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How Hangovers Work

by Lacy Perry

Browse the article How Hangovers W ork

Introduction to How Hangov ers Work

It's no secret that intoxication has a number of immediate negative consequences. Among other
Drug Image Gallery
things, it impairs judgment, it impairs the ability to do most things and it can bring on a depressed
mood. But even after a drinker has sobered up, alcohol can still be causing the body trouble.
More than 75 percent of alcohol consumers have experienced a hangover at least once; 15
percent have one at least every month; and 25 percent of college students feel symptoms weekly.

In this article, we'll explain what causes hangover symptoms

Learn More and examine the science of the popular prevention methods
and morning-after remedies.
Alcohol Quiz
9 Home Remedies for
Hangov ers
Discov eryHealth.com: What is a Hangov er?
Blood Alcohol Content The formal
Calculator name for a In the Most Surprising Places
hangover is Stockbyte

v eisalgia, from the Norwegian word for Hangovers have plagued people More than 75 percent of alcohol consumers
"uneasiness following debauchery" (kveis) and throughout history. The Bible even makes hav e experienced a hangov er at least once.
mention of the pain that follows a night of See more drug pictures.
the Greek word for "pain" (algia) -- an
heavy drinking: "Woe unto them that rise
appropriate title considering the uncomfortable
up early in the morning, that they may
symptoms experienced by the average drinker.
follow strong drink" (Isaiah 5:11). And
The common hangover includes some or all of Shakespeare knew the unwanted effects of
the following: alcohol, as shown in his play Macbeth (Act
2 scene 3):
Headache
Poor sense of overall well-being Macduff: What three things does
Sensitivity to light and sound drink especially promote?
Diarrhea Porter: Marry sir, nose-painting,
Loss of appetite sleep, and urine.
Trembling
Nausea
Fatigue
Increased heart rate and blood pressure
Dehydration(dry mouth, extreme thirst, dry eyes)
Trouble concentrating
Anxiety
Difficulty sleeping
Weakness

The most common symptoms are headache, fatigue and dehydration, and the least common is trembling. The severity and number of symptoms
varies from person to person; however, it is generally true that the more alcohol a drinker consumes, the worse the hangover will be.

It usually takes five to seven cocktails over the course of four to six hours to cause a hangover for a light-to-moderate drinker (a man who drinks up
to three alcoholic beverages a day or a woman who drinks up to one). It may take more alcohol for heavier drinkers because of increased
tolerance. Other than the number of drinks consumed, hangovers can be made worse by:

Drinking on an empty stomach

Lack of sleep
Increased physical activity while drinking (dancing, for example)
Dehydration before drinking
Poor health

The reason for some symptoms isn't fully understood, but research has led scientists to have a
pretty good understanding of the primary causes of a hangover. In the next sections, we'll find Quiz Corner
out what's going on in the body to cause these problems.
Biology of a Hangov er: Vasopressin Inhibition
How much do you know about the alcohol
When alcohol is consumed, it enters the bloodstream and causes the pituitary gland in the brain
that gave you that hangover? Take the
to block the creation of v asopressin (also known as the antidiuretic hormone). Without this
Alcohol Quiz and find out.
chemical, the kidneys send water directly to the bladder instead of reabsorbing it into the body.
This is why drinkers have to make frequent trips to the bathroom after urinating for the first time
after drinking.

According to studies, drinking about 250 milliliters of an alcoholic beverage causes the body to expel 800 to 1,000 milliliters of water; that's four
times as much liquid lost as gained. This diuretic effect decreases as the alcohol in the bloodstream decreases, but the aftereffects help create a
hangover.

The morning after heavy drinking, the body sends a desperate message to replenish its water supply -- usually manifested in the form of an
extremely dry mouth. Headaches result from dehydration because the body's organs try to make up for their own water loss by stealing water from
the brain, causing the brain to decrease in size and pull on the membranes that connect the brain to the skull, resulting in pain.

The frequent urination also expels salts and potassium that are necessary for proper nerve and
muscle function; when sodium and potassium levels get too low, headaches, fatigue and If You Need Help
nausea can result. Alcohol also breaks down the body's store of glycogen in the liver, turning the
chemical into glucose and sending it out of the body in the urine. Lack of this key energy source Alcoholism is a serious medical condition.
is partly responsible for the weakness, fatigue and lack of coordination the next morning. In If you often drink more than you mean to,
you suffer from memory lapses while
addition, the diuretic effect expels vital electrolytes such as potassium and magnesium, which
drinking or you feel drinking is negatively
are necessary for proper cell function.
impacting your life in any way, please
Different types of alcohol can cause different types of hangover. In the next section, we'll look at contact Alcoholics Anonymous.
the differences.

