What is a hangover and why does it occur?
A hangover is a whole range of physical and psychological symptoms that occur after drinking alcohol, when the level of alcohol in the blood has already dropped to almost zero. Symptoms include a range of negative conditions and disorders in the body. We will tell you everything that science knows about the causes and ways to deal with a hangover today.
The main causes and their consequences of a hangover are expressed in symptoms:
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Acetaldehyde – a toxic metabolite of alcohol
Acetaldehyde is the very first substance that is formed after alcohol is metabolised by the enzyme alcohol dehydrogenase (ADH). Few people know that it is much more toxic than ethanol itself and is usually quickly neutralised in the liver by the enzyme aldehyde dehydrogenase (ALDH). However, in many people (especially in Asia due to differences in genetics), this process is significantly slower.
What symptoms does this cause?
– Headache and throbbing – acetaldehyde causes a sharp vasodilation and neuroinflammation
– Nausea and vomiting – it irritates the gastrointestinal tract and central nausea receptors
– tachycardia or palpitations – due to stimulation of the sympathetic nervous system
– feeling of weakness and aches in the body – a consequence of toxic effects on muscle tissue
According to the scientific study ‘Alcohol Hangover – Its Effects on the Human Body: A Review’ published in the Biomedical Journal of Scientific and Technical Research, it is the accumulation of acetaldehyde that is the main trigger of many physical manifestations of a hangover: https://biomedres.us/fulltexts/BJSTR.MS.ID.001112.php.
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Dehydration and electrolyte imbalance
Alcohol acts as a diuretic, inhibiting the release of the hormone vasopressin, which leads to fluid and electrolyte (sodium, potassium, magnesium ions) loss.
Symptoms:
– intense thirst and dry mouth
– headache (caused by a decrease in plasma volume and irritation of the meninges)
– muscle cramps – due to loss of magnesium and potassium
– dizziness, disorientation – due to lowered blood pressure and impaired blood supply to the brain
– constipation or diarrhoea – depending on the balance of sodium and moisture in the intestine
However, according to German and Dutch scientists Marlou Mackus, Ann-Kathrin Stock and Johan Garssen, dehydration is only one part of the complex of hangover symptoms and does not explain all the effects (according to the study ‘Comparing alcohol hangover and dehydration: the effect of drinking water on preventing or alleviating alcohol hangover’, https://www.sciencedirect.com/science/article/pii/S0741832924001009).
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Inflammation and activation of the immune system
After drinking alcohol, the level of cytokines (IL-6, IL-12, TNF-α, IFNγ) in the blood increases, causing neuroinflammation and a systemic reaction similar to a mild infection.
Symptoms:
– pain in muscles and joints – as during SARS
– fever, trembling
– irritability, emotional instability – negative impact on neurotransmitters
– fog in the head, reduced cognition – cytokines affect the adequacy of the hippocampus
– bad mood or anxiety – inflammatory molecules also have a strong effect on dopamine receptors
This is confirmed by the study ‘Alcohol hangover – a mysterious phenomenon’ published in the journal Alcohol and Alcoholism, which found that immune activation is closely related to cognitive impairment of hangover: https://academic.oup.com/alcalc/article-abstract/43/2/124/122754?redirectedFrom=fulltext.
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Decreased glucose levels and sleep disturbances
Alcohol also disrupts insulin and glucose regulation, which can lead to hypoglycaemia. On top of that, it blocks the deep sleep phase and REM sleep, which are very necessary for the body to recover.
Symptoms:
– a strong feeling of hunger or ‘shaking’ – a consequence of a drop in blood glucose levels
– drowsiness, fatigue or irritability – the consequences of sleep disturbance and hypoglycaemia
– decreased attention and noticeable lethargy – the result of the fact that the brain has not received high-quality recovery
– shallow or disturbed sleep
According to the study ‘Alcohol Hangover: Mechanisms and Mediators’ published in the journal Alcohol Health and World Studies, alcohol disrupts circadian rhythms, causing prolonged fatigue and mood changes: https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=30a70328b636e8a01fbb9407ec4b9d77a0030a9b.
Thus, we can conclude that a hangover is not only a consequence of dehydration and intoxication, but is also associated with immune system activation and metabolic stress.
Medical ways to deal with a hangover
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Rehydration and electrolytes
Although water does not cure a hangover completely, it helps to restore fluid loss. However, the effect will be limited (study ‘Comparison of alcohol hangover and dehydration: the effect of drinking water on preventing or relieving alcohol hangover’, Alcohol, https://www.sciencedirect.com/science/article/pii/S0741832924001009).
To relieve a hangover, you should drink water with added electrolytes (sodium, potassium, magnesium) or use medications such as Rehydron, which effectively restore lost fluids and electrolytes.
