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    Alcohol Withdrawal (Holistic)

    Alcohol Withdrawal (Holistic)

    About This Condition

    Headache. Jitters. Upset stomach. Symptoms of alcohol withdrawal can be worse than a hangover?but help is available. According to research or other evidence, the following steps may be helpful.
    • Seek support

      Join a community support group like Alcoholics Anonymous to support recovery from alcohol abuse

    • Work with a specialist

      When withdrawing from alcohol, don?t risk medical complications; find a doctor or clinic that is knowledgeable about alcohol detoxification

    • Diet right

      To improve health and reduce alcohol cravings, eat more whole grains, fruit, and other healthful foods, and limit sugar, caffeine, and junk food

    • Mix in a multi

      Take a daily multivitamin to speed recovery from common alcohol-related deficiencies

    • Try milk thistle

      420 to 600 mg of an extract from this herb can help the liver recover from the effects of alcohol

    About

    About This Condition

    Alcohol withdrawal is a set of symptoms that occur with the elimination of alcohol when a person is psychologically and/or physiologically addicted to it.

    A majority of people who have been drinking alcohol and decide to stop (often for health-related reasons) are able to do so without much trouble. Alcohol withdrawal typically becomes difficult only when problem drinkers?alcoholics?attempt to quit. Almost inevitably, alcoholics need help in achieving this goal. Sometimes, this help requires medical intervention in detoxification centers.

    Finding doctors who work with alcohol detoxification is often as easy as calling the local chapter of Alcoholics Anonymous (AA) and asking for referral information. Most programs successful in getting alcoholics to quit drinking are either part of the AA network or employ AA techniques. Natural approaches to alcohol withdrawal should not be a substitute for detox centers or for AA or AA-related programs.

    Symptoms

    A person typically has a mild to severe hangover that lasts several days. Symptoms may include stomach upset ; headache; shakes or jitters; feelings of generalized anxiety or panic attacks; and insomnia that may be accompanied by bad dreams. There may be also be increases in heart rate, breathing rate, and body temperature. In a small proportion of alcoholics, withdrawal may result in severe symptoms, such as hallucinations, delirium tremens (DTs), or generalized seizures.

    Healthy Lifestyle Tips

    Most experts agree that alcoholics must stop drinking completely in order to overcome the addiction. Moreover, before nutritional supplements can be used, effective treatment of the malabsorption problems requires a complete avoidance of alcohol.

    Eating Right

    The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

    Recommendation Why
    Eat a healthy diet
    Eating more complex carbohydrates, such as whole grains, and consuming less sugar, junk food, and caffeine reduces alcohol cravings and increases the chances of staying sober.

    Some of the nutritional deficiencies associated with alcoholism can be caused by a poor diet?a factor that needs correction on an individual basis. Improving the overall diet should be done in conjunction with a doctor. Sometimes liver or pancreatic disease associated with alcoholism also contributes to nutritional deficiencies. These problems require medical assessment and intervention.

    In one trial, a hospital diet was compared with a special diet including fruit and wheat germ and excluding caffeinated coffee, junk food, dairy products, and peanut butter.1 After six months, fewer than 38% of those on the hospital diet remained sober, compared with over 81% of those eating the special diet. A review of the research shows that diets loaded with junk food increase alcohol intake in animals.2 In a human trial, restricting sugar, increasing complex carbohydrates, and eliminating caffeine also led to a reduction in alcohol craving.3 While the support for dietary intervention remains somewhat unclear, some doctors suggest that alcoholics reduce sugar and junk food intake and avoid caffeine.

    Supplements

    What Are Star Ratings?

    Our proprietary ?Star-Rating? system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

    For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

    3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

    2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

    1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

    Supplement Why
    3 Stars
    Milk Thistle
    420 to 600 mg of silymarin daily
    Though not a treatment for withdrawl symptoms, milk thistle extract is commonly recommended to counteract the harmful effects of alcohol on the liver, as this herb speeds the regeneration of injured liver cells.

    Milk thistle extract is commonly recommended to counteract the harmful effects of alcohol on the liver.4 Milk thistle extracts have been shown in one double-blind study to reduce death due to alcohol-induced cirrhosis of the liver ,5 though another double-blind study did not confirm this finding.6 Milk thistle extract may protect the cells of the liver by both blocking the entrance of harmful toxins and helping remove these toxins from the liver cells.7 , 8 Milk thistle has also been reported to regenerate injured liver cells.9

    2 Stars
    Zinc
    Take under medical supervision: 135 to 215 mg daily
    Supplementing with zinc may correct the deficiency common in alcoholic liver cirrhosis and may correct the impaired taste function that people with cirrhosis often experience.

