If you’re regularly drinking too much alcohol, you could be hurting your health without realizing it. Alcohol is a toxin that most tissues in the body absorb. That means too much of it can harm many of your organs — either creating health problems or making existing ones worse. Alcohol also increases your chances of getting all types of cancers.

Alcohol was already a leading cause of preventable death, but the spike in drinking during the pandemic impacted public health immediately. In 2020, alcohol-related deaths in the U.S. rose 25%, mainly in people 35 to 44.3 Most deaths were from liver disease and mental or behavioral disorders. Here are some common health issues related to drinking too much:

Liver Disease: Your liver does most of the work in breaking down alcohol, so it’s the organ most at risk of damage. The amount of alcohol needed to hurt your liver depends on your genetic makeup. Dr. Attia says “The most common issue I see is fatty liver disease”. Alcohol-related fatty liver disease is curable, but it can lead to cirrhosis, a disease that causes liver failure. When liver cells die, they’re replaced by scar tissue. Cirrhosis can be fatal without a liver transplant.

Since the pandemic, the number of people waiting for a liver transplant has risen.4 “We’re getting 3 to 4 cases a week,” up from 1 to 2 a month, Dr. Attia says. Most patients are in their 50s, but she’s now seeing some in their early 30s.

Heart Disease: Heavy drinking can cause a rapid, irregular heart rhythm called atrial fibrillation (AFib). People over 55 and those who drink even one glass of alcohol each day have a greater chance of developing AFib.5 If it happens often, AFib can increase your risk of stroke. And drinking can lead to other issues, like high blood pressure.

Insomnia: Often, people become dependent on alcohol to fall asleep, Dr. Attia says. But after a few hours, alcohol can wake you up and make it difficult to go back to sleep. It may take up to 90 days without alcohol for your brain to reset its sleep cues, she says. While you adjust, drink less caffeine and exercise every day.

Depression and Anxiety: Mental health issues and alcohol misuse are often connected. People who use alcohol regularly are more likely to develop symptoms of depression and anxiety — and people who have depression or anxiety are more likely to have alcohol problems. Limiting how much you drink or quitting drinking altogether may help address some mental health issues, Dr. Attia says. However, if you’re still struggling with mental health issues after a few months of changing your drinking habits, talk to your doctor about treatment options. They can also help you assess your drinking and come up with a plan.

Be mindful of your alcohol use

If you choose to drink alcohol, the key is to keep your drinking at low to moderate levels. You may also decide that you want to change your habits. If so, here are some tips for how to drink less.