The Three Pathways
Ethanol metabolism in the liver runs through three pathways simultaneously rather than through a single linear cascade 1. The first and largest is the ADH/ALDH oxidation chain: alcohol dehydrogenase converts ethanol to acetaldehyde, then aldehyde dehydrogenase converts acetaldehyde to acetate, which the body breaks down into water and carbon dioxide. The second is CYP2E1, a microsomal P450 enzyme that handles ethanol at higher concentrations and is induced upward with chronic exposure. The third is catalase, which contributes a smaller fraction in normal physiology.
Acts by promoting aldehyde and alcohol metabolism of foods.†
† These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
The ADH/ALDH pathway dominates at low and moderate alcohol intake. As intake rises, CYP2E1 takes over a larger fraction of the work, particularly in chronic drinkers whose CYP2E1 expression has been induced upward by sustained ethanol exposure 3. The relative contribution of each pathway varies with chronicity and dose, in the published animal data at least.
The NAD+ Bottleneck
Both ADH and ALDH require NAD+ as a cofactor to function. The reaction generates NADH as a byproduct, which the mitochondrial respiratory chain has to recycle back to NAD+. At low alcohol loads this recycling keeps up. At higher loads NAD+ becomes rate-limiting -- the enzyme has substrate available, but no oxidized cofactor to bind, so the reaction slows. This is why a third drink lingers longer than a first.
The NAD+ bottleneck is part of why DHM has a measurable effect on serum acetaldehyde clearance: the published animal work shows DHM both induces ADH/ALDH expression and helps restore NAD+ levels depleted by chronic ethanol 2.
The Acetaldehyde Problem
Triggers the liver to produce more of the aldehyde- and alcohol-metabolizing enzymes (ADH and ALDH) and boosts their efficiency in breaking down aldehydes and alcohols in foods as well as their by-products.†
† These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Acetaldehyde is the most consequential intermediate in this story. It is a known carcinogen, it binds readily to cellular proteins and DNA, and most of the morning-after damage people associate with drinking traces back to acetaldehyde rather than to ethanol itself 4. The genetic variant that produces the so-called Asian flush is a useful natural experiment -- ALDH2 variants convert ethanol to acetaldehyde at normal speed but cannot clear it efficiently, and the symptom severity scales almost exactly with how much accumulates 2.
The ROS Side
The ADH/ALDH oxidation chain produces NADH that destabilizes mitochondrial redox balance and indirectly drives ROS formation. CYP2E1 directly produces ROS as a side reaction. The combined oxidative load depletes glutathione, which is the cell's main defense against ROS 3. This is the side of alcohol metabolism that supplement formulations targeting glutathione restoration (like SAG in the H180 formula) are addressing.
The GABA Side
Supports balanced consumption of alcohol (from all sources of food and drink).†
† These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Alcohol's effects on the brain run through a separate mechanism -- GABA-A receptor potentiation in the first hour or two of drinking, followed by compensatory down-regulation that produces the post-clearance rebound anxiety that is part of the next-day picture 4. This is a separate target from the metabolism story, but it overlaps in a person's experience of drinking and is why DHM's GABA-modulation effects matter alongside its metabolic effects. (this integrated picture is what convinced me to build the formula around multiple intervention points rather than betting everything on a single mechanism.)
What This Page Is Not Claiming
This page is the integrated explanation, not a substitute for the cluster-page detail. Each pathway has its own dedicated coverage in the DHM and SAG clusters. The point here is that alcohol metabolism is a system rather than a single reaction adn supplements that treat it as a single point of intervention tend to disappoint, which is why H180 was designed around multiple intervention points across the cascade.
For the metabolic enzyme story in detail, see How DHM Works -- The ADH/ALDH Pathway. For the oxidative-stress side, see ROS and Oxidative Stress. For the GABA side, see DHM and GABA Modulation.