    Alcoholic liver cirrhosis is associated with zinc deficiency.10 , 11 In a double-blind trial, zinc acetate supplementation (200 mg three times daily, providing a total of 215 mg of elemental zinc per day), given to cirrhosis patients for seven days, significantly improved portal-systemic encephalopathy (PSE).12 A second trial achieved similar results after three months of treatment 13 and a third trial found a beneficial effect from 6 months of treatment with 51 mg per day of zinc in the form of zinc L-carnosine complex.14 People with cirrhosis sometimes have impaired taste function, and it has been suggested that zinc deficiency may be the cause of this abnormality. Although one study demonstrated that taste problems in cirrhosis are due to the disease process itself and not to zinc deficiency,15 a double-blind trial showed that 200 mg three times per day of zinc sulfate (providing 135 mg of elemental zinc per day) for six weeks significantly improved taste function in people with alcoholic liver cirrhosis.16 A doctor should supervise long-term supplementation of zinc in these amounts.

    1 Star
    Beta-Carotene
    Refer to label instructions
    Though not a treatment for withdrawal, beta-carotene supplementation may be a safe way to correct vitamin A deficiencies common to alcoholics (requires a doctor?s supervision to monitor liver function and avoid damage).

    Caution: Synthetic beta-carotene has been linked to increased risk of lung cancer in smokers. Until more is known, smokers should avoid all beta-carotene supplements.

    Although the incidence of B-complex deficiencies is known to be high in alcoholics, the incidence of other vitamin deficiencies remains less clear.17 Nonetheless, deficiencies of vitamin A , vitamin D , vitamin E , and vitamin C are seen in many alcoholics. While some reports have suggested it may be safer for alcoholics to supplement with beta-carotene instead of vitamin A,18 potential problems accompany the use of either vitamin A or beta-carotene in correcting the deficiency induced by alcoholism.19 These problems result in part because the combinations of alcohol and vitamin A or alcohol and beta-carotene appear to increase potential damage to the liver. Thus, vitamin A-depleted alcoholics require a doctor?s intervention, including supplementation with vitamin A and beta-carotene accompanied by assessment of liver function. Supplementing with vitamin C, on the other hand, appears to help the body rid itself of alcohol.20 Some doctors recommend 1 to 3 grams per day of vitamin C.

    1 Star
    D,L-Phenylalanine (DLPA) (Food Allergies)
    Refer to label instructions
    In double-blind research, alcoholics treated with DLPA (D,L-phenylalanine) combined with L-tyrosine, L-glutamine, prescription L-tryptophan, plus a multivitamin had reduced withdrawal symptoms and decreased stress.

    Kenneth Blum and researchers at the University of Texas have examined neurotransmitter deficiencies in alcoholics. Neurotransmitters are the chemicals the body makes to allow nerve cells to pass messages (of pain , touch, thought, etc.) from cell to cell. Amino acids are the precursors of these neurotransmitters. In double-blind research, a group of alcoholics were treated with 1.5 grams of D,L-phenylalanine (DLPA), 900 mg of L-tyrosine , 300 mg of L-glutamine , and 400 mg of L-tryptophan (now available only by prescription) per day, plus a multivitamin-mineral supplement.21 This nutritional supplement regimen led to a significant reduction in withdrawal symptoms and decreased stress in alcoholics compared to the effects of placebo.

    1 Star
    Evening Primrose Oil
    Refer to label instructions
    In a double-blind study of alcoholics in a detox program, supplementing with EPO led to greater improvement than did placebo in some parameters of liver function.

    Alcoholics may be deficient in a substance called prostaglandin E1 (PGE1) and in gamma-linolenic acid (GLA), a precursor to PGE1.22 In a double-blind study of alcoholics who were in a detoxification program, supplementation with 4 grams per day of evening primrose oil (containing 360 mg of GLA) led to greater improvement than did placebo in some, but not all, parameters of liver function.23

    1 Star
    Glutamine
    Refer to label instructions
    Animal and double-blind human research has shown that this amino acid reduces desire for alcohol and anxiety levels.