Biology of a Hangov er: Congeners

Different types of alcohol can result in different hangover symptoms. This is because some types of alcoholic
drinks have a higher concentration of congeners, byproducts of fermentation in some alcohol.

The greatest amounts of these toxins are found in red wine and dark liquors such as bourbon, brandy, whiskey
and tequila. White wine and clear liquors such as rum, vodka and gin have fewer congeners and therefore cause
less frequent and less severe hangovers. In one study, 33 percent of those who drank an amount of bourbon
relative to their body weight reported severe hangover, compared to 3 percent of those who drank the same
amount of vodka.

Because different alcoholic drinks (beer, wine, liquor) have different congeners, combining the various impurities
Dark w ines and liquors hav e
can result in particularly severe hangover symptoms. Additionally, the carbonation in beer actually speeds up higher lev els of certain toxins.
the absorption of alcohol. As a result, following beer with liquor gives the body even less time than usual to
process the toxins.

Biology of a Hangov er: Acetaldehyde

A product of alcohol metabolism that is more toxic than alcohol itself, acetaldehyde is created when the alcohol in the liver is broken down by an
enzyme called alcohol dehydrogenase. The acetaldehyde is then attacked by another enzyme, acetaldehyde dehydrogenase, and another
substance called glutathione, which contains high quantities of cysteine (a substance that is attracted to acetaldehyde). Together, the
acetaldehyde dehydrogenase and the glutathione form the nontoxic acetate (a substance similar to vinegar). This process works well, leaving the
acetaldehyde only a short amount of time to do its damage if only a few drinks are consumed.

Unfortunately, the liver's stores of glutathione quickly run out when larger amounts of alcohol enter the system. This causes the acetaldehyde to
build up in the body as the liver creates more glutathione, leaving the toxin in the body for long periods of time. In studies that blocked the
enzyme that breaks down acetaldehyde (acetaldehyde dehydrogenase) with a drug called Antabuse, designed to fight alcoholism, acetaldehyde
toxicity resulted in headaches and vomiting so bad that even alcoholics were wary of their next drink. Although body weight is a factor (see How
Alcohol Works), part of the reason women should not keep up with men drink-for-drink is because women have less acetaldehyde dehydrogenase
and glutathione, making their hangovers worse because it takes longer for the body to break down the alcohol.

Some of the most common hangover symptoms -- fatigue, stomach irritation and a general sense of illness all over -- can be further attributed to
something called glutamine rebound. In the next section, we'll see what this aftereffect is all about.

Biology of a Hangov er: Glutamine Rebound

After a night of alcohol consumption, a drinker won't sleep as soundly as normal because the body is rebounding from alcohol's depressive effect
on the system. When someone is drinking, alcohol inhibits glutamine, one of the body's natural stimulants. When the drinker stops drinking, the
body tries to make up for lost time by producing more glutamine than it needs.

The increase in glutamine levels stimulates the brain while the drinker is trying to sleep, keeping them from reaching the deepest, most healing
levels of slumber. This is a large contributor to the fatigue felt with a hangover. Severe glutamine rebound during a hangover also may be
responsible for tremors, anxiety, restlessness and increased blood pressure.

Because alcohol is absorbed directly through the stomach, the cells that line the organ become irritated. Alcohol also promotes secretion of
hydrochloric acid in the stomach, eventually causing the nerves to send a message to the brain that the stomach's contents are hurting the body
and must be expelled through vomiting. This mechanism can actually lessen hangover symptoms in the long run because vomiting gets rid of the
alcohol in the stomach and reduces the number of toxins the body has to deal with. The stomach's irritation may also be a factor in some of the
other unpleasant symptoms of a hangover, such as diarrhea and lack of appetite.

So now we know why alcohol causes hangovers. In the following sections, we'll look at the science behind the most common hangover "cures."
Food and Drink Remedies - Fact or Fiction?

Hangover remedies include everything from "a hair of the dog that bit you" (drinking a little more alcohol the next morning), to burnt toast and
black coffee to an over-the-counter product like Chaser. Which of all the endless theoretical remedies actually have truth behind them?

Hair of the Dog

Contrary to popular belief, more of the "hair of the dog that bit you" only delays the inevitable. One of the reasons hangovers are so unpleasant is
the liver is still processing the toxins left over from alcohol metabolism. Drinking more alcohol can make the symptoms seem to lessen at first but
will only make the situation worse once the liver breaks the alcohol down, because it will have even more toxins to deal with.

Conclusion:

FICTION - Remedy

Burnt Toast

At first, the burnt toast remedy may seem that it's actually based on scientific fact. The culprit behind this
fictional cure is the carbon in the charred bread. Carbon can act like a filter in the body. While it's true that
activ ated charcoal (which is a treated form of carbon) is used to treat some types of poisonings, it's not currently
used to treat alcohol poisoning (something that is vastly different from a regular hangover).

