Hangovers are the body’s way of reminding us about the hazards of overindulgence. In this blog post, I’ll delve into what goes on behind the scenes to cause a hangover. I’ll then explore what science has to say about all those supposed ‘hangover cures’. And finally, I’ll outline the practical things that are in your control to help prevent and treat a hangover.
The dreaded hangover. That painful period between trying to get out of bed without hating life and once again being a normal, contributing member of society. If you have ever experienced a nasty hangover, then you know just how much the combination of tiredness, headache, nausea and poor concentration can crush you.
The science behind a hangover
Hangovers happen because of the effects of alcohol (which is a toxin after all) on the brain and the rest of the body. So, let’s look at what is going on to explain the classic collection of hangover symptoms.
To start with, alcohol is a diuretic. That explains the dehydration and much of the regret you feel the next day from drinking too much. On top of that, frequent trips to the bathroom during the night mean sleep disturbances. That makes you even more tired the next day.
But the symptoms of a hangover can’t all be blamed on dehydration and poor sleep. Alcohol irritates the stomach. This leads to inflammation which also causes the digestive system to produce more gastric acid. This contributes to the nausea and queasy stomach of a hangover.
Hangovers could also be driven by the way alcohol messes with your immune system. There is a strong correlation between high levels of cytokines – which are molecules that the immune system uses for signalling and to control inflammation – and hangover symptoms. Normally, the body might use cytokines to trigger a fever or inflammatory response to battle an infection. Excessive drinking can cause cytokine release, which leads to muscle aches, fatigue, headache and nausea. It can also affect memory and cause irritation.
It gets worse. When the body metabolises alcohol, it creates a toxic by-product called acetaldehyde. That acetaldehyde is up to 30 times more toxic than alcohol itself. The build-up of acetaldehyde leads to sweating, skin flushing, nausea, vomiting, and headaches. And it seems that people who have a genetic variant in one of the enzymes involved in alcohol metabolism (called aldehyde dehydrogenase-2) have higher levels of acetaldehyde. These people may get hit with a hangover even worse.
Finally, a hangover exists hand-in-hand with many hormonal and metabolic changes that are plausible causes of the classic fatigue and brain fog of a hangover. Here, you can see changes in insulin, cortisol, testosterone, aldosterone and growth hormone. Even brain chemicals like adrenaline, dopamine, serotonin and the endocannabinoid system are affected. These chemicals regulate immune response, cell communication, appetite, metabolism and memory.
It’s true, dark spirits are worse for your hangover
You may have heard that dark-coloured spirits such as whiskey and rum as well as red wine can make your hangover worse. And you heard correctly. These types of drinks are high in distillation and fermentation products called congeners. Congeners give distilled alcoholic drinks their distinctive taste and smell and affect the flavour of non-distilled drinks. They are also considered a likely culprit contributing to hangovers. So, there could be something to be said for opting for white wine over red wine or vodka instead of bourbon.
Hangover cures put to the test
Okay, enough of the hangover science – it is undoubtedly causing way too many traumatic flashbacks for many of you. Can you cure it? Let’s look at some of the popular options.
The greasy breakfast is a popular hangover cure to help put a ‘lining back on your stomach’. The benefit the next day is more of a placebo effect which, if it makes you feel better, then that’s not such a bad thing. With food though, you get the greatest benefit by having it the night before as food helps to slow down the absorption of alcohol from the stomach.
One thing that will help with a hangover is to rehydrate. This is where those popular sports drinks can help. They speed up water absorption and replace electrolytes lost through increased urination. Having it before bed may be a good preventative measure too.
What about a strong cup of coffee? Caffeine will help make you more alert but will do little to sober you up. Studies that looked at the effects of caffeinated versus non-caffeinated alcoholic drinks on a simulated driving task and alertness found that caffeine did not reduce the effects of alcohol on driving ability or reaction time.
Then there is the popular ‘hair of the dog’ where you attempt to drink yourself out of a hangover. All this does is delay the hangover as your body switches to metabolising the new alcohol you’ve ingested. Once it has done that job, then you’re back to square one. And even worse, you’ve got more by-products of alcohol metabolism in your system.
Can you cure a hangover with a magic pill? Sadly, no foods or supplements are proven to prevent hangovers (at least supplements that have been tested at least more than once), yet the Internet is full of supposed cures. Ginseng, Japanese raisin tree, prickly pear cactus, Korean pear, and a mixture of pear, green grape, and the Japanese herb Ashibata have all been tested and have at least one study to support them. However, few studies have been replicated. And even studies that show a benefit only look at certain aspects of a hangover and are normally tested in a controlled situation which may not replicate very well a classic ‘big night out’ on the beers.
The British Medical Journal has also weighed into the elusive search for a hangover cure with a systematic review of randomised-controlled trials. But their comprehensive search for any medical therapy that could prevent or treat hangovers came up with naught. Their conclusion? The most effective way to avoid the symptoms of a hangover is to practise abstinence or moderation. It may not be what you want to hear, but it is the most effective cure we have yet.
Are there health benefits?
One final question to ponder today is if there could be any health benefits to be gained from the pain that alcohol can cause you. The health harms of alcohol are long indeed so I won’t go into a lot of detail about those, but every now and then you see something surface about the health benefits of alcohol. Is there any truth to this?
A low level of alcohol consumption may offer a small benefit in reducing overall earlier mortality rates – mostly by offering some degree of protection against coronary heart disease in those with existing risk factors. Alcohol can raise the levels of HDL-cholesterol. This is the type of cholesterol that removes cholesterol from the blood and reduce the ‘stickiness’ of blood and the risk of blood clots forming.
Scientists call the observed small health benefit of alcohol ‘the J curve effect’ where a benefit is seen with light to moderate amounts of consumption (1-2 drinks per day), but skyrocketing health risks with increasing consumption. There is debate though if the J curve effect may be from other factors such as healthier lifestyles of light drinkers, rather than the alcohol itself.
What this means is that the relationship between alcohol consumption and mortality is complex and can vary depending on various factors such as the amount and frequency of alcohol consumed, individual health conditions, and other lifestyle factors.
However, the truth is that alcohol’s health benefits mostly apply to men over 40 and women over 50. These benefits are seen in those who consume one to two standard drinks per day or less. Younger people do not get the same health benefits from drinking.
What it all means
If you can’t cure a hangover, you can do some things to help reduce it the night before. And for that, make sure that you:
- Eat food when drinking
- Alternate your drinks with water
- Try a sports drink before bed and the morning after
- Get plenty of sleep
- Get active the next day – the endorphin release will make you feel better
Once you have a hangover, there’s no magic pill to cure it. But something as simple as aspirin and a strong coffee can help to clear your head and perk you up a little as you bunker down and wait it out.