    Kenneth Blum and researchers at the University of Texas have examined neurotransmitter deficiencies in alcoholics. Neurotransmitters are the chemicals the body makes to allow nerve cells to pass messages (of pain , touch, thought, etc.) from cell to cell. Amino acids are the precursors of these neurotransmitters. In double-blind research, a group of alcoholics were treated with 1.5 grams of D,L-phenylalanine (DLPA), 900 mg of L-tyrosine , 300 mg of L-glutamine , and 400 mg of L-tryptophan (now available only by prescription) per day, plus a multivitamin-mineral supplement.24 This nutritional supplement regimen led to a significant reduction in withdrawal symptoms and decreased stress in alcoholics compared to the effects of placebo.

    The amino acid L-glutamine has also been used as an isolated supplement. Animal research has shown that glutamine supplementation reduces alcohol intake, a finding that has been confirmed in double-blind human research.25 In that trial, 1 gram of glutamine per day given in divided portions with meals decreased both the desire to drink and anxiety levels.

    1 Star
    Kudzu
    Refer to label instructions
    Traditional Chinese medicine, animal research, and some preliminary studies have found extracts of this herb may help reduce alcohol cravings, though some studies have not shown benefit.

    Kudzu is most famous as a quick-growing weed in the southern United States. Alcoholic hamsters (one of the few animals to become so besides humans) were found to have decreased interest in drinking when fed kudzu extract.26 Traditional Chinese medicine practitioners generally recommend 3 to 5 grams of root three times per day; some herbal practitioners also suggest that 3 to 4 ml of tincture taken three times per day may also be helpful to reduce alcohol cravings. Nonetheless, a double-blind trial using 1.2 grams of powdered kudzu root twice per day failed to show any benefit in helping alcoholics remain abstinent from alcohol.27 On the other hand, supplementing with a kudzu extract (1,000 mg three times a day for seven days) significantly reduced the amount of beer consumed by heavy alcohol drinkers in a short-term experiment.28

    1 Star
    L-Tyrosine, D,L-Phenylalanine (DLPA), L-Glutamine, L-Tryptophan, and a Multivitamin
    Refer to label instructions
    In double-blind research, alcoholics treated with L-tyrosine combined with DLPA (D,L-phenylalanine), L-glutamine, prescription L-tryptophan, plus a multivitamin had reduced withdrawal symptoms and decreased stress.

    Kenneth Blum and researchers at the University of Texas have examined neurotransmitter deficiencies in alcoholics. Neurotransmitters are the chemicals the body makes to allow nerve cells to pass messages (of pain , touch, thought, etc.) from cell to cell. Amino acids are the precursors of these neurotransmitters. In double-blind research, a group of alcoholics were treated with 1.5 grams of D,L-phenylalanine (DLPA), 900 mg of L-tyrosine , 300 mg of L-glutamine , and 400 mg of L-tryptophan (now available only by prescription) per day, plus a multivitamin-mineral supplement.29 This nutritional supplement regimen led to a significant reduction in withdrawal symptoms and decreased stress in alcoholics compared to the effects of placebo.

    1 Star
    Magnesium
    Refer to label instructions
    Alcoholics are sometimes deficient in magnesium, and some researchers believe that symptoms of withdrawal may result in part from this deficiency.

    Alcoholics are sometimes deficient in magnesium , and some researchers believe that symptoms of withdrawal may result in part from this deficiency.30 Nonetheless, a double-blind trial reported that magnesium injections did not reduce symptoms of alcohol withdrawal.31

    1 Star
    Multivitamin
    Refer to label instructions
    Because of multiple nutrient deficiencies associated with alcoholism, most alcoholics who quit drinking should take a high-potency multivitamin for at least several months after the detox period.

    Kenneth Blum and researchers at the University of Texas have examined neurotransmitter deficiencies in alcoholics. Neurotransmitters are the chemicals the body makes to allow nerve cells to pass messages (of pain , touch, thought, etc.) from cell to cell. Amino acids are the precursors of these neurotransmitters. In double-blind research, a group of alcoholics were treated with 1.5 grams of D,L-phenylalanine (DLPA), 900 mg of L-tyrosine , 300 mg of L-glutamine , and 400 mg of L-tryptophan (now available only by prescription) per day, plus a multivitamin-mineral supplement.32 This nutritional supplement regimen led to a significant reduction in withdrawal symptoms and decreased stress in alcoholics compared to the effects of placebo.

    Because of the multiple nutrient deficiencies associated with alcoholism, most alcoholics who quit drinking should supplement with a high-potency multivitamin-mineral for at least several months after the detoxification period. Whether or not the supplement should include iron should be discussed with a doctor.

    1 Star
    Vitamin A
    Refer to label instructions
    Because of potential liver damage, correcting the vitamin A deficiency common to alcoholics requires a doctor?s supervision to monitor liver function.

