The effect of ethanol on heme and porphyrin synthesis

Despite the inherent difficulties in interpreting in vivo data on the effects of alcohol, it appears quite evident that ethanol itself alters the metabolism of the porphyrins and in so doing directly influences heme and hemoglobin synthesis. The mechanism of ethanol-induced iron overload remains elusive but, through observing the effects of phlebotomies and rechallenge with iron, the relationships of iron and alcohol to porphyria cutanea tarda are being more clearly defined. The control mechanisms of porphyrin synthesis by endogenous factors may be part of a more general red blood cell regulatory apparatus.