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The Science of Hangovers

*This article is intended for educational purposes only and should not be considered medical advice.

The winter holidays are a time for many people to celebrate with friends and family and can also become a time of excess. Excess food, dessert, and, yes, alcohol. While this article may have been more appropriately published before New Year’s Eve for some people, I am sure its release date won’t affect the majority of my readers due to their ability to show restraint and moderation. Still, I thought the topic of hangovers, from a purely scientific perspective, would be interesting to explore.

So, what exactly is a hangover? A hangover refers to a set of symptoms associated with drinking too much alcohol. Symptoms may include fatigue, weakness, thirst, muscle aches, nausea, stomach pain, vertigo, sensitivity to light and sound, anxiety, irritability, sweating, increased blood pressure, and the dreaded headache (or so I’ve heard).

Though most people associate the aforementioned symptoms with alcohol, scientists are not quite sure what exactly the link is. For the sake of your next trivia night, however, they do have a name for it: veisalgia.

Historically, dehydration was blamed for the pain and fogginess of too much partying, as it is a diuretic and increases urine output, combined with the likelihood that the partier is not drinking enough water. This may account for some of the hangover symptoms. Still, studies have found that the connection between symptom severity and level of dehydration does not explain everything and that other factors are at play.

According to Joe Stromberg, writer for Smithsonian Magazine, many scientists attribute hangover symptoms to alcohol’s interference with the body’s natural chemical balance, and that to process alcohol, our bodies need to convert an enzyme called NAD+ to an alternate form, NADH. With too much NADH and insufficient NAD+ in our systems, we cannot perform certain metabolic functions. But studies have also nixed this hypothesis. Showing that people with hangovers do not have significantly lower levels of glucose and electrolytes in their blood.

The prevailing theory is that hangovers are caused by the build-up of a compound called acetaldehyde, a byproduct of the metabolism of alcohol, which has been shown to cause symptoms such as nausea, vomiting, sweating, and flushed skin. A study published in the Journal of Medicine by Mackey et al. disputes acetaldehyde as a direct cause of hangover symptoms. However, these researchers believe that it does play an indirect role.

Studies have also shown a correlation between alcohol consumption and cytokines, proteins that act as chemical signalers to the immune system. The body usually uses cytokines to trigger the body’s inflammatory response to infection, but alcohol has also been shown to activate them, which can cause hangover symptoms.

In addition, some drinks have been shown to cause hangovers more often and of more severity than others. Ultimately, hangovers are caused by alcohol consumption. Therefore, hard liquor drinks such as whiskey and rum are more likely to cause symptoms than beer because they contain more alcohol by volume and can be consumed more quickly. In addition, some drinks have higher levels of trace chemicals called congeners that are produced during fermentation. Research has shown that darker-colored drinks, such as bourbon, cause more severe hangovers than their lighter-colored counterparts, such as vodka. One such congener, methanol, is particularly nasty and can remain in a person’s system long after the alcohol is metabolized and may account for longer-lasting symptoms.

So, what can you do if you are suffering from a hangover or, better yet, prevent one in the first place? According to drinking folklore, Americans favor a greasy meal such as eggs and bacon the following morning to alleviate symptoms. Some people believe that the hair of the dog and additional drinking is the best course of action. Or, if you are from Germany, your preferred cure is pickled herring. Romanians seem to like tripe soup; if you are from Mexico, you might have heard shrimp for breakfast.

The truth is that none of these home remedies is likely to cure a hangover. By far, the best way to cure a hangover is to avoid one to begin with by drinking in moderation or not at all. Staying hydrated both during and after alcohol consumption is a good idea. If you do choose to drink, drink slowly and on a full stomach. Also, non-steroidal anti-inflammatory (NSAID) meds such as ibuprofen may alleviate headache pain but do NOT take acetaminophen as it can interact with alcohol and damage your liver. If you are unsure what, if anything, to take, consult with a medical professional.