Hangover Facts

Behold!  The most comprehensive Hangover FAQ the internet has to offer. Hangover facts and more.

Contents

  1. Definition
  2. Symptoms
    1. List of common hangover side-effects
    2. On alcohol withdrawal
    3. Mood alteration
  3. Causes
    1. Alcohol’s toxins
    2. Metabolic toxins
    3. Dehydration and electrolyte imbalance
    4. Gastrointestinal disturbances
    5. Low blood sugar
    6. Disruption of sleep and other biological rhythms
    7. Hormone level disturbances
  4. Prevention
    1. Drink small amounts of alcohol
    2. Over-the-counter drugs
    3. Commercial hangover prevention pills
    4. Other hints and tricks
  5. Remedies
    1. Time
    2. Eating and drinking
    3. Natural remedies
    4. Commercial hangover remedy pills
    5. Medications
    6. Drinking more
    7. Other potentially beneficial remedies
  6. Links and References

Definition

‘Hangover’ is a term used to describe the effects felt the next day after a night of proper drinking.  If you are guilty of boozing just a little too much the night before, then you will most likely wake up hungover.  A hangover is defined as having more than one of the following symptoms with severity enough to disrupt normal life (percentage of population experiencing each symptom): headache (66%), post alcohol blues (60%), diarrhea (36%), anorexia (21%), tremulousness (20%), fatigue (20%), and vomiting (9%).

‘Veisalgia’ is the medical term for hangover.  The term ‘hangover’ is a 19th century expression describing unfinished business or survival.  The meaning “morning after-effect of drinking too much” first surfaced in 1904.

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Symptoms

Hangovers have several physical symptoms such as a pounding headache, queasy stomach, fatigue, redness of the eyes, dry throat and thirst.  In addition you may also experience some less common symptoms such as a rapid heartbeat, the shakes, muscle aches and sweating.  Mental symptoms include dizziness, depression, irritability and anxiety.

List of common hangover side-effects

  • Constitutional: weakness, fatigue, and thirst
  • Pain: muscle aches and headaches
  • Gastrointestinal: vomiting, nausea, and stomach pain
  • Sleep and biological rhythms: decreased sleep, increased slow-wave sleep, and decreased REM
  • Sensory: vertigo and sensitivity to light and sound
  • Cognitive: decreased concentration and attention
  • Mood: depression, irritability, and anxiety
  • Sympathetic hyperactivity: sweating, tremors, and increased pulse and blood pressure

A hangover can make you feel ill and impaired.  Although a hangover may impair task performance and thereby increase the risk of injury, empirical data does not exist on whether or not a hangover actually impairs difficult mental tasks.

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On alcohol withdrawal

A typical hangover begins within several hours after the last drink, when blood alcohol concentration (BAC) begins to fall. Symptoms usually peak around the time BAC is reduced to zero and may continue for as long as 24 hours thereafter.  Hangover symptoms can sometimes be similar to the symptoms of mild alcohol withdrawal which leads to the assertion that a hangover is a manifestation of mild withdrawal.  However, hangovers may occur after a single drinking session, whereas withdrawal occurs usually after multiple, repeated sessions. Other differences between hangover and alcohol withdrawal include a shorter period of impairment (hangovers usually last hours, while withdrawal can last days) and a lack of seizures and hallucinations in a hangover.

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Mood Alteration

It makes sense that a mood-altering substance, such as alcohol, will affect your mood.  Although it may feel like it alters your mood positively while you’re drinking, the remnants of alcohol in your blood the next day affect your body’s natural ‘feel good’ chemicals and can cause mood disturbance.  We at www.caveday.com have coined this phenomenon as Post Alcohol Blues or P.A.B.’s.

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Causes

Hangovers are a frequent and unpleasant experience among social, casual, and professional drinkers alike.  Despite the prevalence of hangovers, however, we continue to drink on regular basis like clockwork.  This condition is not well understood scientifically, nor are the causes of hangovers.

Multiple possible contributors to the hangover state have been studied and researchers have produced evidence that alcohol can directly produce hangover symptoms through its effects on urine production, the gastrointestinal tract, blood sugar levels, sleep patterns, and biological rhythms.  In addition, some researchers claim that effects related to alcohol metabolism and other factors (e.g., non-alcohol compounds in beverages, the use of other drugs, personality traits, and alcoholism) also may contribute to the hangover condition.

