DEAR DR. GOTT: Your response about the effects of alcohol consumption missed many concerns I wish you had discussed. Specifically, you emphasized the social and health impacts of binge and alcoholic consumption, which are certainly quite real. However, your discussion might be easily dismissed by the AVERAGE American drinker, leaving him or her thinking that a couple drinks a day is harmless or even, as my parents believe, beneficial.

Daily consumption of alcohol can increase a woman’s risk for developing breast cancer, which is already far too common. In addition, please emphasize that one need not have a “problem” to be consuming sufficient alcohol to significantly alter the risk of impaired health via obesity, auto accidents, gallbladder disease, colon cancer, diabetes, heart disease and ischemic strokes.

For women in particular, two drinks each evening is too much, especially as they age. For teens, that same level of “moderate” consumption is correlated with higher rates of suicide, pregnancies and lower academic achievement. It should be considered a cause for caring discussions and intervention by every responsible parent of a teen.

I dearly hope you will do a follow-up article providing more specific evidence on the concerns related to commonly “acceptable” levels of everyday drinking so the public is more aware that it is not as healthy as they may think.

DEAR READER: People have long been aware of the harmful effects of consuming alcohol in excess. This, despite the fact that some studies from 1999 by the deputy director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) indicate that moderate drinking may be associated with a reduced risk of heart attack, stroke and atherosclerosis. You might remember that positive reports of drinking red wine for cardiovascular health came out around that time.Here comes the difficult part. A drink must be defined in terms of its alcohol content, for which there is great variation. For example, some beer may contain 5 percent alcohol by volume. A light beer may contain less than 3 percent. Wine averages around 13 percent alcohol. Liquors typically range from 40 percent (80 proof) to 60 percent (120 proof), but can be as high as 95 percent (190 proof).So can we say that a man or woman who drinks two beers a day is overindulging, as opposed to the person who has one glass of scotch? This makes the definition of “moderate” somewhat difficult.Even temperate daily alcohol consumption can have an effect on a person’s general health, despite the fact that there aren’t a great number of studies available regarding patients who drink in moderation. Rather, we dwell on people who drink to excess.However, when it comes to discussing alcoholism, I failed to expand my answer to cover the fact that moderate drinking can be habitual and can lead to eventual abuse. The liver can be affected, leading to cirrhosis; sexual function can diminish, resulting in erectile dysfunction in men or interruption of menstruation in women; and the risk of high blood pressure, heart failure and stroke is elevated. Also, the lining of the stomach can become inflamed, leading to gastritis; eye weakness and paralysis of the muscles of the eye can occur; paresthesias (numbness and tingling) of the hands and feet may be present; and the risk of cancer of the liver, throat, breast, colon and other areas of the body is increased. In addition, the development of new bone can be interrupted, leading to osteoporosis; and diabetics are affected when alcohol interferes with the release of glucose from the liver, leading to hypoglycemia.Frankly, almost every part of body can be affected in a negative manner, and the collective outcome can be dismal. Therefore, the answer may be not to drink in moderation that can lead to excess.Fortunately, help is available at any stage. Clinics and facilities are available to help with detoxification. Therapy and counseling are available. Oral medications such as Antabuse may be prescribed if a person is serious about shaking the addiction. Vivitrol can be injected once monthly by a physician or other health care professional. Some people may gain better control when performing yoga or tai chi. Whatever it takes is what a person should take advantage of.—————-

To contact the doctor, address letters to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.