Why alcohol hits your body harder as you age, even if you're drinking the same amount

Changes often begin in late 30s due to reduced muscle mass, hormonal shifts and slower metabolism

Dry January is prompting many Americans to face the sobering reality that their bodies may no longer shrug off a night of drinking as they used to — and experts say the shift often begins earlier than expected.

Many people feel the difference as early as their late 30s and early 40s, according to Dr. Meena Malhotra, an Illinois-based internal medicine and obesity physician.

"The body processes alcohol differently even if the diet or the habits haven't changed," Malhotra told Fox News Digital.

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"As we age, body composition shifts. Liver enzymes, for example, slow down and hydration levels change, too."

The liver becomes less efficient at breaking down alcohol, allowing it to remain in the bloodstream longer and raising blood alcohol levels from the same amount of drinking. 

Many people begin noticing alcohol’s effects in their late 30s and early 40s, according to experts. (iStock)

People typically lose lean muscle and gain more body fat with age, which also changes how alcohol is processed in the body, Malhotra added. 

For women in menopause, hormonal changes can further intensify alcohol's effects and slow recovery.

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While the change might be gradual, it is real, according to Derek Brown, a Washington, D.C.-based veteran mixologist and National Academy of Sports Medicine wellness coach. 

"The same amount of alcohol can lead to a higher blood alcohol concentration and greater impairment," Brown told Fox News Digital. He said reduced muscle mass and lower total body water can make alcohol more concentrated in the bloodstream.

Hormonal changes during menopause can intensify alcohol’s effects and slow recovery, doctors say. (iStock)

Metabolism is another piece of the puzzle, he added. 

While overall energy metabolism can remain stable from young adulthood through about age 60, it tends to slow more noticeably after that, meaning some people clear alcohol from their system more slowly as they age.

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Harvard Health has reported similar findings, noting that older adults reach higher blood alcohol concentrations than younger people drinking the same amount, even at "normal" levels.

The idea that hangovers worsen with age is nearly universal, but Brown points out that the science is more nuanced.

Alcohol can disrupt REM and deep sleep more as people age, experts say. (iStock)

"Some research suggests older people report less severe and fewer hangovers overall," he said. 

"Anecdotally, I know many of us feel that hangovers get worse, and [research suggests] one possible mechanism: We become more sensitive to pain as we age."

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"With children, early mornings and high-pressure jobs, feeling lousy has a greater impact on your life," Brown added. "That may be part of why it feels subjectively worse, even if the hangover isn't always worse itself."

Malhotra agreed that midlife hangovers often feel worse because the body is less resilient.

"Alcohol is inflammatory, and inflammation increases with age," she said. 

"Sleep quality is already poorer, dehydration hits harder and blood sugar regulation isn't as strong. All of that adds up to headaches, fatigue and body aches that last longer."

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Alcohol also disrupts sleep more in midlife, a problem compounded by age-related changes in REM and deep sleep, The New York Times recently reported.

Beyond hangovers and poor nights' sleep, doctors warn that alcohol carries greater long-term risks with age.

Dry January may prompt adults to notice that alcohol affects their bodies differently with age. (iStock)

AARP and public health experts have highlighted increased risks for falls, medication interactions, high blood pressure, cognitive decline and cancer. 

Alcohol is now classified as a Group 1 carcinogen, the same category as tobacco.

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But that doesn't mean you have to stop completely, experts agree.

Dr. Ken Koncilja, a geriatrician at the Cleveland Clinic, recently told NPR that he makes it a point to talk with aging patients about the benefits of cutting back on alcohol.

Cutting back on alcohol consumption can benefit you later in life, experts say. (iStock)

"These conversations about alcohol use — being proactive with people in their 50s and 60s — [have] a huge impact on their health and wellbeing when they're in their 80s and 90s," Koncilja told the outlet.

Malhotra advised, "You can try slowing down, drinking alcohol with food, choose lower alcohol options, always drink alcohol with water to prevent dehydration and avoid late-night drinking."

Doctors recommend hydrating, drinking with food and choosing lower-alcohol options to reduce alcohol's effects. (iStock)

Another useful tip to limit hangovers is to alternate each drink with water or a non-alcoholic drink, Ian Anderson, co-founder of Sunnyside, a mindful drinking app, previously told Fox News Digital.

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Many alcohol-related symptoms improve when people cut back, doctors say, though how strongly alcohol affects someone depends on factors like genetics, medications, health conditions and drinking habits. 

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