Adult living with a liver condition

Alcohol

and liver disease

Alcohol is the biggest cause of liver disease in the UK. Anyone who regularly drinks more than the recommended limits could be at risk. Around 1 in 4 of us drink alcohol in a way that could harm our health.

But there are many causes of liver disease. People with other liver conditions may need to limit or avoid alcohol. Even if alcohol was not the cause of their condition.

This page has information on alcohol and the liver. And links to more information and support.

On this page:

Why is alcohol bad for the liver?

Your liver has hundreds of jobs. These include helping to break down a lot of what you eat and drink. When the liver breaks down alcohol, it makes harmful chemicals. These can damage and kill liver cells.

The liver is very good at repairing itself. But it can only take so much. If someone is regularly drinking too much alcohol, it can’t keep up with the damage. This can cause scarring to build up in the liver. Over time, this can prevent the liver from working properly. It may lead to serious long-term liver damage known as cirrhosis.

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Who gets alcohol related liver disease?

Anyone who drinks more than the recommended limits is at risk of alcohol related liver disease.

How big that risk is can vary between individuals. Not everyone who drinks too much alcohol will be affected. And some people who only drink a little over the limits will develop liver disease.

It is usually impossible to predict who will get alcohol related liver disease and who will not. But there are some things that we know increase the risk:

Having another type of liver disease.

If someone already has liver damage, the extra damage from alcohol can make things worse.

Being overweight or having a metabolic condition like type 2 diabetes.

The second most common type of liver disease in the UK is called MASLD. This is linked to fat in the liver. When this is combined with alcohol it makes serious liver disease more likely.

Genetics and family history

These can also play a role for some people. They could make it more likely that drinking leads to alcohol related liver disease.

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How much alcohol is too much?

There is no completely safe amount of alcohol. But if your liver is healthy and you choose to drink, you can keep the health risks low by following the UK alcohol guidelines:

Do not drink more than 14 units of alcohol in a week
Spread drinking out over several days
Have 3 alcohol-free days a week. It’s even better if they’re in a row

Taking a few alcohol-free days each week helps your liver recover. The liver has a special ability to repair itself. But it the damage keeps coming it cannot keep up. Weekly breaks can stop damage from building up. And help prevent serious liver disease.

But even with that break it’s important not to drink more than 14 units a week. And not have too much in one session. A heavy drinking day can quickly harm your liver, especially if it’s already damaged. It also makes accidents and injuries more likely.

Binge drinking means consuming 6+ units (women) or 8+ units (men) in one session.

If you already have a liver condition it is important to get personal advice. For some conditions it is ok to drink within the limits. But for others it is important never to drink at all. Your specialist liver healthcare team are the best people to talk to for advice.

Cutting down on alcohol can be hard. If following these rules is not working for you then it might be better to get some extra help. You can find information about support further down the page.

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What are alcohol units?

Alcohol is measured in units. Units show you the alcohol content in a drink. One unit is the same as 2 teaspoons of pure alcohol.

The label on a drink should tell you either the number of units in it or the ABV (alcohol by volume). The ABV shows the drink’s strength.

You can use our free, confidential at-risk checker. It helps you work out how many units you drink. And learn about other liver disease risk factors.

Liver disease at-risk checker

The table below shows how many units are in various drinks, rounded to the nearest half unit.

Wine (all types).
750ml bottle	13% ABV	10 units
175ml glass	13% ABV	2.5 units
125ml glass	12% ABV	1.5 units
Beer, ale, lager and cider. Watch out for high strength drinks, try a smaller serving – some pubs offer one- and two-third servings as well as pints and halves.
1 pint	4% ABV	2.5 units
1 pint	5% ABV	3 units
Half pint	7% ABV	2 units
1 pint	7% ABV	4 units
Spirits (with or without a mixer). In England and Wales, a single is always 25ml. But in Scotland and Northern Ireland it can be 25ml or 35ml.
25ml single measure	40% ABV	1 unit
35ml single measure	40% ABV	1.5 units
Alcopops, ready-to-drink and pre-mixed drinks.
250ml bottle or can	4% ABV	1 unit

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How can I cut down on alcohol?

There are many ways to cut down on alcohol. Explore different options and stick with the ones that work best for you.