    Although the incidence of B-complex deficiencies is known to be high in alcoholics, the incidence of other vitamin deficiencies remains less clear.33 Nonetheless, deficiencies of vitamin A , vitamin D , vitamin E , and vitamin C are seen in many alcoholics. While some reports have suggested it may be safer for alcoholics to supplement with beta-carotene instead of vitamin A,34 potential problems accompany the use of either vitamin A or beta-carotene in correcting the deficiency induced by alcoholism.35 These problems result in part because the combinations of alcohol and vitamin A or alcohol and beta-carotene appear to increase potential damage to the liver. Thus, vitamin A-depleted alcoholics require a doctor?s intervention, including supplementation with vitamin A and beta-carotene accompanied by assessment of liver function. Supplementing with vitamin C, on the other hand, appears to help the body rid itself of alcohol.36 Some doctors recommend 1 to 3 grams per day of vitamin C.

    1 Star
    Vitamin B1
    Refer to label instructions
    Supplementing with vitamin B1 (thiamine) may prevent brain damage and nerve disorders in people with alcoholism, including those withdrawing from alcohol.
    Thiamine deficiency is very common among alcoholics, including those who are withdrawing from alcohol. Even short-term thiamine deficiency can cause irreversible damage to the brain and nervous system.
    1 Star
    Vitamin B3
    Refer to label instructions
    Preliminary research has suggested that niacin may help wean some alcoholics away from alcohol. Niacinamide?a safer form of the same vitamin?might have similar actions.

    Many alcoholics are deficient in B vitamins, including vitamin B3 . John Cleary, M.D., observed that some alcoholics spontaneously stopped drinking in association with taking niacin supplements (niacin is a form of vitamin B3). Cleary concluded that alcoholism might be a manifestation of niacin deficiency in some people and recommended that alcoholics consider supplementation with 500 mg of niacin per day.37 Without specifying the amount of niacin used, Cleary?s preliminary research findings suggested that niacin supplementation helped wean some alcoholics away from alcohol.38 Activated vitamin B3 used intravenously has also helped alcoholics quit drinking.39 Niacinamide?a safer form of the same vitamin?might have similar actions and has been reported to improve alcohol metabolism in animals.40

    The daily combination of 3 grams of vitamin C , 3 grams of niacin , 600 mg of vitamin B6 , and 600 IU of vitamin E has been used by researchers from the University of Mississippi Medical Center in an attempt to reduce anxiety and depression in alcoholics.41 Although the effect of vitamin supplementation was no better than placebo in treating alcohol-associated depression, the vitamins did result in a significant drop in anxiety within three weeks of use. Because of possible side effects, anyone taking such high amounts of niacin and vitamin B6 must do so only under the care of a doctor.

    1 Star
    Vitamin B6
    Refer to label instructions
    Alcohol-related anxiety may be improved by a combination of vitamin B6, vitamin C, niacin, and vitamin E, though the high amounts of niacin and vitamin B6 used in the study need a doctor?s supervision.

    The daily combination of 3 grams of vitamin C , 3 grams of niacin , 600 mg of vitamin B6 , and 600 IU of vitamin E has been used by researchers from the University of Mississippi Medical Center in an attempt to reduce anxiety and depression in alcoholics.42 Although the effect of vitamin supplementation was no better than placebo in treating alcohol-associated depression, the vitamins did result in a significant drop in anxiety within three weeks of use. Because of possible side effects, anyone taking such high amounts of niacin and vitamin B6 must do so only under the care of a doctor.

    1 Star
    Vitamin B-Complex
    Refer to label instructions
    Research suggests it is possible that successful treatment of B-complex vitamin deficiencies may actually reduce alcohol cravings, because animals crave alcohol when fed a B-complex-deficient diet.

    Deficiencies of B-complex vitamins are common with chronic alcohol use.43 The situation is exacerbated by the fact that alcoholics have an increased need for B vitamins.44 It is possible that successful treatment of B-complex vitamin deficiencies may actually reduce alcohol cravings, because animals crave alcohol when fed a B-complex-deficient diet.45 Many doctors recommend 100 mg of B-complex vitamins per day.

    1 Star
    Vitamin C
    Refer to label instructions
    Vitamin C appears to help the body rid itself of alcohol. Alcohol-related anxiety may also be improved by a combination of vitamin C, vitamin B6, niacin, and vitamin E, though the high amounts B vitamins studied need a doctor?s supervision.

