Review| Volume 5, ISSUE 1, P88-98, February 1994

Download started.


Alcohol ingestion and temperature regulation during cold exposure

      This paper is only available as a PDF. To read, Please Download here.
      Outdoor or wilderness activities are sometimes combined with the ingestion of alcoholic beverages. Despite the feeling of warmth induced by alcohol ingestion, it is widely believed that alcohol actually causes a decrease in body core temperature and increases the risk of hypothermia during cold exposure. However, the literature on the effects of alcohol ingestion on thermoregulation is conflicting. This review summarizes the scientific findings concerning this topic and identifies a number of confounding factors that may explain the conflicting observations. These factors include quantity of alcohol ingested, severity of the cold stress, nutritional state of the individual, composition of the drink, body composition of the individual and alcohol tolerance of the individual. When these factors are considered, it appears that (1) alcohol acts as a poikilothermic agent, causing a reduction in body core temperature during cold exposure, with the magnitude of reduction related to blood alcohol concentration, (2) the severity of cold and the individual's body composition modify the thermoregulatory effects of alcohol, and (3) hypoglycemia greatly exacerbates the reduction in body temperature caused by alcohol ingestion. Furthermore, the primary mechanism by which alcohol ingestion exacerbates the fall in body core temperature during cold exposure appears to be via an impairment of shivering thermogenesis resulting from alcohol-induced hypoglycemia, rather than by increasing heat dissipation via vasodilation as commonly believed.

