Nope! If you got super excited when you read the title, you might have a problem (just kidding, maybe). Drink shaming aside, hangovers suck. If you’ve never had a hangover, consider yourself lucky. I absolutely hate hangovers. If I were a captured spy—I’m giving up all the secrets if someone threatened me with a hangover. Waterboarding and all that other Geneva Convention stuff, I’d take like a champ. Hangovers? I’d be a snitch after a couple of shots of vodka.
The last time I had a hangover was after my bachelor party 12 years ago (to my wife- my friends and I just played chess all night with show tunes playing in the background). Desperately hoping someone would turn off the lights at my rehearsal dinner taught me that hangovers should be avoided by any means necessary. Doing a quick google search for hangover cures taught me that some people can’t handle the phrase, “by any means necessary.”
There are some hangover fixes that don’t make sense and others that are simply dangerous. In this post, I’ll break down the causes and symptoms of hangovers. I’ll also highlight a few ways to treat and prevent hangovers.
What is a hangover? There’s actually a medical definition for hangovers.
For many years, few respectable researchers actively studied hangovers. Curing hangovers probably wasn’t the most acceptable route to tenure. Nonetheless, a group of brave researchers bucked the status quo and established themselves as the Alcohol Hangover Research Group.
Their argument for researching hangovers is that hangovers are common and that they have societal costs due to absenteeism, lost productivity, and their potential to lead to injuries (i.e., motor vehicle accidents).
At their annual meeting in 2017, they established a definition for hangovers from alcohol. They defined alcohol hangovers as the
combination of mental and physical symptoms, experienced the day after a single episode of heavy drinking, starting when blood alcohol concentration approaches zero.
Having a blood alcohol level of zero is the key part of the definition. If you feel like you are hungover when you still have alcohol in your system, you’re drunk—not hung over.
What are the symptoms of a hangover?
First, not all hangovers were created equal. Second, people’s experience with hangovers may vary slightly. Nonetheless, hangovers do have a few common symptoms. Here are a few:
- GI upset
- Sensitivity to light and sound
- Mood changes
- Poor cognition
One study suggests that fatigue and thirst are the most common symptoms associated with hangovers. All in all, you feel like sh*t.
Most treatments for hangovers target these symptoms and the causes of hangovers.
So what causes hangovers?
Obviously, drinking alcohol plays a role. If you have a hangover and you haven’t been drinking— I question the legality of whatever it is you were doing #ijs. Ultimately, consuming too much alcohol is the foundation for a hangover. Since the definition of a hangover requires a blood alcohol level of zero. There must be other factors. Researchers don’t know the exact causes of hangovers, but here are some of the prevailing thoughts.
Although some individuals can develop a hangover after 1-2 drinks, most people are going to need a little more. According to experimental studies, people develop hangovers after consuming 1.5 g per kilogram of one’s body weight or reaching a blood alcohol concentration of .1 (.08 is the legal limit). In one study, researchers triggered hangovers with intravenous ethanol in a research study (they would have had to pay off my students loans for me to even think about participating in that study).
Enzymes in the stomach convert alcohol to acetaldehyde. Acetaldehyde is toxic and can trigger symptoms similar to a hangover. Most people clear acetaldehyde easily. However, there are genetic variations that prevent others from doing so. These genetic variations cause some people to develop flushing after drinking alcohol—a phenomenon more common in people of Asian descent. The build-up of acetaldehyde can stimulate the release of histamine from immune cells. Histamine can then trigger headaches, dizziness, flushing, and other symptoms involved in hangovers.
Dehydration and hangovers
If you’ve ever drank a decent amount, you are probably aware that drinking too much can send you to the bathroom. Alcohol can lead to dehydration by increasing urination through its effects on anti-diuretic hormone (ADH). Dehydration can subsequently lead to electrolyte abnormalities. The combination of dehydration and an altered electrolyte profile contributes to hangover symptoms.
Drinking too much alcohol can trigger inflammation. According to one theory, the inflammation could be due to alcohol increasing the permeability of the lining of the gastrointestinal tract. The increase in permeability exposes toxic metabolites to the gut’s immune system. This exposure can trigger an inflammatory cascade.
Is there any way to prevent hangovers?
The best way to prevent hangovers is not drinking too much. Outside of that, there’s no preventive measure substantiated by evidence.
I don’t recommend trying to take medications and herbal products for hangover prevention because of the possibility of interactions with alcohol. Case in point, some people who experience flushing when drinking take Zantac or Pepcid as a preventive measure. Some studies show that these medications may make alcohol more potent—actually increasing the risk of intoxication with smaller amounts of alcohol.
Here are a few tips that may decrease the severity of hangovers.
Don’t smoke cigarettes while drinking heavily.
Get a good night’s sleep before drinking.
Try drinks with low histamine levels
Red wine, beer, and dark liquors typically contain higher amounts of histamine (check out my article on red wine and headaches). Again, the histamines play a role in the cause of hangovers. Try low histamine drinks like gin or vodka.
Try light liquor instead of dark liquor
Dark alcohol typically contains congeners—chemicals that accumulate when dark liquor ages in barrels. Methanol is a congener that’s converted into formaldehyde, a toxic metabolite. Congeners can remain in the body after alcohol has cleared. These lingering congeners contribute to symptoms associated with hangovers. FYI, tequila contains a decent amount of congeners although it is a light liquor.
Stay hydrated and avoid drinking alcohol on an empty stomach.
You should know this by now. Seriously?
How do you treat hangovers?
There isn’t a magical cure for hangovers. Many people have tried to find one, but none have been proven effective with research. Even Coca-Cola may have started as a potential hangover cure.
Ultimately, since no single cure exists, the best you can do is managing the symptoms while addressing the underlying causes of hangovers. One more thing, time is the best cure.
Dehydration, Electrolytes, and Thirst
- Try oral rehydration solutions. These solutions hydrate better than water. When it comes to oral rehydration solution, most people think of Gatorade. Drip Drop and Pedialyte are better for hydration, but Gatorade is definitely better than water. If you know that you’re going to have a long night, you should consider carrying powder packets of Drip Drop or Pedialyte.
- Don’t try the “hair of the dog” and drink more alcohol. Drinking alcohol to cure a hangover is only going to prolong your symptoms. On a side note, the “hair of the dog” is an old saying that stems from people trying to heal a dog bite by placing hair from the dog that bit them in their wound.
Inflammation and Headaches
- Aspirin or ibuprofen may help your hangover
- I don’t recommend taking these to prevent hangovers
- Stay away from Tylenol (acetaminophen)—the path to liver failure is paved with Tylenol and alcohol.
Histamine and GI upset
- Try taking Pepcid (famotidine) or Zantac (ranitidine) to help with any GI discomfort. Again, take these to treat a hangover, not to prevent one.
- Ginger root tablets are a safe way to treat nausea associated with hangovers.
- Sleep in a dark place (as dark as possible).
- Otherwise, caffeine will help you get through the day.
What’s the bottom line?
- Hangovers are terrible.
- Prevent them by not drinking too much, avoiding smoking, staying hydrated, and sleeping well.
- There’s no clearly established treatment for a hangover.
- Some meds can help with symptoms, but time is the best cure.
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I am a physician and trained chef. I specialize in gastroenterology and nutrition. Currently I work as the Associate Director of Adult Nutrition at the University of Chicago.