Chronic alcoholism impairs the production of blood cells from the bone marrow. When the bone marrow is having trouble making and sending out blood cells it takes longer to form the blood cells so the shapr ends up being bigger, although they have less of the hemoglobin contained in them to carry oxygen. Therefore when looked at under the microscope they look bigger than normal. This is termed "macrocytosis" or "macrocytic anemia". There may be associated malnutriton or iron deficiency in alcoholism also, and an underactive thyroid or thalassemia (inherited blood disorder) can produce a similar picture. This results in anemia - lack of energy, and sometimes impaired ability to fight infection. Alcohol is also toxic to platelets, teh blood components that clot the blood when necessary.
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