    The daily combination of 3 grams of vitamin C , 3 grams of niacin , 600 mg of vitamin B6 , and 600 IU of vitamin E has been used by researchers from the University of Mississippi Medical Center in an attempt to reduce anxiety and depression in alcoholics.46 Although the effect of vitamin supplementation was no better than placebo in treating alcohol-associated depression, the vitamins did result in a significant drop in anxiety within three weeks of use. Because of possible side effects, anyone taking such high amounts of niacin and vitamin B6 must do so only under the care of a doctor.

    Although the incidence of B-complex deficiencies is known to be high in alcoholics, the incidence of other vitamin deficiencies remains less clear.47 Nonetheless, deficiencies of vitamin A , vitamin D , vitamin E , and vitamin C are seen in many alcoholics. While some reports have suggested it may be safer for alcoholics to supplement with beta-carotene instead of vitamin A,48 potential problems accompany the use of either vitamin A or beta-carotene in correcting the deficiency induced by alcoholism.49 These problems result in part because the combinations of alcohol and vitamin A or alcohol and beta-carotene appear to increase potential damage to the liver. Thus, vitamin A-depleted alcoholics require a doctor?s intervention, including supplementation with vitamin A and beta-carotene accompanied by assessment of liver function. Supplementing with vitamin C, on the other hand, appears to help the body rid itself of alcohol.50 Some doctors recommend 1 to 3 grams per day of vitamin C.

    1 Star
    Vitamin D
    Refer to label instructions
    If deficient, supplementing with this vitamin may help prevent bone loss and muscle weakness.

    Although the incidence of B-complex deficiencies is known to be high in alcoholics, the incidence of other vitamin deficiencies remains less clear.51 Nonetheless, deficiencies of vitamin A , vitamin D , vitamin E , and vitamin C are seen in many alcoholics. While some reports have suggested it may be safer for alcoholics to supplement with beta-carotene instead of vitamin A,52 potential problems accompany the use of either vitamin A or beta-carotene in correcting the deficiency induced by alcoholism.53 These problems result in part because the combinations of alcohol and vitamin A or alcohol and beta-carotene appear to increase potential damage to the liver. Thus, vitamin A-depleted alcoholics require a doctor?s intervention, including supplementation with vitamin A and beta-carotene accompanied by assessment of liver function. Supplementing with vitamin C, on the other hand, appears to help the body rid itself of alcohol.54 Some doctors recommend 1 to 3 grams per day of vitamin C.

    1 Star
    Vitamin E
    Refer to label instructions
    Alcohol-related anxiety may be improved by a combination of vitamin E, vitamin B6, niacin, and vitamin C, though the high amounts of niacin and vitamin B6 used in the study need a doctor?s supervision.

    The daily combination of 3 grams of vitamin C , 3 grams of niacin , 600 mg of vitamin B6 , and 600 IU of vitamin E has been used by researchers from the University of Mississippi Medical Center in an attempt to reduce anxiety and depression in alcoholics.55 Although the effect of vitamin supplementation was no better than placebo in treating alcohol-associated depression, the vitamins did result in a significant drop in anxiety within three weeks of use. Because of possible side effects, anyone taking such high amounts of niacin and vitamin B6 must do so only under the care of a doctor.

    Although the incidence of B-complex deficiencies is known to be high in alcoholics, the incidence of other vitamin deficiencies remains less clear.56 Nonetheless, deficiencies of vitamin A , vitamin D , vitamin E , and vitamin C are seen in many alcoholics. While some reports have suggested it may be safer for alcoholics to supplement with beta-carotene instead of vitamin A,57 potential problems accompany the use of either vitamin A or beta-carotene in correcting the deficiency induced by alcoholism.58 These problems result in part because the combinations of alcohol and vitamin A or alcohol and beta-carotene appear to increase potential damage to the liver. Thus, vitamin A-depleted alcoholics require a doctor?s intervention, including supplementation with vitamin A and beta-carotene accompanied by assessment of liver function. Supplementing with vitamin C, on the other hand, appears to help the body rid itself of alcohol.59 Some doctors recommend 1 to 3 grams per day of vitamin C.

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    26. Keung W, Vallee B. Daidzin and daidzein suppress free-choice ethanol intake by Syrian golden hamsters. Proc Natl Acad Sci USA 1993;90:10,008?12.

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    28. Lukas SE, Penetar D, Berko J, et al. An extract of the Chinese herbal root kudzu reduces alcohol drinking by heavy drinkers in a naturalistic setting. Alcohol Clin Exp Res 2005;29:756?62.

