Alcohol is a diuretic (causing loss of fluid), which results in a loss of essential salts such as potassium and magnesium. Blood-sugar levels are also disrupted and toxins from the intake of alcohol can remain in the body for several hours after drinking has ended. This general loss of essential salts and dehydration leads to a hangover.
A hangover is a kind of drug withdrawal, the result of sinking blood-alcohol levels which affect the brain after high levels have been reached. This is also why drinking alcohol the morning after a night of drinking temporarily delays the hangover and, in the end, only makes matters worse.
The type of alcohol you drink does make a difference. The darker, sweeter drinks have more congeners (complex organic molecules of which methanol is one). Therefore brandy, sherry, red wine and whiskey will give you more of a hangover than will white wine or vodka. Cheap, poorly-refined spirits are more likely to give you a hangover.
Symptoms of hangover vary, but usually include headaches and mental fogginess, thirst, weakness and trembling, sensitivity to noise, irritability, and a general feeling of misery. The stomach feels queasy and nauseous because alcohol irritates the stomach lining.
Drinking more alcohol ("hair of the dog") actually does work to an extent. This is because ethanol in alcoholic drinks blocks the breakdown of methanol to formaldehyde and formic acid. It is, however, a very bad way of dealing with hangovers because of the strain it puts on the liver and stomach. It also puts off the hangover to a later time which, when it does arrive, can feel even worse.
The most obvious source of headaches due to hangovers is dehydration caused when alcohol suppresses anti-diuretic hormone. This hormone normally orders the body to conserve water, but alcohol dulls the command, causing people to lose far more water to urination than they take in with the alcohol.
The body reacts to the open floodgates by borrowing water from other organs, such as the brain. As a result, the brain shrinks. While that may not cause pain by itself, the brain has a covering called the dura that is connected to the skull by pain-sensitive filaments. Deformation of the dura can cause the headaches that come with a hangover.
A deficiency in thiamine (vitamin B1) makes it harder for your body to break down alcohol. Interestingly, beer contains a good amount of thiamine, but as vitamin B1 oxidizes the alcohol out of the blood in the liver, thiamine is used up and must be replaced.
Acetaldehyde is a toxic substance produced in the body from alcohol and is one of the impurities found in cheap wine and 'moonshine' spirits. Some researchers believe that an acetaldehyde buildup is the cause of hangovers. If the liver's detoxification pathways are impaired, aldehydes can, instead of being converted to the next intermediate product, build up to harmful levels and cause damage since they are often more toxic than the original substances from which they are derived.
It is probably the metabolism of methanol to formaldehyde and formic acid that caused the symptoms of the hangover. Quick methanol metabolizers suffer more. This is reinforced by the fact that the types of drinks associated with more severe hangovers contain higher levels of methanol. [Hangovers: Not The Ethanol, Perhaps The Methanol, British Medical Journal, January 4, 1997;14: pp.2-3]
All types of alcoholic drinks contain some methanol, a substance blamed for the worst hangovers. Whiskey, cheap red wine, fruit brandy and other dark spirits contain the most methanol, sometimes as much as 2% by volume. Vodka and other clear drinks contain the least. In the liver, methanol takes 10 times longer than ethanol to break down.
Both ginger and the homeopathic remedy Nux vomica can help to quell nausea the morning after. Either make ginger tea by infusing freshly grated root ginger in hot water or swallow a 1,000mg supplement.
If you can stomach it, bananas help to replenish many essential salts. One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system.
Drink lots of water – at least twice the amount of water to alcohol.
Take some form of sugar; alcohol lowers your blood sugar levels.
By all means take some pain relief tablets, but avoid aspirin as the alcohol has probably already made your stomach lining sensitive.
A few hours of sleep can work miracles. Don't drive until you have fully recovered. Just because you've slept after a drinking session doesn't mean you're sober. Nothing can speed alcohol out of the body so don't kid yourself that a strong coffee will do it (it's more likely just to help replenish a little fluid).
Smoking intensifies the problems of a hangover because of the additional toxins and further dehydration.
If time allows, catching a short nap in a darkened, quiet room with an ice bag or cold compress on your forehead can work wonders. The cold compress helps constrict the vessels in your head and reduce the headache.
DMAE decreases the incidence and severity of hangovers in people who consume excessive amounts of alcohol. Subjects in one study reported freedom from the depression or headaches associated with hangovers.
The B-vitamins help to calm and strengthen the nervous system, reduce the toxic effects of alcohol and stop cravings for more.
Milk thistle is renowned for its ability to support and stimulate the liver, the organ primarily responsible for ridding the body of alcohol. Some recommend taking 500mg of milk thistle before embarking on a long night of drinking, and if the session is particularly heavy, taking 350mg three times daily for a couple of days thereafter.
The only sure-fire method of prevention is the obvious – abstinence!
Alcohol tends to go very quickly through the intestines if drunk on an empty stomach, inducing the drop in blood sugar that makes one feel light-headed and drunk, and then keeping it low throughout the night and into the following day, resulting in a major hangover. Do not drink any alcohol until your stomach contains food.
Caffeinated coffee and cola drinks are an area of controversy. These may upset your stomach but on the other hand the caffeine will assist with vessel constriction. If you're used to a morning coffee, it may help. Coffee or tea can make your hangover twice as bad by dehydrating your body. Herbal infusions such as dandelion tea, or a fruit smoothie, or even simply hot water, will be much kinder to your body.
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