Hangovers and Remedies

There are three basic ways to combat hangover:

A hangover has several components:

1) dehydration: alcohol is a diuretic, and when you're drinking hard you're unlikely to be getting enough water anyway. Simple dehydration can produce many hangover effects on its own, including fatigue, headache, and irritability.

2) low energy: Drinking also correlates with being up too late. But alcohol also depletes your blood sugar, by encouraging your liver to dump glycogen into your blood. The next morning, your blood sugar will be low, which can cause loss of concentration, irritability, and fatigue.

3) toxicity: Alcohol is metabolized into a chemical which is toxic to your brain and liver. You feel lousy for sort of the same reason you feel lousy when a virus is destroying lots of cells in your body.

4) rebound excitation: Alcohol is a depressant, meaning that it suppresses certain kinds of brain activity. It begins by suppressing judgment and inhibition (which is why it can make you more active), and moves on to suppressing brain stem functions like balance, coordination, and life support. Your brain tries to cope with this by releasing more excitatory neurotransmitters, to overwhelm the depressant effects of alcohol. This takes a while to start, which is why you're more drunk on your way up than on your way down. Unfortunately, it also takes a while to stop -- so in the morning, when the alcohol is out of your body, your brain is still flooded with excitatory neurotransmitters (this is possibly the reason for hangover-induced sensitivity to light and noise). Too much stimulation of this type can cause brain cells to burn themselves out and die, causing headache and, in the long term, dementia.


Common hangover preparations attack different aspects of the syndrome:

The most infamous hangover cure is the hair of the dog that bit you -- a little drink upon awakening. It's easy to see how this addresses (4), because now you have more depressant to reduce the excessive excitation. And it's not such a bad idea, since gradually reducing the depressant load gives your brain time to adjust. However, it exacerbates the other alcohol effects mentioned above, and it can also be a sign of drug abuse.
Some commercial hangover cures claim to take their virtue from exotic stimulants and rare Tibetan herbs, but it's actually the base of 72% alcohol that does the job.
Note that this probably isn't the same mechanism that causes the similarly-infamous wake-and-bake; that just means that you're a loser.

Most commercial cures that I've seen contain B vitamins. This is a solid and well-established principle. Many of the B vitamins are metabolic co-factors, which means that they help your body produce energy. They can counteract the problems of low blood sugar and fatigue in (2). Indeed, anyone who is suffering from fatigue and depression would be well-advised to try a B multivitamin.
Additionally, alcohol directly impedes absorption of B1 (thiamin), to such an extent that long-term alcoholics may develop a life-threatening deficiency.

The less-common track of hangover treatment is prevention and, as in many other areas, it's by far the most effective. In addition to preventing the symptoms, we're also preventing the damage that causes them. However, prevention requires forethought and preparation. You have to take the vitamins before or during drinking; taking them in the morning helps far less.

There are two major prevention strategies: speeding detoxification and blocking toxicity.

Alcohol itself, while responsible for the specific drug effects we associate with it, is not very toxic. While it can cause overexcitation (4), most of the brain and organ damage is caused by its metabolite. Alcohol is metabolized into acetaldehyde, a highly irritating toxin. Acetaldehyde builds up until your body can get rid of it by using another enzyme to turn it into acetic acid (vinegar), which is basically food.
fun: methanol, the famous adulterant that makes people who drink moonshine go blind, acts a lot like alcohol and is metabolized by the same enzymes. But it is changed into a relative of acetaldehyde -- formaldehyde.
Acetaldehyde is metabolized by combination with a sulfur group which is contained in some amino acids. The two major ones are glutathinone and cysteine. These chemicals are normal components of protein and are in many things we eat, but when administered at high concentrations their effects on alcohol are startling. One study injected rats with an LD90 dose of acetaldehyde (meaning that under normal conditions, it would kill 90% of them), and then gave them cysteine, B1, and vitamin C (discussed below). No one died.
Mentioning is more efficient than cysteine, but cysteine is cheaper and better-absorbed. Cysteine is often sold as N-acetyl-cysteine (NAC), which is almost as good.

For a more complete discussion of cysteine and its effects, I recommend this article by the people at CERI.

The second goal, blocking toxicity, is achieved by neutralizing free radicals. Acetaldehyde destroys or deforms proteins and other molecules in your body, and in the process it creates free radicals -- unbound oxygen atoms which are so anxious to mate with something that they'll tear it away from whatever it was supposed to be bound to. Free radicals do everything from hardening arteries to causing wrinkles to making cells become cancerous. A full discussion of free radicals and free radical scavengers (antioxidants) is beyond the scope of this document. Suffice it to say that one of the most effective and inexpensive antioxidant vitamins is vitamin C.

The hangover packets that I distribute contain:

500mg vitamin C
500-600mg cysteine or NAC
500mg B-1

It is highly unlikely that anyone will have an allergic or overdose reaction to these vitamins in these quantities, so I recommend giving them away to all and sundry. One packet before drinking and one every two or three drinks thereafter is recommended, but one is better than nothing.

A vital fourth component of the package is water. I can't emphasize this enough. Drinking a cup of water with every drink is one of the most effective ways to prevent hangover. Few things are as universally beneficial to your body's functioning as proper hydration. While I highly endorse the magical act of washing down your vitamins with a margarita, it may be better to give others water in order to ensure that they get at least a little that night.

Back to index © Michael Cohn 2002 - Please contact me for permission to reproduce.