Alcohol’s Toxins

Alcohol products contain a toxin known as congeners.  These toxins are the byproducts of the fermentation process that gives alcoholic beverages their flavor, color and aroma.  The concentration of congeners found in your drink can be a major factor in the production of hangover symptoms.  When released into the bloodstream, congeners cause reactions leading to inflammation and pain.  In addition, these toxins are positively charged molecules which invade the body’s cells, disrupting your pH balance.  This imbalance causes the body to fight back.  That result of this fight presents itself as upset stomach, vomiting, headache, sweats, chills, the spins and more.  You know the rest of this story.  If you have ever had a hangover, you know how ungodly these symptoms can be.  Once you are at this stage, there is nothing you can do, but tough it out and consider some of the relief options presented in this FAQ.  Time, agonizing time, rest and nutrition are your best friends at this point.

Dark drinks such as red wine, brandy and whiskey contain more congeners which increase the symptoms of a hangover.  Cheaper products are also known to result in a worse hangover because fewer impurities have been removed.  A 40oz of OE may be cheap, but it will cost you in the long run.  Red wines have more congeners than whites and some people note less of a hangover with white wine.  Some people have a strong reaction to red wine, called ‘red wine headache,’ that can affect them within 15 minutes after drinking a single glass of red.  The headache is usually accompanied by flushing and nausea.

Mixing drink types is a sure fire way to become quickly inebriated and consequently lead to a hangover.  You ever hear the saying, “beer before liquor, never been sicker”?  Well, it’s true.  The converse, “liquor before beer, in the clear” happens to be utterly false.  When you mix your drink types you are actually mixing the different poisonous toxins of the alcohol together.  More pressure is then placed on your liver to rid your body of these toxins and cleanse the system by flushing them out – causing more dehydration.

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Metabolic Toxins

Because alcohol is something our bodies don’t efficiently process well, certain by-products are created during its metabolism which contribute to a hangover.  The liver is the organ responsible for the breakdown of toxins in the body.  Alcohol, when the liver breaks it down, creates toxins that can result in the flu-like symptoms that are commonly associated with hangovers.  Other important factors involved in the intensity and production of hangover symptoms include the elimination of toxins (the liver converts alcohol into acetaldehyde and acetate) and the increased production of thromboxanes.  Thromboxanes are metabolic byproducts and are responsible for blood vessel constriction (blood pressure increase), increase in blood clot formation, and a decrease in immune levels.  Add to this a bit of congeners, a drop in cell redox potential, dehydration, and reduced sleep quality and it’s no mystery why we feel so terrible.

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Dehydration and Electrolyte Imbalance

Alcohol is a diuretic and causes the body to urinate more.  Drinking alcohol increases urine production by inhibiting the release of an antidiuretic hormone, vasopressin, from the pituitary gland.  In turn, reduced levels of vasopressin prevent the kidneys from absorbing water and thus increase urination.  Sweating, vomiting, and diarrhea also common symptoms of a hangover, and these conditions result in additional fluid loss and electrolyte imbalances.  Symptoms of dehydration include thirst, malaise, dryness, and dizziness – all commonly observed during a hangover.

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Gastrointestinal Disturbances

Alcohol irritates the stomach, causing inflammation and delayed stomach emptying, especially when beverages with a high alcohol concentration are consumed.  High quantities of alcohol consumption also can produce fatty liver, an accumulation of fat compounds called triglycerides in liver cells. In addition, alcohol increases the production of gastric acid as well as pancreatic and intestinal secretions.  Any of these factors can result in the upper abdominal pain, nausea, and vomiting experienced during a hangover.

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Low Blood Sugar

The presence of alcohol in the body can alter in the metabolic state of the liver and other organs which can lead to blood sugar levels (i.e., low glucose levels, or hypoglycemia).  Alcohol metabolism leads to fatty liver (described above) and a buildup of lactic acid in body fluids.  Both of these effects can interfere with glucose production. Alcohol-induced hypoglycemia generally occurs after binge drinking over several days in combination with lack of food.  This combination not only decreases glucose production but also uses up the reserves of glucose stored in the liver, thereby leading to hypoglycemia.  Because glucose is the brain’s primary energy source, hypoglycemia can contribute to hangover symptoms such as fatigue, weakness, and mood disturbances.  Diabetics should use more caution as they are particularly sensitive to the alcohol-induced alterations in blood glucose.