The carbon/charcoal found on burnt toast is not the same as activated charcoal.

Conclusion:

FICTION - Prevention and Remedy

Black Coffee

Coffee contains a high amount of caffeine, which is a stimulant and therefore helps fight fatigue. But when the
caffeine wears off, a drinker may be even more tired than before. Coffee can help alleviate a pounding head
because caffeine is a v asoconstrictor, meaning it reduces the size of blood vessels. This counteracts the effect
of the alcohol, which makes them swell, making the head hurt in the first place. Unfortunately, caffeine is also a
diuretic like alcohol and can make a drinker even more dehydrated than before, thereby increasing the severity
of the hangover. Overall, coffee isn't a good hangover cure.

Conclusion:

FICTION - Remedy

Fried or Fatty Foods

Although eating fried or fatty foods the morning after will probably only irritate a drinker's stomach further, eating
them before drinking can actually be helpful. Putting anything in the stomach prior to indulging in alcohol helps
prevent a hangover, but fatty foods in particular stick to the stomach lining longer and therefore slow down the
absorption of alcohol into the bloodstream. While that might make it take longer to feel the alcohol's effects, it
also gives the body more time to process the byproducts and will increase a drinker's chances of feeling decent in
the morning. So much so, in fact, that a Mediterranean folk tactic is to take a spoonful of olive oil before drinking
alcohol. Eating lighter food such as a fruit smoothie will provide energy and alleviate some symptoms by
replenishing the electrolytes the body lost from dehydration.

Conclusion:

FACT - Prevention
FICTION - Remedy

Eggs

Eating eggs the morning after provides energy like any other food, which is the primary benefit. But eggs do also
contain large amounts of cysteine, the substance that breaks down the hangover-causing toxin acetaldehyde in
the liver's easily depleted glutathione. Therefore, eggs can potentially help mop up the left-over toxins.

Conclusion:

FACT - Remedy

Bananas

Eating bananas the morning after a night of heavy drinking provides lost electrolytes like any food would, but it
also specifically replenishes the potassium lost to alcohol's diuretic effect. Other potassium-rich foods such as kiwi
fruit or sports drinks work just as well.

Conclusion:

FACT - Remedy

Water
Replenishing the body's water supply after a night of drinking combats dehydration, and it also helps dilute the
leftover byproducts in the stomach. Adding salt and sugar to water helps replace the sodium and glycogen lost the
night before. Non-caffeinated, non-carbonated sports drinks can achieve the same effect.

As a prevention method, drinking a glass of water for every alcoholic beverage slows down drinking, providing
more time for the body to deal with the alcohol (the body can only process about three-quarters of an ounce of
alcohol in an hour). Drinking a few glasses of water before going to bed helps fight dehydration after the body
finishes breaking down the alcohol.

Conclusion:

FACT - Prevention and Remedy

Fruit Juice
The fructose -- fruit sugar -- in fruit juice helps to naturally increase the body's
energy. Studies have proven that it also increases the rate at which the body gets
rid of toxins such as those left over from alcohol metabolism. Fruit juice is also a
good idea the morning after because it's high in vitamins and nutrients that were
depleted the night before because of alcohol's diuretic effect. Vitamin
supplements high in vitamins C and B are also effective.

Conclusion:

FACT - Remedy

Other Remedies - Fact or Fiction?

Painkillers

Certain painkillers are more effective at combating a hangover than others. For instance, Excedrin can be helpful
for a headache because it combines acetaminophen for the pain and caffeine to reduce the size of the pounding
blood vessels; however, prolonged combination of alcohol and acetaminophen has been shown to cause liver
damage, and caffeine is a diuretic.

Aspirin is a non-caffeinated pain reliever and is also in a class of anti-inflammatory drugs known as prostaglandin
inhibitors. High levels of prostaglandin have been associated with increased hangover severity. In one study,
participants who took a prostaglandin inhibitor before bed reported less of a headache and less nausea and thirst
than those who had drank the same amount of alcohol but did not take the prostaglandin inhibitor before bed. If
you have a sensitive stomach, though, beware -- taking aspirin after drinking can make your stomach hurt even
worse.

Conclusion:

FACT - Prevention and Remedy if non-caffeinated and acetaminophen-free

Ov er-the-counter Remedies

Hangover remedies such as Chaser, Sob'r-K Hangover Stopper, RU-21, Berocca and Rebound are highly varied
both in price and ingredients, so their effectiveness varies accordingly. They're classified as dietary
supplements, meaning:

They contain vitamins and minerals.

They don't require a prescription.
They're usually taken in pill form.

