"They can drink a lot of alcohol and still have a relatively low blood alcohol level."
Any sources for this? My understanding is that an enlarged liver does not process more alcohol because the enlargement is typically fatty deposits, cirrhosis, and inflammation. I did find an article that says alcoholic livers can produce a different set of enzymes to metabolize the alcohol. But it says it produces a different buzz, bit nothing about faster processing.
It's well known that alcoholics are for the most part better metabolizers of alcohol (see https://www.sciencedirect.com/science/article/pii/S166526811... Current concepts in alcohol metabolism, Caballeria), but its not at all related to liver enlargement. My understanding is that an enlarged liver is a symptom of alcoholic liver disease, not a physiologic adaptation to better metabolize alcohol. The current consensus is that most of the increased metabolism of alcohol comes from enzyme upregulation in the liver.
The authors misunderstanding of physiology makes me doubt any further conclusions he makes.
"Moreover, in human studies it has been found that alcohol consumption produces an increase in the ethanol elimination rate, specially at high concentrations, which is when the action of MEOS take place.37 This is important since it leads to a greater plasma concentration of acetaldehyde as well as an increase in toxic metabolites which may cause liver damage."
Ah, this is the thing I was mentioning earlier, but my other source didn't say that it increased the elimination rate.
Any sources for this? My understanding is that an enlarged liver does not process more alcohol because the enlargement is typically fatty deposits, cirrhosis, and inflammation. I did find an article that says alcoholic livers can produce a different set of enzymes to metabolize the alcohol. But it says it produces a different buzz, bit nothing about faster processing.