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Disruption of Sleep and Other Biological Rhythms

Although alcohol has sedative effects that can help you fall asleep, the fatigue experienced during a hangover results from alcohol’s disruptive effects on sleep quality.  Alcohol-induced sleep may be of shorter duration and poorer quality because of the body’s rebound excitation after BAC’s fall, which can lead to insomnia.  To add, when drinking takes place in the evening or at night (as it usually does), it can compete with sleep time.  Alcohol also disrupts sleep patterns, decreasing the time spent in the dreaming state (REM) and increasing the time spent in deep sleep.  In addition, alcohol relaxes the muscles in the throat, which can increase snoring and possibly induce periodic cessation of breathing (sleep apnea).

Drinking interferes with other biological rhythms and these effects persist into the hangover period. For example, alcohol disrupts the normal 24-hour body temperature rhythm, which results in a body temperature that is low during intoxication and high during a hangover.  Intoxication also impairs the nighttime secretion of growth hormone, which is important in protein synthesis and bone growth.   The disruption of rhythms induces a “jet lag” feeling that is thought to account for some of the symptoms of a hangover.

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Hormone Level Disturbances

The pituitary gland produces an anti-diuretic hormone (ADH) which causes the body to retain water.  While drinking, production of ADH diminishes causing us to urinate more which makes us dehydrated. However, during a hangover, ADH production is ramps-up causing fluid retention resulting in puffiness and bloating.

Other hormonal imbalances include the level disturbances of hormones aldosterone and cortisol.  Aldosterone helps regulate sodium, chloride, and potassium levels.  During drinking, aldosterone levels drop causing a decrease in sodium and an increase in potassium levels resulting in decreased blood volumes and a decrease in blood pressure.  Conversely, during the hangover period aldosterone rises causing an increase in sodium levels and an increase in blood volumes and blood pressure.  Sodium electrolyte imbalances can contribute to muscle weakness, fatigue, vomiting, and the loss of appetite experienced during a hangover.

Cortisol is a hormone which regulates fat, carbohydrate, and protein metabolism.  It also balances electrolytes, and functions as an anti-inflammatory.  During times of hangover, cortisol imbalances cause an increase in blood sugar levels.  Increased blood sugar levels cause an increase in insulin production and abnormal stress on the pancreas and liver.  Cortisol also decreases muscle protein which causes a redistribution of fat from the legs and arms to the torso and shoulder blade regions.

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Prevention

A literary review in the British Medical Journal concludes: “No compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover. The most effective way to avoid the symptoms of alcohol induced hangover is to avoid drinking.”  – Pittler MH, Verster JC, Ernst E (December 2005).  Despite this dismal quote, there is still hope.  Depending on you (your drinking habits, your health, etc.) certain techniques may and may not work for you.  Below you’ll find a list of prevention strategies and why they can be effective.

Drink Small Amounts of Alcohol

Pay attention to the quantity and quality of alcohol you drink.  These factors are probably the most effective in hangover prevention.  Hangover symptoms are less likely if a person drinks only small, non-intoxicating amounts.   Of course, this is no fun, so Caveday encourages you to explore other techniques as well.  Among people who drink to intoxication, those who consume lower amounts of alcohol appear less likely get a hangover than those who drink higher amounts, obviously.  However, contrary to popular belief, drinking beverages with low alcohol does not ensure less of a hangover.  It’s the amount of total alcohol consumed which matters.  Drinking 10 beers is likely worse than having 4 cocktails.

The type of alcohol consumed also has a significant effect on hangover intensity.  Alcoholic beverages that contain few congeners (vodka and gin, for example) are associated with a lower hangover rate than are beverages that contain a high number of congeners (brandy, whiskey, and red wine).

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Over-the-counter Drugs

There are several over-the-counter (OTC) treatments commonly used for hangover prevention.  OTC drugs such as aspirin and non steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are useful for hangover prevention.  Please remember to use caution as anti-inflammatory drugs are gastric irritants and may intensify alcohol-induced stomach issues.

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Commercial Hangover Prevention Pills

Note: Caveday does not sponsor, promote, or validate the effectiveness of the any products for hangover prevention or relief.  This is simply a guide containing brief excerpts from the most competitive brands.

  • Chaser – http://www.doublechaser.com/

“Chaser is a patented formula of activated calcium carbonate and vegetable carbon (activated charcoal). Calcium carbonate is the active ingredient in most calcium supplements and antacids. Vegetable carbon has been used for centuries to absorb toxins and is still used in hospitals today. These ingredients attract and absorb hangover-causing toxins (congeners) and passes them from your system – like a filter. Both ingredients are Generally Recognized As Safe (GRAS) by the FDA

Congeners, are the byproducts of the fermentation process that gives alcoholic beverages flavor, aroma and color. When released into your bloodstream, congeners cause a reaction leading to inflammation and pain. Chaser attracts and absorbs congeners, then passes them from your system – like a filter.”