The manufacturers claim these products work because they make use of the effective filtering qualities of carbon
to reduce the number of impurities the body has to process (see "Burnt Toast" in the last section for the science
on that one). As for RU-21, marketed as a secret KGB pill, the manufacturer says specifically that it is not an
anti-hangover pill but a supplement for detoxification. (By the way, its main ingredients -- dextrose, L-Glutamine
and vitamin C -- can be found in high amounts in everyday foods). Rebound has the same ingredients as RU-21 plus a few other vitamins and
oddities such as "young barley grass juice powder," but it's still basically a multivitamin. Berocca, again, is not a hangover cure -- it's simply a
multivitamin that claims to increase energy naturally (through vitamins).

The secret to most of these purported "miracle cures" may in fact be the amount of w ater a drinker ingests when taking them. Many require taking
a pill (or two) with a glass (or two) of water before drinking alcohol, and then continuing to take the pills over the course of the evening with full
glasses of water, before bed with a full glass of water, and upon waking with a full glass of water. The hydration alone greatly improves the
chances of having little-to-no hangover, and the vitamins in the pills just give it a little, albeit expensive, boost.

Conclusion:

FICTION - Prevention and Remedy

Time

The only complete cure for a hangover is time. No matter what a drinker does, the body still has to clean up all the toxic byproducts left over from
the evening before. But the above factual remedies can help speed up the process.
Conclusion:

FACT - Remedy

Hangov er Remedy Ov erv iew

The only fool-proof way to avoid a hangover, of course, is not to drink alcohol. But from a
scientific perspective, researchers have found the following general regimen minimizes the If You Need Help
symptoms of a hangover. Alcoholism is a serious medical condition.
If you often drink more than you mean to,
Before Drinking
you suffer from memory lapses while
Eat a full meal - A full stomach slows down the absorption of alcohol, giving the body drinking or you feel drinking is negatively
more time to process the toxins. Fatty foods and carbohydrates increase this effect. Having impacting your life in any way, please
contact Alcoholics Anonymous.
food in the stomach also decreases stomach irritation, in turn reducing the likelihood that
a drinker will vomit. (See Biology of a Hangover.)

Drink a glass of w ater - This ensures the body is hydrated before the diuretic effect takes hold.

Take multiv itamins - This better prepares the body for the depletion of vitamins caused by frequent urination.

Before Drinking

Drink in moderation - Ideally, drinkers should limit themselves to one drink per hour because the body takes about an hour to process
a single drink.

Drink a glass of w ater after ev ery alcoholic bev erage - In addition to helping keep a drinker hydrated, this will give the body more
time to process the alcohol, dilute the toxins and reduce irritation of the stomach. A sports drink like Gatorade or Propel will also
replenish electrolytes, salts and sugars lost in the urine.

Watch your drink choice - Drinkers generally fare better when they stick with one drink. Each new type of alcohol a drinker puts into
his or her system makes the body work that much harder and puts that many more toxins in the body, leading to a more severe
hangover. Here's a rundown of the major types of alcohol and their effects:

Beer has the lowest percentage of alcohol (4 to 6 percent), but it's also carbonated, which speeds up the absorption and
can lead to toxin buildup.
Wine has a higher percentage of alcohol (7 to 15 percent) than beer, but it's usually not carbonated. White wine is safer
than red or blush because it has fewer congeners. In general, the cheaper the wine, the higher the congener content and
the worse the hangover.
Liquor has the highest alcohol content (40 to 95 percent) and therefore increases the likelihood of a hangover. Clear
liquors like vodka, rum and gin are better bets than dark or sweet liquors like bourbon, scotch or tequila because they have
fewer congeners. Generally, cheaper liquor will result in a worse hangover than more expensive liquor.

After Drinking

Before Bed

Take tw o aspirin w ith a full glass of w ater - The prostaglandin inhibitors in the aspirin can decrease hangover severity.

In the Morning

Take tw o more aspirin w ith a full glass of w ater - This has been shown to minimize headaches as well as decrease inflammation
from leftover prostaglandin.

Take another multiv itamin - Replenishing C and B vitamins in particular can help get rid of the rest of the toxins.

Eat breakfast - A meal that includes eggs (for the cysteine), a banana (for the potassium), and fruit juice (for the fructose) or a sports
drink (for the electrolytes, sugars and salts) can get the body on the road to recovery. Keep in mind that caffeinated coffee, tea and
soda will further dehydrate a drinker.

For more information on hangovers, alcohol and related topics, check out the links on the next page.

Lots More Information

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More Great Links

Alcoholics Anonymous
WebMD: Hangovers More of a Headache Than You Think
MSN Women: How do I get over a hangover?
BBC: h2g2: Hangover Cures

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