Don’t stress over a small mistake; nobody is perfect all the time. Just keep moving forward. Think over what happened and why. Is there something you could change for next time?

If you have physical withdrawal symptoms, It can be dangerous to stop drinking suddenly. Speak to a doctor before trying to cut down or stop drinking. Physical withdrawal symptoms include shaking, sweating or feeling anxious until you have your first drink of the day.

What does cutting down mean for you?

It can help to be clear in your mind about what you mean by cutting down

Is there a particular limit you want to set yourself, for units or drinks?
Do you want to have more drink-free days?
Or is it more about no longer drinking in certain situations?

Telling someone else, like a partner or friend, can also help you to set a clear goal and stick to it.

If you aren’t sure where to start, try one of these ideas:

Choose a lower strength drink or go for a low or no alcohol version. Beer, wine or a cocktail, there’s lots of choice. If you need to avoid all alcohol check the label, some drinks still contain a small amount.
Set yourself a budget. You might be surprised at how much you spend on alcohol. Cut down by giving yourself a fixed budget. Save up the extra money for a treat, like a family day out or some new clothes.
Buddy up and cut down with a friend. You can help one another stick to your goals.
Track your drinks so you know where you started and can see the progress you’re making. It can help you cut down too. Visit Alcohol Change to download a free drinks tracker.
Go half and half and have a shandy or a spritzer. Or make every other drink a soft one, starting with your first.
Stay out of rounds and in control. Don’t let other people set the pace. It’s easy to drink more than you meant to when you’re keeping up with the group.
Don’t top up your glass as it’s easy to lose track of how much alcohol you’ve really had. Try measuring the glasses you use at home, so you know how much you’re drinking.
Only drink alcohol with your evening meal. Cut out drinks before or afterwards.
Do something different when you go out. Try bowling, the cinema or going for a coffee instead of heading to the pub.

Download some of our top tips for cutting down – either for yourself or a friend.

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How can I deal with the pressure to drink?

We know that in the UK there is still a lot of stigma around liver disease and alcohol. But for many people there is also a lot of pressure to drink alcohol. Especially if you are out with friends.

The good news is that more and more people are choosing to cut down on alcohol. There is a good chance you will find others who will respect your decision. They may even want to join you.

It might help to share this information so others can find out more. And to help them understand that you are still you. You are just making a change to look after yourself.

Find out more about dealing with stigma and liver disease.

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How can I get help to cut down on alcohol?

Cutting down on alcohol can be hard. Lots of people struggle. If you are one of them it is nothing to feel ashamed or embarrassed about.

Deciding to make a change is the most important step. Getting help means you are more likely to succeed and to stick to it.

Speak to your GP.

Lots of people drink more than they would like to. Your GP should be used to talking about this. They can refer you to local alcohol services who can help you understand your drinking. They can also support you to either cut down or stop, whichever is best for you.

Contact a support organisation

Drinkline. A national alcohol helpline. Calls are free and completely confidential. Call 0300 123 1110 (weekdays 9am-8pm and weekends 11am-4pm).

Alcoholics Anonymous. They offer support to stop drinking throughout the UK. Call free on 0800 9177 650 or visit www.alcoholics-anonymous.org.uk.

Smart Recovery. A charity that promotes addiction recovery through meetings and online resources, including online meetings. Visit www.smartrecovery.org.uk

NHS alcohol support information. Find more information about when and how to get help. Including links to more UK support organisations and local support services in England. Visit www.nhs.uk/live-well/alcohol-advice/alcohol-support/

Supporting someone else?

You can find more support in our Family, Friends and Carers section. Including more links to organisations who can help your loved one and information on support for you.

Support for family friends and carers.

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When should I get medical help?

Always see a doctor if:

You have alcohol withdrawal symptoms
You would like support for cutting down
You have a liver condition and are not sure you can drink alcohol
You have any symptoms of liver disease
You are at higher risk of liver disease

Symptoms of liver disease

Many people have no symptoms in the early stages of liver disease. But this is the best time to find the problem and start to make changes. Never wait for symptoms if you think you might be at risk.

If you do have symptoms, it is important to go to your GP for tests.

For more on liver disease symptoms and what to do if you have them, visit our symptoms page:

Symptoms of liver disease