Beer

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 5-(or 2)-Ethyl-2-(or 5)-methyl-4-hydroxy-3(2H)-furanone, 8-prenylnaringenin (8-PN), alcohol, alpha-acids, barley, barley in a funnel, barley juice, barley soda, benzoic acid derivatives, brew, brew dog, brew juice, brew-ha-ha, brewski, catechin, chalcone xanthohumol, cholesterol cold water sandwich, cinnamic acid derivatives, condensed polyphenols, coumarins, Da’ Instigator, delphinidin B3, dimeric proanthocyanidins, epicatechin, ferulic acid, flavonoids, formula for naked frat fun, furanones, gold elixir, hop juice, hops, hordenine, Hordeum vulgare, hydroquinone, iso-alpha-acids, isohumulones, isoxanthohumol, leucocyanidin, liquid sleep, malt, mevalonic acid, monomeric polyphenols, monophenols, nisin, oligomeric proanthocyanidins, phenolic compounds, phytoestrogens, polyamines, polyphenols, postparty cologne, prenylated chalcones, prenylflavonoids, procyanidin B3, purines, putrescine, quercetin, reeb, si, sorghum beer, spermidine, spermine, steam, suds, sulfites, sulphites, swill, the key to malty man love, trimeric proanthocyanidins, tyrosine, tyrosol, vitamin B2, vitamin B6, wallop, xanthohumol, yeast.

  • Note: This monograph does not cover nonalcoholic or low-alcohol beer, barley, hops, or malt.

Background

  • Beer is a popular alcoholic beverage produced by the fermentation of sugars derived from starch-based materials. Barley (malt), hops, water, and yeast are the major ingredients in beer.

  • Archeological and biblical studies show that beer has been a part of human culture for thousands of years.

  • According to secondary sources, the United States consumes less alcohol, including beer, than other countries in the world. European cultures vary by the types of alcohol consumed. Beer is the major contributor to alcohol consumption by men living in the Netherlands, Germany, Sweden, and Denmark. In Murcia, Spain, women drink more beer than wine. In general, culture, age, and sex are important determinants of the type of alcohol consumed.

  • At this time, there is a lack of strong scientific evidence to support beer consumption for any clinical purpose.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Anti-inflammatory

Studies suggest that moderate alcohol-consuming beer drinkers have lower levels of C-reactive protein, fibrinogen, plasma viscosity, and white blood cell counts than non-beer drinkers. Further research is required before conclusions can be made.

Antioxidant

Further research on the effect of beer on antioxidants is required before conclusions can be made.

Cardiovascular risk reduction

Although moderate beer drinking is associated with improved cardiovascular risk reduction, further research on the mechanisms is required before conclusions can be made.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Breast milk stimulant, cancer, diabetes, endometrial cancer, esophageal cancer, estrogenic effects, kidney stone prevention, metabolic disorders (metabolic syndrome), mortality, osteoporosis, thrombosis.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • Note: Drinking beer may not raise total mortality above the normal risk level, provided that imbibers do not exceed 168-280 grams of alcohol weekly for men and 84-140 grams weekly for women.

  • General: According to several clinical trials, the consumption of a moderate amount of beer has been defined as an alcohol intake of 40 grams daily for men and 30 grams daily for women during meals over two successive periods of three weeks. Beer consumption of 330 milliliters daily (about 20 grams of alcohol) for 30 consecutive days had favorable effects on lipids and fibrinogen (protein in blood clotting). Daily or weekly drinkers of low-alcohol beer (0.9% vol/vol) for four weeks experienced reduced systolic blood pressure.

Children (under 18 years old)

  • Beer drinking is not recommended in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid with known allergy or hypersensitivity to beer, alcohol, hops, barley, or malt. According to several authors, beer may trigger rhinitis (inflamed nose), itching, facial swelling, headache, cough, and asthma. Over a third of studied asthmatics reported allergic or allergic-like symptoms after consuming alcohol. Alcohol-induced respiratory problems may stem from various factors, including histamine and acetaldehyde. Protease enzymes, papain, and bromelain are used to stabilize beer and may induce allergic reactions.

Side Effects and Warnings

  • Note: The blood alcohol levels of subjects in most studies are not known.

  • Note: Although experts do not advise beer consumption during breastfeeding, as the alcohol in beer can be transferred to the infant and cause adverse effects, beer has been used traditionally to stimulate milk production.

  • General: Beer has wide-ranging effects on the body, both positive and negative, especially the gastrointestinal, cardiovascular, and neurological systems.

  • Beer may cause high or low blood pressure. Use cautiously in patients with high blood pressure or those taking other agents that may affect blood pressure.