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Anti-inflammatory drugs
Ibuprofen reduces headache and muscle pain. But avoid paracetamol (especially after alcohol), as it can damage the liver in this combination.
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Protect the liver and speed up detoxification
Preparations based on artichoke, silymarin, or amino acids (e.g. N-acetylcysteine) will help the liver neutralise toxins.
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Betargin
This dietary supplement is a source of effective compounds:
– arginine – an amino acid that supports and stimulates the liver’s detoxification function;
– betaine – an effective ‘utiliser’ of fat cells. This substance prevents the development of hepatic dystrophy, quickly relieves inflammation, and prevents blood clots in the body’s vessels;
Citrate ions contained in Betargin contribute to rapid normalisation of the digestive system in case of increased gastric acidity, effectively reduce acidosis and eliminate existing dyspeptic manifestations. In order to prevent deterioration of adequate liver function due to the toxic effects of alcohol, doctors recommend taking Betargin according to the following regimen: 1 ampoule or stick is diluted in half a glass of water and taken 3 times a day; to consolidate the effect, Betargin can be taken for another 2-3 days after the onset of a hangover syndrome – this is guaranteed to remove all toxic substances formed as a result of the breakdown of alcohol from the body.
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Modern adsorbents
Doctors also recommend drinking a new generation adsorbent (such as Bionorm), which is a source of insoluble dietary fibre (lignin and cellulose) in combination with prebiotics (such as lactulose), as soon as possible after the onset of a hangover (and ideally before it manifests itself) – this normalises the gastrointestinal tract and adsorbs toxic products of alcohol breakdown.
If you don’t have strong adsorbents with prebiotics of this type at hand, you can take activated charcoal.
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Succinic acid.
It is good for restoring liver cells and protecting them from damage caused by excessive alcohol consumption.
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Magnesium supplements
They restore all components of the nervous system, muscles, and relieve stress and swelling.
Folk remedies
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Fruits of Hovenia dulcis
This tree is native to East Asia: in a randomised clinical trial, Hovenia dulcis fruit extract reduced headaches, dizziness and weakness after alcohol, and improved liver function (ALT): ‘Effects of Hovenia dulcis fruit extract on alcohol-induced metabolism, inflammation and hangover after acute alcohol consumption: a randomised, double-blind, placebo-controlled study’, Journal of the Federation of American Societies for Experimental Biology, https://faseb.onlinelibrary.wiley.com/doi/10.1096/fasebj.30.1_supplement.lb209.
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Bay leaves
In an animal study, bay leaf extract accelerated the metabolism of alcohol (by increasing ADH/ALDH activity), reduced acetaldehyde, and protected the liver from damage: ‘Aqueous extract of laurel leaves accelerates alcohol metabolism and prevents liver damage in ethanol-only rats’, Journal of Nutrition Research and Practice https://e-nrp.org/DOIx.php?id=10.4162/nrp.2023.17.6.1113.
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Fermented foods
Products based on Pueraria lobata, Coix, fermented beans and fruits (pear, citrus) have also demonstrated good hepatoprotective and anti-inflammatory effects: study ‘Combined aqueous extracts from oxidation-treated leaves and branches of Hovenia dulcis have anti-hangover and protective effects on the liver during alcohol consumption by male mice’, Nutrients, https://www.mdpi.com/2072-6643/13/12/4404.
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High-quality black tea
Scientific studies show that high-quality black (red) tea with tipis (buds) contains specific volatile substances that can significantly improve liver function in case of alcohol damage, reduce the level of liver enzymes ALT, AST (alanine aminotransferase and aspartate aminotransferase are liver enzymes that are released into the blood when its cells are damaged) and adjust fat metabolism: ‘Joint transcriptome and proteomics analysis reveals the anti-alcohol effect of liver damage by volatile compounds in Dianhong black tea’, published in the journal Food Science and Nutrition, https://onlinelibrary.wiley.com/doi/10.1002/fsn3.3763.
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Other folk remedies (although partially supported by science)
Sauerkraut or brine – restores electrolytes quite quickly.
Honey with lemon dissolved in water is a great source of fructose, which speeds up the metabolism of alcohol.
Green or ginger tea – has antioxidant and antiemetic effects.
Broths, especially chicken broth, are nutritious and stimulate metabolism.
What doesn’t work for a hangover or is even harmful?
‘Hangover’ with alcohol – this will only provide temporary relief, which prolongs intoxication and the above problems.
Paracetamol – it is toxic with alcohol residues in the body.
Energy drinks – they give a false sense of vigour, but do not solve the problem in any way.