    29. Blum K. A commentary on neurotransmitter restoration as a common mode of treatment for alcohol, cocaine and opiate abuse. Integr Psychiatr 1986;6:199?204.

    30. Embry CK, Lippmann S. Use of magnesium sulfate in alcohol withdrawal. Am Fam Phys 1987;35:167?70.

    31. Wilson A, Vulcano B. A double-blind, placebo-controlled trial of magnesium sulfate in the ethanol withdrawal syndrome. Alcohol Clin Exp Res 1984;8:542?5.

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    34. Chapman K, Prabhudesai M, Erdman JW. Vitamin A status of alcoholics upon admission and after two weeks of hospitalization. J Am Coll Nutr 1993;12:77?83.

    35. Leo MA, Lieber CS. Alcohol, vitamin A, and beta-carotene: adverse interactions, including hepatotoxicity and carcinogenicity. Am J Clin Nutr 1999;69:1071?85 [review].

    36. Chen M, Boyce W, Hsu JM. Effect of ascorbic acid on plasma alcohol clearance. J Am Coll Nutr 1990;9:185?9.

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    38. Smith RF. A five-year field trial of massive nicotinic acid therapy of alcoholics in Michigan. J Orthomolec Psychiatry 1974;3:327?31.

    39. O?Halloren P. Pyridine nucleotides in the prevention, diagnosis and treatment of problem drinkers. West J Surg Obstet Gynecol 1961;69:101?4.

    40. Eriksson CJP. Increase in hepatic NAD level?its effect on the redox state and on ethanol and acetaldehyde metabolism. Fed Eur Biochem Soc 1974;40:3117?20.

    41. Replogle WH, Eicke FJ. Megavitamin therapy in the reduction of anxiety and depression among alcoholics. J Orthomolec Med 1988;4:221?4.

    42. Replogle WH, Eicke FJ. Megavitamin therapy in the reduction of anxiety and depression among alcoholics. J Orthomolec Med 1988;4:221?4.

    43. Baker H. A vitamin profile of alcoholism. Int J Vitam Nutr Res 1983;(suppl 24):179.

    44. Schuckit MA. Alcohol and Alcoholism. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds, Harrison?s Principles of Internal Medicine, 14th ed. New York: McGraw-Hill, 1998, 2503?8.

    45. Norton VP. Interrelationships of nutrition and voluntary alcohol consumption in experimental animals. Br J Addiction 1977;72:205?12.

    46. Replogle WH, Eicke FJ. Megavitamin therapy in the reduction of anxiety and depression among alcoholics. J Orthomolec Med 1988;4:221?4.

    47. Morgan MY, Levine JA. Alcohol and nutrition. Proc Natl Acad Sci 1988;47:85?98.

    48. Chapman K, Prabhudesai M, Erdman JW. Vitamin A status of alcoholics upon admission and after two weeks of hospitalization. J Am Coll Nutr 1993;12:77?83.

    49. Leo MA, Lieber CS. Alcohol, vitamin A, and beta-carotene: adverse interactions, including hepatotoxicity and carcinogenicity. Am J Clin Nutr 1999;69:1071?85 [review].

    50. Chen M, Boyce W, Hsu JM. Effect of ascorbic acid on plasma alcohol clearance. J Am Coll Nutr 1990;9:185?9.

    51. Morgan MY, Levine JA. Alcohol and nutrition. Proc Natl Acad Sci 1988;47:85?98.

    52. Chapman K, Prabhudesai M, Erdman JW. Vitamin A status of alcoholics upon admission and after two weeks of hospitalization. J Am Coll Nutr 1993;12:77?83.

    53. Leo MA, Lieber CS. Alcohol, vitamin A, and beta-carotene: adverse interactions, including hepatotoxicity and carcinogenicity. Am J Clin Nutr 1999;69:1071?85 [review].

    54. Chen M, Boyce W, Hsu JM. Effect of ascorbic acid on plasma alcohol clearance. J Am Coll Nutr 1990;9:185?9.

    55. Replogle WH, Eicke FJ. Megavitamin therapy in the reduction of anxiety and depression among alcoholics. J Orthomolec Med 1988;4:221?4.

    56. Morgan MY, Levine JA. Alcohol and nutrition. Proc Natl Acad Sci 1988;47:85?98.

    57. Chapman K, Prabhudesai M, Erdman JW. Vitamin A status of alcoholics upon admission and after two weeks of hospitalization. J Am Coll Nutr 1993;12:77?83.

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