The formal name for a hangover is veisalgia, from the Norwegian word for “uneasiness following debauchery” (kveis) and the Greek word for “pain” (algia) — an appropriate title considering the uncomfortable symptoms experienced by the average drinker. The common hangover includes some or all of the following:

* Headache
* Poor sense of overall well-being
* Sensitivity to light and sound
* Diarrhoea
* Loss of appetite
* Trembling
* Nausea
* Fatigue
* Increased heart rate and blood pressure
* Dehydration (dry mouth, extreme thirst, dry eyes)
* Trouble concentrating
* Anxiety
* Difficulty sleeping
* Weakness

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The most common symptoms are headache, fatigue and dehydration, and the least common is trembling. The severity and number of symptoms varies from person to person; however, it is generally true that the more alcohol a drinker consumes, the worse the hangover will be.

It usually takes five to seven cocktails over the course of four to six hours to cause a hangover for a light-to-moderate drinker (a man who drinks up to three alcoholic beverages a day or a woman who drinks up to one). It may take more alcohol for heavier drinkers because of increased tolerance. Other than the number of drinks consumed, hangovers can be made worse by:

* drinking on an empty stomach
* lack of sleep
* increased physical activity while drinking (dancing, for example)
* dehydration before drinking
* poor health

The reason for some symptoms isn’t fully understood, but research has led scientists to have a pretty good understanding of the primary causes of a hangover. In the next sections, we’ll find out what’s going on in the body to cause these problems.

Biology of a Hangover: Vasopressin Inhibition –
When alcohol is consumed, it enters the bloodstream and causes the pituitary gland in the brain to block the creation of vasopressin. Without this chemical, the kidneys send water directly to the bladder instead of reabsorbing it into the body. This is why drinkers have to make frequent trips to the bathroom after urinating for the first time after drinking.

According to studies, drinking about 250 milliliters of an alcoholic beverage causes the body to expel 800 to 1,000 milliliters of water; that’s four times as much liquid lost as gained. This diuretic effect decreases as the alcohol in the bloodstream decreases, but the after effects help create a hangover.

The morning after heavy drinking, the body sends a desperate message to replenish its water supply — usually manifested in the form of an extremely dry mouth. Headaches result from dehydration because the body’s organs try to make up for their own water loss by stealing water from the brain, causing the brain to decrease in size and pull on the membranes that connect the brain to the skull, resulting in pain.

The frequent urination also expels salts and potassium that are necessary for proper nerve and muscle function; when sodium and potassium levels get too low, headaches, fatigue and nausea can result. Alcohol also breaks down the body’s store of glycogen in the liver, turning the chemical into glucose and sending it out of the body in the urine. Lack of this key energy source is partly responsible for the weakness, fatigue and lack of coordination the next morning. In addition, the diuretic effect expels vital electrolytes such as potassium and magnesium, which are necessary for proper cell function.

Different types of alcohol can cause different types of hangover. In the next section, we’ll look at the differences.

Biology of a Hangover: Congeners –
Different types of alcohol can result in different hangover symptoms. This is because some types of alcoholic drink have a higher concentration of congeners, by-products of fermentation in some alcohol.

The greatest amounts of these toxins are found in red wine and dark liquors such as bourbon, brandy, whiskey and tequila. White wine and clear liquors such as rum, vodka and gin have fewer congeners and therefore cause less frequent and less severe hangovers. In one study, 33 percent of those who drank an amount of bourbon relative to their body weight reported severe hangover, compared to 3 percent of those who drank the same amount of vodka.

Because different alcoholic drinks (beer, wine, liquor, etc.) have different congeners, combining the various impurities can result in particularly severe hangover symptoms. Additionally, the carbonation in beer actually speeds up the absorption of alcohol. As a result, following beer with liquor gives the body even less time than usual to process the toxins.

Biology of a Hangover: Glutamine Rebound –
After a night of alcohol consumption, a drinker will not sleep as soundly as normal because the body is rebounding from alcohol’s depressive effect on the system. When someone is drinking, alcohol inhibits glutamine, one of the body’s natural stimulants. When the drinker stops drinking, the body tries to make up for lost time by producing more glutamine than it needs.

The increase in glutamine levels stimulates the brain while the drinker is trying to sleep, keeping them from reaching the deepest, most healing levels of slumber. This is a large contributor to the fatigue felt with a hangover. Severe glutamine rebound during a hangover also may be responsible for tremors, anxiety, restlessness and increased blood pressure.

