Hangovers 101

With Thanksgiving over and now Christmas past, everyone’s attention turns to planning for their New Year’s celebration. I don’t really have a regular plan for the New Year’s Eve. Some years it is out with friends to party it up and other years it is a quiet affair at home. This year is probably going to be the latter. Regardless of what the plan for the evening might be, something that has played a part in a few too many of my New Year Day’s rituals has been dealing with a hangover. As stated succinctly on the MayoClinic.com Web site, “Hangovers are caused by drinking too much alcohol”. Yep, I got it… the root cause of the problem has never really been in doubt, but let’s look a little closer at this “dreaded” phenomenon.

Hangover Causes

So… we know that drinking too much causes hangovers, but why? That is not so simple of a question to answer, as there are many factors in play and how they all come together can produce a range of discomfort from mild irritation, like a “summer shower”, to something more akin to the “Perfect Storm”; which can make itself known for days after the celebratory event and produce the lasting memory of “that” New Year.

When ethyl alcohol (ethanol) is consumed, the organ responsible for its breakdown and disposal is the liver. The liver contains an enzyme called alcohol dehydrogenase which is responsible for the initial breakdown of the alcohol to acetaldehyde (yes, it is a chemically related compound to formaldehyde). Like ethanol, acetaldehyde is quite toxic to your body and is responsible for many of the more memorable symptoms of a hangover, like the severe headaches and vomiting that are sometimes a part of the after effects. The liver enzymes tasked with the breakdown of this toxin are stored by the liver in limited quantities, so the more alcohol that is consumed, the longer this toxic denizen stays in the body. A few studies have shown, somewhat inconclusively, that females and people of certain ethnic backgrounds may produce less of these acetaldehyde-busting enzymes to begin with and may suffer worse hangovers as a result. Medications, like “Anabuse”, used to treat alcoholism, actually prevent (intentionally) the body from further breaking the acetaldehyde down too rapidly. This, of course, works to produce the “mother of all hangovers” for those being treated in hopes of dissuading them from drinking again anytime soon. For the rest of us not being treated in this manner, the acetaldehyde eventually is broken down by the liver to a non-toxic acetate compound (similar to vinegar) which can be safely eliminated via the kidneys.

Other factors that work to produce the affects of this undesirable affliction are:

• dehydration – alcohol stimulates the kidneys to produce more urine
• stomach upset – alcohol stimulates gastric acid production and delays stomach emptying, which can lead to nausea and/or vomiting
• drop in blood sugar – while the liver is being distracted by alcohol breakdown, not enough glycogen is broken down to glucose to maintain blood sugar; causing fatigue, shakiness and mood disturbances
• sleep disturbance – while alcohol is a depressant and will cause sleepiness, the combined effects of the alcohol in the body may severely reduce the quality of sleep; thus contributing to that familiar next day fatigue.

Alcoholic drinks also contain other substances (impurities), called cogeners, which can contribute significantly to a hangover. In distilled liquors, generally, the higher the level of distillation the lower the amount of cogeners they contain… vodka and gin are both highly distilled and relatively pure alcohol and water; they therefore contain lower amounts of these compounds. Darker colored liquors, like whiskeys, rums, brandies and bourbons, contain higher amounts (bourbon is the worst) of these cogeners and are much more likely to produce the hangover effect. Beer does not escape this problem and does contain some cogeners as well. Beer (and wine) follow the same pattern, darker beers contain more cogeners. As a matter of fact, because beer contains a relatively high ratio of water to alcohol, the hangover effects from beer are sometimes more likely exacerbated by these cogeners than by the effects of dehydration, a more frequent contributing factor for distilled spirit drinkers.

Hangover “Cures”

Ask any drinker, almost anywhere in the world, and they can tell you the remedy of choice for dealing with a hangover. Some of these purported “cures” have a scientific basis and many others are rooted in the local folklore. Some of the more scientifically-based cures include:

• Drink plenty of water – As discussed above, alcohol has a diuretic effect and rehydration is an important part of hangover recovery. Dehydration may also be responsible for some of the headache pain. The addition of water also helps to ensure that as the body breaks down the alcohol, it has a “vehicle” to leave the body.
• Avoid caffeinated drinks – Caffeine, like alcohol, has a diuretic effect and simply compounds the dehydration problems of the hangover. Caffeine also raises your blood pressure, which can turn a little headache into a really big one pretty quickly.
• Sports drinks – As your body dehydrates when drinking, the water takes with it salts and other minerals that your body needs. “Gatorade-like” drinks not only replenish the water, but some of these other substances that your body craves.
• Over-the-counter pain relievers – Aspirin, acetaminophen and ibuprofen can be effective in dulling the pain of the morning after headache. Caution: You should avoid taking acetaminophen when under the influence of alcohol; particularly those brands that contain caffeine (like Excedrin). These can cause significant additional liver damage when used in this manner.
• Take a multivitamin – Some researchers believe that the depletion of “B” vitamins (B6 and B12) during your “bender” can intensify your hangover. Replacing these vitamins with readily available supplements may help. Keep in mind that your body needs/uses only a tiny amount of these compounds, so “mega” doses are not required or recommended.
• Get additional rest – This approach also has some important benefits. The sleep disturbance caused by the alcohol likely means that you are sleep deprived. Sleep also means that you are not aware of some of the other effects of your overindulgence.

