 hours later
Hello again,

It is not common to experience increase heart rate and shakiness in hangover. But in your case it is happening because you are having two conditions together: anxiety disorder and hangover.

Drinking 3-4 times per month does not cause alcohol dependence but people tend to increase dose and frequency over a period, (as you must have seen personally) which leads to dependence.

Do not worry; you are not having atrial fibrillation, as you are developing palpitation during hangover, not during intoxication.

You are having increase heart rate, excessive worry and shakiness during normal period which indicate presence of anxiety disorder itself. These kinds of symptoms can also occur in thyroid problem also, so get your thyroid hormone level done. Consultation with psychiatrist help you in relieving alcohol related worry and anxiety. You may also need some medicines to relieve anxiety after detail history and examination

Wish you good health,
Regards
Above answer was peer-reviewed by
 
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