Because alcohol is absorbed directly through the stomach, the cells that line the organ become irritated. Alcohol also promotes secretion of hydrochloric acid in the stomach, eventually causing the nerves to send a message to the brain that the stomach’s contents are hurting the body and must be expelled through vomiting. This mechanism can actually lessen hangover symptoms in the long run because vomiting gets rid of the alcohol in the stomach and reduces the number of toxins the body has to deal with. The stomach’s irritation may also be a factor in some of the other unpleasant symptoms of a hangover, such as diarrhoea and lack of appetite.

So now we know why alcohol causes hangovers. In the following sections, we’ll look at the science behind the most common hangover “cures.”

Food and Drink Remedies – Fact or Fiction? –
Hangover remedies include everything from “a hair of the dog that bit you” (drinking a little more alcohol the next morning), to burnt toast and black coffee to an over-the-counter product like Chaser. Which of all the endless theoretical remedies actually have truth behind them?

Hair of the Dog:
Contrary to popular belief, more of the “hair of the dog that bit you” only delays the inevitable. One of the reasons hangovers are so unpleasant is the liver is still processing the toxins left over from alcohol metabolism. Drinking more alcohol can make the symptoms seem to lessen at first but will only make the situation worse once the liver breaks the alcohol down, because it will have even more toxins to deal with.
Conclusion: * FICTION – Remedy

Burnt Toast:
At first, the burnt toast remedy may seem that it is actually based on scientific fact. The culprit behind this fictional cure is the carbon in the charred bread. Carbon can act like a filter in the body. While it is true that activated charcoal (which is a treated form of carbon) is used to treat some types of poisonings, it is not currently used to treat alcohol poisoning (something that is vastly different from a regular hangover).

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Reportedly, the filtering effect of charcoal is behind the success of over-the-counter remedies such as Chaser and Sob’r-K HangoverStopper, which claim carbon as their main ingredient. These over-the-counter remedies are taken prior to drinking. Manufacturers claim that the activated charcoal in the pills “attracts” congeners.

The carbon/charcoal found on burnt toast is not the same as activated charcoal, nor is it the equivalent of taking an OTC hangover remedy.
Conclusion: * FICTION – Prevention and Remedy

Black Coffee:
Coffee contains a high amount of caffeine, which is a stimulant and therefore helps fight fatigue. But when the caffeine wears off, a drinker may be even more tired than before. It can help alleviate a pounding head because caffeine is a vasoconstrictor, meaning it reduces the size of blood vessels. This counteracts the effect of the alcohol, which makes them swell, making the head hurt in the first place. Unfortunately, caffeine is also a diuretic like alcohol and can make a drinker even more dehydrated than before, thereby increasing the severity of the hangover. Overall, coffee is not a good hangover cure.
Conclusion: * FICTION – Remedy

Fried or Fatty Foods:
Although eating fried or fatty foods the morning after will probably only irritate a drinker’s stomach further, eating them before drinking can actually be helpful. Putting anything in the stomach prior to indulging in alcohol helps prevent a hangover, but fatty foods in particular stick to the stomach lining longer and therefore slow down the absorption of alcohol into the bloodstream. While that might make it take longer to feel the alcohol’s effects, it also gives the body more time to process the by-products and will increase a drinker’s chances of feeling decent in the morning. So much so, in fact, that a Mediterranean folk tactic is to take a spoonful of olive oil before drinking alcohol. Eating lighter food such as a fruit smoothie will provide energy and alleviate some symptoms by replenishing the electrolytes the body lost from dehydration.
Conclusion: * FACT – Prevention * FICTION – Remedy

Eggs:
Eating eggs the morning after provides energy like any other food, which is the primary benefit. But eggs do also contain large amounts of cysteine, the substance that breaks down the hangover-causing toxin acetaldehyde in the liver’s easily depleted glutathione. Therefore, eggs can potentially help mop up the left-over toxins.
Conclusion: * FACT – Remedy

Bananas:
Eating bananas the morning after a night of heavy drinking provides lost electrolytes like any food would, but it also specifically replenishes the potassium lost to alcohol’s diuretic effect. Other potassium-rich foods such as kiwi fruit or sports drinks work just as well.
Conclusion: * FACT – Remedy

Water:
Replenishing the body’s water supply after a night of drinking combats dehydration, and it also helps dilute the leftover by-products in the stomach. Add salt and sugar to water helps replace the sodium and glycogen lost the night before. Non-caffeinated, non-carbonated sports drinks can achieve the same effect.