  • Beer may affect the metabolism of anticoagulants (particularly warfarin) and, therefore, the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs, herbs, or supplements that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Beer may interfere with the way the body processes certain drugs using the liver’s cytochrome P450 enzyme system. As a result, beer may change the levels of these drugs in the blood and increase or decrease the intended effects.

  • Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.

  • Beer may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Other possible side effects of beer include aggressive behavior; altered levels of drugs (anticonvulsants); asthma symptoms; blood clots; cardiomyopathy (with cobalt therapy); carpal tunnel syndrome; changes in vitamin B levels; decreased bioavailability of aspirin and salicylates; decreased success of in vitro fertilization; disulfiram-like reactions (with antibiotics); dizziness; effects on estrogen levels; facial swelling or rash; feelings of depression or hopelessness (with St. John’s wort); flushing; gastrointestinal problems (loss of appetite, nausea, vomiting, a feeling of fullness, flatulence or passing gas, abdominal pain, stomach upset, bleeding, and ulcers); gout; impaired balance and judgment; increased plasma magnesium or serum iron; increased risk of brain damage, breast cancer, cardiovascular disease, cirrhosis of the liver, dehydration, dizziness, fainting, nerve damage, and obesity; increased testosterone levels in men; increased urine flow; insulin resistance; itching; liver damage; low bone density; low sodium or potassium levels; migraine; nerve damage; postprandial reflux; seizure; tolerance to famotidine; and weight gain.

  • Use cautiously at levels greater than those of moderate consumption in all patients, because of beer’s alcohol content. Drinking large amounts of beer can increase the risk of brain damage, cardiovascular disease, cirrhosis of the liver, nerve damage, and obesity. Beer consumption may impair balance and judgment and facilitate aggression.

  • Use cautiously in postmenopausal women, in patients with diabetes, in patients with gastrointestinal disorders, in obese patients, in patients using diuretics, in those at risk for electrolyte imbalances or those using agents that may affect electrolytes, in patients at risk for carpal tunnel syndrome, in patients with neuropathies (nerve pain), in patients prone to migraine attacks, in patients with asthma, in patients trying to become pregnant or those taking fertility agents, in men and those receiving testosterone therapy, in patients with osteoporosis, and in patients with gout.

  • Use cautiously in patients using analgesics (pain medications), antibiotics (including cephalosporins, metronidazole, trimethoprim/sulfamethoxazole, and isoniazid), anticonvulsant (antiseizure) agents, antidepressants (particularly MAOIs), St. John’s wort, HMG-CoA reductase inhibitors (also called “statins”), niacin, anticancer agents, famotidine, cobalt therapy, iron, magnesium supplements, aspirin or salicylates, marijuana or tetrahydrocannabinol, vasodilators (drugs that dilate veins and arteries, such as nitrates), dehydroepiandrosterone (DHEA) supplements, B-vitamin supplements, or agents used for alcohol withdrawal (such as naltrexone, diazepam, antiepileptic drugs, and kudzu supplements).

  • Use cautiously before or after exercise.

  • Avoid in patients using methotrexate or central nervous system (CNS) depressants, in patients with liver disease or those using drugs that may affect the liver, in patients with known allergies or an addiction to alcohol or ingredients in beer, in children, and in pregnant and breastfeeding women.

Pregnancy and Breastfeeding

  • According to expert opinion, drinking beer during pregnancy may adversely affect the fetus. The alcohol found in beer may cause long-term physical and behavior problems, as well as increase the risk of fetal alcohol syndrome.

  • According to expert opinion, the alcohol found in beer consumed by a breastfeeding woman can be transferred to the infant and cause adverse effects. However, beer has been used traditionally to increase milk production.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

  • In general, the alcohol in beer interacts with a wide variety of medicines. According to experts, a person who is not habituated to alcohol or sedatives may cause himself or herself serious harm or death by consuming low doses of each.

  • Beer may increase or decrease the risk of bleeding when taken with drugs that increase risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

  • Beer may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Beer may lower blood pressure. Caution is advised when taking other agents that affect blood pressure.

  • Beer may interfere with the way the body processes certain drugs using the liver’s cytochrome P450 enzyme system. As a result, beer may change the levels of these drugs in the blood and increase or decrease the intended effects.

  • Because beer contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

  • Beer may increase the amount of drowsiness caused by some drugs, including sedatives. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

  • Beer may also interact with acetaminophen, agents processed by the liver, agents that harm the liver, analgesics (pain medications), antiasthma agents, antibiotics (including cephalosporins, metronidazole, trimethoprim/sulfamethoxazole, and isoniazid), anticancer drugs, anticonvulsants (antiseizure drugs), antidepressants (MAOIs), antigout agents, antihistamines, antiobesity agents, antiulcer agents, calcium salts, cholesterol- and lipid-lowering agents, CNS depressants, cobalt, diuretics, drugs used for osteoporosis, fertility agents, hormonal agents, iron, magnesium supplements, naltrexone, potassium salts, salicylates, sedatives, sodium, tetrahydrocannabinol, and vasodilators (drugs that increase the size of veins and arteries).

