Suppression of Hematopoiesis by Ethanol *

Abstract

Alcohol, in amounts readily consumed by "heavy drinkers," suppresses the hema-topoietlc response of anemic, folate -deficient patients to doses of folic acid in the range of the minimal daily adult folate requirement. This suppression can be overcome, either with larger doses of follc acid or by cessation of alcohol. The observation of "spontaneous" hematologic improvement seen in anemic alcoholics after hospitaltzation is, therefore, due to both ingestion of folate-containing foods and to cessation of ingestlon of alcohol. Suppression of erythropoiesis, leukopoiesis and thrombopoiesis, and conversion of the bone marrow from normoblastic to megaloblastic within 10 days was observed with either commercially available alcoholic beverages or pure U.S.P. ethanol. The serum iron concentration and saturation of Fe-binding protein were increased during alcohol ingestlon and fell upon alcohol withdrawal. This could be dissociated from the reticulocyte responses, suggesting an effect of alcohol on iron metabolism separate from the observed effects on hematopoietic activity. The effects of alcohol may be of significance in the evolution of syndromes of iron overload including hemochromatosls in alcoholic subjects. The mechanslm of the hematosuppresslve effect of alcohol is presently unknown but may be partly via an effect on folate metabolism.