As a prevention method, drinking a glass of water for every alcoholic beverage slows down drinking, providing more time for the body to deal with the alcohol (the body can only process about three-quarters of an ounce of alcohol in an hour). Drinking a few glasses of water before going to bed helps fight dehydration after the body finishes breaking down the alcohol.
Conclusion: * FACT – Prevention and Remedy

Fruit Juice:
The fructose — fruit sugar — in fruit juice helps to naturally increase the body’s energy. Studies have proven that it also increases the rate at which the body gets rid of toxins such as those left over from alcohol metabolism. Fruit juice is also a good idea the morning after because it is high in vitamins and nutrients that were depleted the night before because of alcohol’s diuretic effect. Vitamin supplements high in vitamins C and B are also effective.
Conclusion: * FACT – Remedy

Hangover Remedy Overview –
The only fool-proof way to avoid a hangover, of course, is not to drink alcohol. But from a scientific perspective, researchers have found the following general regimen minimizes the symptoms of a hangover.

Before Drinking:
* Eat a full meal – A full stomach slows down the absorption of alcohol, giving the body more time to process the toxins. Fatty foods and carbohydrates increase this effect. Having food in the stomach also decreases stomach irritation, in turn reducing the likelihood that a drinker will vomit.
* Drink a glass of water – This ensures the body is hydrated before the diuretic effect takes hold.
* Take multivitamins – This better prepares the body for the depletion of vitamins caused by frequent urination.

While Drinking:
* Drink in moderation – Ideally, drinkers should limit themselves to one drink per hour because the body takes about an hour to process a single drink.
* Drink a glass of water after every alcoholic beverage – In addition to helping keep a drinker hydrated, this will give the body more time to process the alcohol, dilute the toxins and reduce irritation of the stomach.
A sports drink like Gatorade or Propel will also replenish electrolytes, salts and sugars lost in the urine.
* Watch your drink choice – Drinkers generally fare better when they stick with one drink. Each new type of alcohol a drinker puts into his or her system makes the body work that much harder and puts that many more toxins in the body, leading to a more severe hangover. Here’s a rundown of the major types of alcohol and their effects:

* Beer: Beer has the lowest percentage of alcohol (4 to 6 percent), but it is also carbonated, which speeds up the absorption and can lead to toxin build-up.
* Wine: Wine has a higher percentage of alcohol (7 to 15 percent) than beer, but it is usually not carbonated. White wine is safer than red or blush because it has fewer congeners. In general, the cheaper the wine, the higher the congener content and the worse the hangover.
* Liquor: Liquor has the highest alcohol content (40 to 95 percent) and therefore increases the likelihood of a hangover. Clear liquors like vodka, rum and gin are better bets than dark or sweet liquors like bourbon, scotch or tequila because they have fewer congeners. Generally, cheaper liquor will result in a worse hangover than more expensive liquor.

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After Drinking:
Before Bed –
* Take two aspirin with a full glass of water – The prostaglandin inhibitors in the aspirin can decrease hangover severity.

In the Morning –
* Take two more aspirin with a full glass of water – This has been shown to minimize headaches as well as decrease inflammation from leftover prostaglandin.
* Take another multivitamin – Replenishing C and B vitamins in particular can help get rid of the rest of the toxins.
* Eat breakfast – A meal that includes eggs (for the cysteine), a banana (for the potassium), and fruit juice (for the fructose) or a sports drink (for the electrolytes, sugars and salts) can get the body on the road to recovery. Keep in mind that caffeinated coffee, tea and soda will further dehydrate a drinker.

The Truth About Hangover Cures

Myths about hangovers are as varied and as fanciful as the cocktails that cause the dreaded syndrome. From eating pasta at bedtime to popping prickly pear pills, the list of supposed hangover cures warrants a closer look. Learn what works — and what hurts — as WebMD sorts through 12 common hangover myths.

MYTH: Hangovers Are No Big Deal
FACT: A hangover is the body’s reaction to being poisoned with too much alcohol. Heavy drinking rocks the central nervous system. It tinkers with brain chemicals — leading to headache, dizziness, and nausea — and sends you running to the bathroom so often you become dehydrated. The morning-after price of this imbalance can include a pounding headache, fatigue, cotton mouth, queasy stomach — and a weakened immune system.