Interactions with Herbs and Dietary Supplements

  • Beer may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Beer may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • Beer may lower blood pressure. Caution is advised when taking herbs or supplements that affect blood pressure.

  • Beer may interfere with the way the body processes certain herbs or supplements using the liver’s cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high or too low in the blood. It may also alter the effects that other herbs or supplements potentially may have on the P450 system.

  • Because beer contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be affected.

  • Beer may increase the amount of drowsiness caused by some herbs or supplements.

  • Beer may also interact with agents processed by the liver, agents that damage the liver, amino acids, analgesics (pain medications), antiasthmatics, antibacterials, anticancer agents, anticonvulsants (antiseizure herbs), antidepressants (MAOIs), antigout agents, antihistamines, antiobesity agents, antioxidants, antiulcer agents, B vitamins, beta-carotene, calcium, cholesterol- and lipid-lowering agents, DHEA, diuretics, fertility agents, food, foods containing antioxidants, hormonal agents, iron, kava, kudzu, magnesium, marijuana, niacin, osteoporosis agents, potassium, salicylates, sodium, vasodilators (herbs or supplements that dilate veins and arteries), vitamin C, vitamin E, and wine.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Chao C. Associations between beer, wine, and liquor consumption and lung cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2007;16(11):2436-2447. View Abstract
  2. Gerhauser C. Beer constituents as potential cancer chemopreventive agents. Eur J Cancer 2005;41(13):1941-1954. View Abstract
  3. Gigleux I, Gagnon J, St-Pierre A, et al. Moderate alcohol consumption is more cardioprotective in men with the metabolic syndrome. J Nutr 2006;136(12):3027-3032. View Abstract
  4. Jugdaohsingh R, O’Connell MA, Sripanyakorn S, et al. Moderate alcohol consumption and increased bone mineral density: potential ethanol and non-ethanol mechanisms. Proc Nutr Soc 2006;65(3):291-310. View Abstract
  5. Lukasiewicz E, Mennen LI, Bertrais S, et al. Alcohol intake in relation to body mass index and waist-to-hip ratio: the importance of type of alcoholic beverage. Public Health Nutr 2005;8(3):315-320. View Abstract
  6. Mahabir S, Leitzmann MF, Virtanen MJ, et al. Prospective study of alcohol drinking and renal cell cancer risk in a cohort of Finnish male smokers. Cancer Epidemiol Biomarkers Prev 2005;14(1):170-175. View Abstract
  7. Miura Y, Hosono M, Oyamada C, et al. Dietary isohumulones, the bitter components of beer, raise plasma HDL-cholesterol levels and reduce liver cholesterol and triacylglycerol contents similar to PPARalpha activations in C57BL/6 mice. Br J Nutr 2005;93(4):559-567. View Abstract
  8. Mukamal KJ, Maclure M, Muller JE, et al. Binge drinking and mortality after acute myocardial infarction. Circulation 2005;112(25):3839-3845. View Abstract
  9. Noonan DM, Benelli R, Albini A. Angiogenesis and cancer prevention: a vision. Recent Results Cancer Res 2007;174:219-224. View Abstract
  10. Pehl C, Wendl B, Pfeiffer A. White wine and beer induce gastro-oesophageal reflux in patients with reflux disease. Aliment Pharmacol Ther 2006;23(11):1581-1586. View Abstract
  11. Piskur J, Rozpedowska E, Polakova S, et al. How did Saccharomyces evolve to become a good brewer? Trends Genet 2006;22(4):183-186. View Abstract
  12. Rashidkhani B, Akesson A, Lindblad P, et al. Major dietary patterns and risk of renal cell carcinoma in a prospective cohort of Swedish women. J Nutr 2005;135(7):1757-1762. View Abstract
  13. Rohsenow DJ, Howland J, Minsky SJ, et al. Effects of heavy drinking by maritime academy cadets on hangover, perceived sleep, and next-day ship power plant operation. J Stud Alcohol 2006;67(3):406-415. View Abstract
  14. Wooding S. Evolution: a study in bad taste? Curr Biol 2005;15(19):R805-R807. View Abstract
  15. Zilkens RR, Burke V, Hodgson JM, et al. Red wine and beer elevate blood pressure in normotensive men. Hypertension 2005;45(5):874-879. View Abstract

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.