  • First call – http://www.anti-hangover.com/products.html

“Basically, our anti-hangover products are preparing your liver to detoxify and flush these toxins out faster and help support your liver while its working so hard to get those cocktails out of your system. Alcohol and its by-products are typically metabolized at the rate of 0.5 ounces of alcohol per hour. The body is normally prepared to process only 2 to 4 ounces of alcohol a night, but we generally consume much more. Eventually, if we drink more than our body can handle, our liver stops processing these toxins and they have to go elsewhere in the body, thus creating all the other side effects we know as a hangover.”

“HANGOFF will prevent hangovers because the herbal constituents of HangOff help in quicker degeneration and excretion of Acetaldehyde, produced during the course of breakdown of ingested alcohol. The herbs in HangOff have also been proved to act extremely efficiently on symptoms like nausea, headache and a queasy stomach.  HANGOFF works by pooling in the strengths of two major groups of herbs that go into making this wonder formulation. One set of herbs that include phyllanthus emblica and vitis vinifera act to ensure that proper digestive functions go on despite the task of alcohol breakdown that starts post alcohol ingestion and produces acetaldehyde in the process. These herbs ensure absence of acidity, nausea and stomach aches or cramps.   The other set of herbs including caryophyllus aromaticus, menthe and foeniculum capillaecum ensure prevention of headache and stop dulling of senses.”

  • Remedy – http://www.remedyworks.com/

“Remedy is effective because it allows our bodies to naturally remove these toxic products in a quick and efficient manner.  Our livers are equipped with an impressive chemical called glutathione whose job it is to grab on to these malicious metabolites, before they react with and harm the surrounding cell, and escort them our of our bodies.  When our drinking exceeds one or two drinks, however, we deplete our natural store of glutathione.  Remedy provides cysteine (along with vitamins), which is a building block for the synthesis or glutathione.”

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Other Hints and Tricks

  • Don’t drink on an empty stomach.  This is a sure-fire way to get wasted, and also a guarantee for a hangover. Eat a good sized meal before drinking to line your stomach and slow down the rate of alcohol absorption into the bloodstream. Here’s some common drunk food we eat when wasted.
  • Don’t drink sweet girlie drinks.  Sugar speeds up the action of the alcohol in your cocktail and increases the effects, and thus the after-effects.
  • Drink water.  Drinking water or electrolyte drinks during and after boozing can minimize dehydration, one of the main hangover culprits.
  • Don’t smoke.  We’ve all heard it… “I’m a social smoker.  I only smoke when I drink!”  Avoid smoking while drinking because smoking constricts the lungs and decreases oxygen flow to the blood stream.  Oxygen, good.  Toxins, bad.  Upset this balance and your hangover will amplify.
  • Take your vitamins.  Vitamin B helps to replace nutrients lost while drinking.

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Remedies

Time

Unfortunately, time is the most effective remedy for alcohol hangover symptoms.  Most hangovers subside after 8 to 24 hours.

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Eating and Drinking

After a night of partying – the most important thing you can do the next day is to drink water… lots and lots of water.  Dehydration is one of the main causes of hangovers and a headache is usually the first sign that the brain is dehydrated; that and the fact that your mouth is dry as a bone.  It is essential to restore your body’s delicate balance by drinking an adequate amount of water, as well as eating a healthy balanced meal (even though you may not feel like it!).  Even though pizza sounds like the right choice, it’s not.  Bland foods containing complex carbohydrates (e.g.: toast or crackers) counter low blood sugar levels and can possibly relieve nausea.  Simple breakfast foods like eggs and milk contain cysteine, which can help to purge the body of toxins, shortening the duration of a hangover. Then of course, there’s the king of all hangover foods, Pho.

Consuming fruits and fruit juices is said to decrease hangover intensity.  Orange juice contains vitamin C which is found to combat the symptoms of a hangover if taken shortly after you stop drinking alcohol.

Restoring electrolytes is also a good idea.  Drinking booze causes your electrolyte levels to drop and pounding a Gatorade might be your ticket back to normality.  Restoring electrolytes increases the need to urinate, thus cleaning the body more quickly and ridding it of the many chemicals that cause or heighten hangover symptoms.