Ammonia is a substance that can revive a person who is heavily intoxicated: 5-7 drops of ammonia are added to a glass of cold water and drunk at a time.
How to avoid a hangover?
In this sense, there are medical, nutritional and behavioural strategies before drinking alcohol, which we will discuss below.
Why is it important to prepare for drinking alcohol at all?
Because a hangover is caused not only by an excessive amount of alcohol, but also by a number of other factors:
– the level of hydration in the body
– liver condition
– glycogen content
– possible presence of sleep disorders
– accompanying food during the feast
– individual genetics (as reflected in the activity of ADH/ALDH enzymes)
That is why preliminary preparation can significantly reduce or completely avoid a hangover.
How to avoid a hangover?
The main scientifically proven ways to avoid a hangover:
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Eating before drinking alcohol
Fatty or protein foods significantly slow down the absorption of alcohol from the stomach into the bloodstream, namely
– slows down the peak concentration of alcohol
– allows the liver to process alcohol efficiently and gradually
Therefore, experts recommend eating a full-fat and protein meal 30-60 minutes before drinking alcohol (for example, eggs with avocado, cottage cheese or meat).
Scientific research by Dutch scientist Joris K. Verster shows that fatty foods reduce blood alcohol levels by 30-50% compared to fasting: ‘Alcohol hangover is a mysterious phenomenon’, Journal of Alcohol and Alcoholism, https://academic.oup.com/alcalc/article-abstract/43/2/124/122754?redirectedFrom=fulltext.
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Hydration before and during drinking
Alcohol is a powerful diuretic. To avoid future dehydration and electrolyte loss, drink water as follows:
– 2-3 hours before drinking – 2 glasses of water
– after each alcoholic drink – 1 glass of water
– before going to bed – preferably another 1-2 glasses with the addition of salt or electrolytes
Studies have shown that intracellular dehydration worsens hangover symptoms even more than total fluid loss: ‘Comparison of alcohol hangover and dehydration: the effect of drinking water on preventing or alleviating alcohol hangover’, Journal of Alcohol, https://www.sciencedirect.com/science/article/pii/S0741832924001009.
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Fruits and other sources of antioxidants
Polyphenols, vitamin C, catechins are good at reducing oxidative stress and neutralising acetaldehyde. The best of them are:
– matcha tea or high-quality green tea
– oranges, kiwi and various berries
– turmeric
– ginger
– milk thistle
A 2022 study by the University of Pennsylvania found that green tea reduces biomarkers of inflammation after alcohol consumption (‘Catechin-rich green tea extract reduces gut inflammation and fasting glucose in metabolic syndrome and healthy adults: a randomised controlled crossover trial’, Current Advances in Nutrition, https://cdn.nutrition.org/article/S2475-2991(23)20819-7/pdf).
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Take natural hepatoprotectors before a party
The following drugs activate ALDH enzymes and protect the liver:
– N-acetylcysteine (NAC) is a precursor of glutathione (a powerful antioxidant)
– L-ornithine – a substance that supports detoxification
– Silymarin (milk thistle) – a strong hepatoprotector
– bay leaves, curcumin, Hovenia dulcis – they will also reduce possible intoxication
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The choice of alcohol itself
Congeners are by-products of fermentation (fusel alcohols, acetone, tannins) that aggravate hangovers. The content of congeners in alcoholic beverages is distributed as follows:
Brandy, bourbons and red wine have the highest levels.
Moderate amounts are found in rum and dark beer.
The least amount is in vodka, gin and white wines.
It has been scientifically proven that people who drink bourbon have worse cognitive function and feel worse the next day than those who drink vodka – with the same alcohol content (‘Alcohol hangover is a mysterious phenomenon’, Alcohol and Alcoholism magazine, https://academic.oup.com/alcalc/article-abstract/43/2/124/122754?redirectedFrom=fulltext).
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Sleep before the party
Lack of sleep before drinking: significantly reduces the activity of liver enzymes, increases sensitivity to alcohol and impairs the neutralisation of acetaldehyde.
Experiments have shown that sleeping before drinking alcohol reduces the likelihood of cognitive deficits the next day: ‘Alcohol Hangover: Mechanisms and Mediators’, Alcohol Health and World Research, https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=30a70328b636e8a01fbb9407ec4b9d77a0030a9b.
To sum up, fatty or protein foods, 1-2 glasses of water, N-acetylcysteine, vitamin C, polyphenols, sleep, and choosing light alcohol reduce the risk of a hangover. And of course, you shouldn’t mix different drinks – this is likely to end badly.
Hydration, electrolytes, antioxidants, and liver support will help you get rid of a hangover quickly and safely. And of course, rest, sleep and light meals.