Some of the more non-traditional and international hangover curatives include:

• Prickly Pear extract – An extract from the Prickly Pear cactus has been shown by some research to eliminate some of the hangover’s symptoms, such as nausea, dry mouth and loss of appetite.
• Tripe Soup (Mexico) – A spicy soup made from the lining of a cow’s stomach. Made with chilies and plenty of garlic. While “tried and true” for some, look more for the distraction of the spices and the addition of nutrients to the body for most of its curative effects.
• Haejangguk (Korea) – Translates as “food for the stomach” and is made with various parts of the cow (including the blood), vegetables and plenty of spices. Again, look for the burn of the spices to distract you from the pounding headache.
• A “big and greasy” breakfast – It might seem counterintuitive for someone that feels so bad, but adding the buffering effects of a slow digesting meal (bacon/cheese omelet/toast) is a technique used by many. If the thought of that approach tickles your gag reflex, toast with jam, bananas or other foods which can help raise you blood sugar can be valuable as well.
• Eat a pickle – Salty and “vinegary” foods, like pickled vegetables, provide replenishment of salt and electrolytes lost through dehydration.
• “Hair of the Dog” – Consuming additional alcohol as a way to “cure” a hangover will probably not produce the long-term benefits you seek, but it may delay some of the effects temporarily. If you truly believe that this approach helps, then the #1 hangover curative drink recommended by AskMen.com is called “The Suffering Bastard” and can be made by combining the following over ice (good luck!):

  • 1 part bourbon

  • 1 part gin

  • 3 parts ginger ale

  • 1 dash bitters

Preventing Hangovers

As stated right up front, hangovers are caused by consuming too much alcohol, so not drinking would be the #1 best way to avoid that hangover. Ouch(!), that approach is a bit too drastic for me and would just, simply, be no fun at all. There are other, less drastic, methods to limiting the “collateral damage” of consuming your favorite alcoholic beverage in mass quantities. Some of the more effective of these include:

• Drink plenty of water or other non-alcoholic liquids – Alternating the alcoholic drinks with a glass of water can help lessen the diuretic effects of the alcohol and could lessen the hangover too.
• Pace yourself – The average person is capable of metabolizing 1 ounce of pure alcohol an hour. You can do your own calculation to see how that translates into your favorite drink and drinking habits, but common sense dictates that the faster you drink the faster you get drunk. There is also the delay between the drink and the time that it takes for you to feel the effects. A slower drinking pace will allow you to more accurately gauge, for yourself, how much alcohol you have consumed.
• Eat something before drinking – This is an important one. Having something in your stomach when you drink slows the body’s absorption of the alcohol, offsets the depletion of vitamins and minerals from dehydration, and gives your body something else to do (increases metabolism).
• Try to stop drinking well before going to sleep – Your body’s metabolism slows down during sleep which prolongs the breakdown of the consumed alcohol. Waking up still drunk is not a pleasant experience.
• Take supplements – Some research has show that certain over-the-counter supplements may help in relieving the symptoms of hangovers or reduce the damage caused by its effects. These include:
  • Kyolic Garlic Formula 105 – This supplement is supposed to reduce the hangover effect by adding a compound to the body called S-allyl-cysteine. This compound is similar to and may have the same effect as the liver’s own cysteine compounds, which are used to neutralize acetaldehyde in the liver
    

  • Silibinin (Special Milk Thistle Extract) – Used to treat liver disease in Germany, this supplement may help reduce the damaging effects of alcohol and its metabolic byproducts on the liver

As you can tell from the length of this article, this is a topic that has a lot of interest and I have only scratched the surface of what is available on the Internet about hangovers. Perhaps one of the most important facts to remember about hangovers is that they are almost always self-inflicted and choosing not to drink to excess is the only known way to completely avoid them. You should be in control of how much you drink and if you are not, then a discussion with a doctor or counselor is in order.

Lastly and most importantly, do not drink and drive… the choice to drink may be within your rights… that does not include the right to injure or take the life of someone else because of your stupidity. Be smart this holiday season and…

Have a Happy New Year!

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