      Key words


        • Gillespie J.A.
        Vasodilator properties of alcohol.
        Br Med J. 1967; 2: 274-277
        • Strong P.J.F.
        Death due to exposure to cold in New Zealand mountains.
        New Zealand Med J. 1969; 4: 11
        • Lee E.C.B.
        • Lee K.
        Safety and survival at sea.
        Cassell & Co., London1971
        • Danzl D.F.
        • Pozos R.S.
        Multicenter hypothermia survey.
        Ann Emerg Med. 1987; 16: 1042-1055
        • Weyman A.E.
        • Greenbaum D.M.
        • Grace W.J.
        Accidental hypothermia in an alcoholic population.
        Am J Med. 1974; 56: 13-21
        • Graham T.
        • Baulk K.
        Effect of alcohol ingestion on man's thermoregulatory responses during cold water immersion.
        A viat Space Environ Med. 1980; 51: 155-159
        • Haight J.S.J.
        • Keatinge W.R.
        Failure of thermoregulation in the cold during hypoglycaemia induced by exercise and ethanol.
        J Physiol. 1973; 229: 87-97
        • Graham T.
        • Dalton J.
        Effect of alcohol on man's response to mild physical activity in a cold environment.
        A viat Space Environ Med. 1980; 51: 793-796
        • Haller E.W.
        • Wittmers Jr, E.
        Ethanol-induced hypothermia and hyperglycemia in genetically obese mice.
        Life Sci. 1989; 44: 1377-1385
        • Andersen K.L.
        • Hellstrom B.
        • Lorentzen F.V.
        Combined effect of cold and alcohol on heat balance in man.
        J Appl Physiol. 1963; 18: 975-982
        • Keatinge W.R.
        • Evans M.
        Effect of food, alcohol, and hyoscine on body-temperature and reflex responses of men immersed in cold water.
        Lancet. 1960; ii: 176-178
        • Martin S.
        • Diervold R.J.
        • Cooper K.E.
        Alcohol, respiration, skin and body temperature during cold water immersion.
        J Appl Physiol. 1977; 43: 211-215
        • Kuehn L.
        • Livingstone S.
        • Limmer R.
        • Weatherson B.
        The effect of ethanol consumption on human heat exchange.
        Environmental Stress: Individual Human Adaptations. Academic Press, New York1978 (303–13)
        • Kalant H.
        • Le A.D.
        Effects of ethanol on thermoregulation.
        Pharmacol Ther. 1984; 23: 313-364
        • Schwiegk H.
        Pathogenesis and treatment of local cold injury.
        Department of the Air Force, German Aviation Medicine, World War II. Air Force, Washington DC1950 (843–57)
        • Hobson G.N.
        • Collis M.L.
        The effects of alcohol upon cooling rates of humans immersed in 7.5° C water.
        Can J Physiol Pharmacol. 1977; 55: 744-746
        • Kohler O.
        Erfahrungen uber die behandlung von frostschaden.
        Zbl Chir. 1942; 69: 1782-1794
        • Fox G.R.
        • Hayward J.S.
        • Hobson G.N.
        Effect of alcohol on thermal balance of man in cold water.
        Can J Physiol Pharmacol. 1979; 57: 860-865
        • Freund G.
        Hypothermia after acute ethanol and benzyl alcohol administration.
        Life Sci. 1973; 13: 345-349
        • Gallaher E.J.
        • Egner D.A.
        Rebound hyperthermia follows ethanol-induced hypothermia in rats.
        Psychopharmacol. 1987; 91: 34-39
        • Murphy M.T.
        • Lipton J.M.
        Effects of alcohol on thermoregulation in aged monkeys.
        Exper Gern. 1983; 18: 19-27
        • Gilliam D.M.
        Alcohol absorption rate affects hypothermic responses in mice: evidence for rapid tolerance.
        Alcohol. 1989; 6: 357-362
        • Koren G.
        • Barker C.
        • Bohn D.
        • Kent G.
        • McGuigan M.
        • Biggar D.
        Effect of hypothermia on the pharmacokinetics of ethanol in piglets.
        Ann Emerg Med. 1989; 18: 118-121
        • Greenfield A.D.M.
        The circulation through the skin.
        Handbook of Physiology. Williams & Wilkins, Circulation, Baltimore1963 (1325–51)
        • Rapaport S.I.
        • Fetcher E.S.
        • Shaub H.G.
        • Hall J.F.
        Control of blood flow to the extremities at low ambient temperatures.
        J. Appl Physiol. 1949; 2: 61-71
        • Krebs H.A.
        • Freeland R.A.
        • Hems R.
        • Stubles M.
        Inhibition of hepatic gluconeogenesisby ethanol.
        Biochem J. 1969; 112: 117-124
        • Wilson N.M.
        • Brown P.M.
        • Juul S.M.
        • Prestwich S.A.
        • Sonksen P.H.
        Glucose turnover and metabolic and hormonal changes in ethanol-induced hypoglycaemia.
        Br Med J. 1981; 282: 849-853
        • Gale E.A.M.
        • Bennett T.
        • Green J.H.
        • MacDonald I.A.
        Hypoglycaemia, hypothermia and shivering in man.
        Clin Sci. 1981; 61: 463-469
        • Martineau L.
        • Jacobs I.
        Muscle glycogen availability and temperature regulation in humans (Abstract).
        J Appl Physiol. 1989; 66: 72-78
        • Young A.J.
        • Sawka M.N.
        • Neufer P.D.
        • Muza S.R.
        • Askew E.W.
        • Pandolf K.B.
        Thermoregulation during cold water immersion is unimpaired by low muscle glycogen levels.
        J. Appl Physiol. 1989; 66: 1809-1816
        • Gordon C.J.
        • Stead A.G.
        Effect of ethyl alcohol on thermoregulation in mice following the induction of hypothermia or hyperthermia.
        Pharmacol Biochem Behav. 1988; 29: 693-698
        • Gordon C.J.
        • Fogelson L.
        • Mohler F.
        • Stead A.G.
        • Rezvani A.H.
        Behavioral thermoregulation in the rat following the oral administration of ethanol.
        Alcohol. 1988; 23: 383-390
        • Kortelainen M.-L.
        Drugs and alcohol in hypothermia and hyperthermia related deaths: a retrospective study.
        J Forensic Sci. 1987; 32: 1704-1712
        • Myers R.D.
        Alcohol's effect on body temperature: hypothermia, hyperthermia or poikilo- thermia.
        Brain Res Bull. 1981; 7: 209-220
        • Madison L.
        Ethanol-induced hypoglycemia.
        Adv Metab Disorders. 1968; 3: 85-109