Sir.—Friedman et al1 suggest three different mechanisms to explain the elevated serum iron concentrations found in adolescent alcohol users, the most likely being an enhanced absorption of dietary iron. Alcohol abuse can affect the nutrient status of an individual, eg, by reducing total food intake because of the high energy content of ethanol and by interfering with the absorption and metabolism of specific nutrients.2,3
The existence of an alcohol-trace metal interaction is known. Alcohol consumption in humans and animals reduces tissue zinc levels because of the diminished intake and intestinal absorption, for example, as well as the increased urinary excretion, of the trace element.3-8 Severe zinc deficiency in rats is accompanied by a striking elevation of iron concentrations in serum, liver, and other body tissues.9 Rogers et al9 have suggested that this effect could explain increased iron absorption and/or increased binding of iron to