MYTH: Hangovers Are Gender-Blind
FACT: Use caution when enjoying those free drinks on Ladies’ Night. Given the same drinks, women are more likely to be slammed with the effects of alcohol than men. Scientists say there’s good reason for this. Men have a higher percentage of water in their bodies, which helps dilute the alcohol they consume. When women drink the same amount, more alcohol builds up in the bloodstream.

MYTH: Only Bingers Get Hangovers
FACT: While it’s true that binge drinking could speed your way to a hangover, you don’t have to get wasted to pay a price the next morning. Depending on your body composition, just a couple of drinks can trigger a headache and other hangover symptoms. Having water or a nonalcoholic drink between each beer or hard drink can help keep you hydrated and reduce the overall amount of alcohol you consume.

MYTH: Wine is the Gentlest Choice
FACT: Red wine contains tannins, compounds that are known to trigger headaches in some people. Malt liquors, like whiskey, also tend to produce more severe hangovers. If you’re worried about how you’ll feel in the morning, the gentlest choices are beer and clear liquors, such as vodka and gin.

MYTH: Diet Cocktails Are a Safe Bet
FACT: Diet drinks may help if you’re counting calories, but not if you’re trying to avoid a hangover. Research suggests that consumption of fruits, fruit juices, or other sugar-containing liquids can decrease hangover intensity.

MYTH: Liquor Before Beer
FACT: It’s not whether you have a shot of whiskey before or after your beer that’s important. It’s the amount of alcohol you consume (not the order of your drinks) that matters most. A standard drink — be it a 12-ounce glass of beer, a 5-ounce glass of wine, or a 1.5-ounce “shot” of distilled spirits — all contain roughly the same amount of alcohol. Don’t be fooled by the size of your drink or any saying about alcohol use that includes the phrase “never fear.”

MYTH: Eat Pasta Before Bed
FACT: This one is wrong on two counts. First, eating at bedtime (after you’re already drunk) is no help. Food has to be in your stomach before Happy Hour to have any impact. Second, while any food can slow the body’s absorption of alcohol, fat does it best. So go for steak or pizza before your first martini, and you might escape a hangover. One bedtime tip that does help — drink water to fight dehydration.

MYTH: Pop Pain Pills Before Bed
FACT: Over-the-counter painkillers peak in about four hours, so the effect of a bedtime dose will be gone by morning. A better plan is to take the pills when you first wake up. Avoid taking acetaminophen after a night of drinking. Alcohol disrupts how the liver processes acetaminophen, possibly leading to liver inflammation and permanent damage.

MYTH: Alcohol Helps You Sleep Well
FACT: Alcohol disrupts sleep. While a nightcap may help you doze off more quickly, it undermines the quality of your sleep. You don’t spend as much time in all-important REM cycles and you tend to wake up too soon. If you’ve been drinking heavily, a hangover might strike in the last part of the night, leaving you too uncomfortable to get back to sleep.

MYTH: A Wake-Up Cocktail is the Cure
FACT: More alcohol in the morning does nothing but postpone a hangover. The worst symptoms hit when blood-alcohol levels drop to zero. If you have a screwdriver at breakfast, this moment will just come later in the day. And if you find you can’t function without a wake-up cocktail, you should discuss the possibility of addiction with your doctor.

MYTH: Coffee Is the Cure
FACT: Coffee leads to more dehydration and could make your hangover worse. After a night of drunkenness, it’s best to avoid anything with caffeine. Instead, sip water and sports drinks to counter dehydration and replace lost electrolytes. This is especially important if you experienced any vomiting.

MYTH: Herbal Remedies Can Help
FACT: British researchers reviewed the available studies on hangover pills, such as yeast and artichoke extract.They concluded that there is no compelling evidence of any effective treatment. Another British team found a supplement made from prickly pear cactus may reduce the nausea and dry mouth associated with hangovers, but not the dreaded headache. The only proven cure is time.

NO MYTH: Alcohol Poisoning
FACT: Alcohol poisoning is a potentially deadly medical emergency. Symptoms of alcohol poisoning include:
– Confusion, stupor
– Vomiting
– Seizures
– Slow, irregular breathing
– Low body temperature, bluish skin
It’s easy to blow off these symptoms as the price of partying hard, but if you see someone vomit multiple times or pass out after drinking heavily, there’s a risk of severe dehydration or brain damage. A visit to the nearest emergency room is urgently needed.