Caffeine can be used to counteract the fatigue and malaise associated with the hangover condition.  This practice however, lacks scientific support.  Take note, caffeine is a diuretic, which will cause interference with the rehydration process.

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Natural Remedies

Indeed there exists some herbal and homeopathic remedies that can be used to treat a hangover naturally and cleanse and detox the body of toxins.  Natural remedies can be gentle, yet very effective hangover cures.  They work by helping to kick-start your body back into normal functional mode and restore balance.

Herbs such as dandelion, fennel and pelargonium reniforme can help to flush out the system, rejuvenate liver operation and reduce bloating.  Always get your herbal remedies from a reputable source to ensure non-contaminated ingredients, maximum efficacy and product integrity.

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Commercial Hangover Remedy Pills

Note: Caveday does not sponsor, promote, or validate the effectiveness of the any products for hangover prevention or relief.  This is simply a guide containing brief excerpts from the most competitive brands.

  • NUX – Natural/Homeopathic

“What is the active ingredient in Nux?
The active ingredient in Nux is “Nux Vomica”. It’s a terrible sounding name, but its name comes from Latin, meaning, “Poison Nut”. Nux Vomica is a homeopathic remedy prepared from the seeds of the Strychnos (yes, strychnine like the poison) Nux Vomica tree. It is a medium sized tree that grows to a height of 40-45 feet, with a short, crooked, thick trunk, and is native to Sri Lanka and India. The Indians have used the seeds in folk medicine for thousands of years. The seeds from the tree are ground to a powder and then diluted way, way down until it reaches a dilution making it suitable as a homeopathic remedy, which is very, very diluted – to the point of almost nothing left. Nux Vomica is a very popular homeopathic remedy that has been used safely for the past 200 years.

How does Nux work?
Nux works a little bit like a vaccination. It’s like giving your body a little bit of the problem so that it can better handle the real problem. In other words it’s like giving an artificial disease to a natural disease. The two are so similar that when they come together they cancel each other out, and lessen or alleviate the symptoms. It’s the idea that a similar substance will cure a similar problem – “Like Cures Like” or in Latin “Similia Similibus Curentur”.

What exactly will Nux do for me?
Nux is best at relieving some very acute, uncomfortable symptoms associated with overindulgence of alcohol and food. Common symptoms particularly associated with Nux are hangover with a headcache, nausea, vomiting, groggy, listless, chilliness, irritiability and sensitivity to light and noise”

  • Hangoff – Also a prevention pill.  See above.

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Medications

Certain medications may provide relief for hangover symptoms.  Antacids can help alleviate nausea and gastritis. Aspirin and other non-steroidal anti-inflammatory medications (e.g., ibuprofen or naproxen) may reduce the headache and muscle aches associated with a hangover but should be used with caution, as these drugs are gastric irritants and may intensify alcohol-induced stomach issues.  Although acetaminophen is common used as an alternative to aspirin, its use should be avoided during and after drinking because alcohol metabolism makes the liver more vulnerable to acetaminophen’s toxicity.

Naprosen:  This is the prescription level dosage of naproxen.  I was prescribed these bad boys as pain relief for some muscle problems.  While they unfortunately didn’t solve that issue, naprosen are very effective at getting rid of that hard-to-beat headache that accompanies a hangover.  Hangover headaches are caused by inflamed cells which constrict blood vessels.  You can take all of the aspirin you like, but it won’t be nearly as effective as an anti-inflamatory, which attacks the problem at the root.

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Drinking More

We’ve all tried the old “hair of the dog” technique and started drinking the next day to combat a hangover. This does work…but only for a short time and then you’re back to the hangover, only worse.  During a hangover, your body is busy breaking alcohol down into the other chemicals that are making you ill.  Adding more alcohol makes your body stop this process so you do get a brief reprieve, but as soon as that added alcohol gets processed, you’re back where you started but with even more toxic chemicals floating around your body.  Unless you intend to keep drinking forever (which is only feasible in Valhalla), this is probably not the best hangover cure.  Some believe a hangover is linked to alcohol withdrawal and that drinking the next day will satisfy a craving.  This is only true in extreme alcoholism where the body goes into potentially fatal shock when alcohol is not consumed.

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Other Potentially Beneficial Remedies

  • Sleep – Sleep eases the fatigue associated with sleep deprivation.
  • Oxygen:  Increased oxygen flow improves the metabolic rate, and thus increases the speed at which toxins are broken down.
  • Vitamin B1: Helps prevent a buildup of GABA in the brain thus reducing some symptoms of hangovers.

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Links and References

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