This piece was originally published in December 2015. The advice hasn’t really changed – if you’re feeling like death this morning (or plan to in the next few days), this advice may prove invaluable.
‘Tis the season to be hammered. Or the season to feel smug about being a teetotaler, while your friends, family and colleagues nurse sore heads and unhappy stomachs with a look that says they’re re-evaluating their life choices to date. If you fit in the remorseful hedonist camp, then it’s worth taking a look at the various things science has to say about the hangover – how to avoid getting one, and how to make the pain go away if you’re reading this the morning after.
What causes a hangover?
That’s a more complex question than it first appears, and the research is muddy.
We know, for example, that around a quarter of people claim to never get hangovers. I used to fit into that category myself. So, even if that’s the case now, give it a few years – you too may one day feel like you’ve been kicked in the head by an angry mule.
The Alcohol Hangover Research Group (AHRG, to give it a more formal sounding acronym) has done a great job of summarising the research on the hangover, and why the common wisdom is a mixed bag of truths and half truths covering up the underlying reality: we don’t know for sure.
For example, we know that alcohol is a diuretic, which means you’re likely to be dehydrated, but the evidence shows that electrolyte levels are pretty similar to those without hangovers. Moreover, when they aren’t, it doesn’t seem to reflect the severity of the hangover. In other words, dehydration is likely only one piece of the puzzle, accounting for thirstiness and dizziness, but not much else.
Some research claims acetaldehyde is the culprit. It’s a toxic byproduct of the breakdown of ethanol, and although it has been metabolised into acetate by the time the hangover hits, certain studies suggest it could be the answer. One piece of research from 2005 noted that symptoms were worse in those that struggle to metabolise acetaldehyde, leading to more severe hangovers.
So what about acetate? Well, it’s a naturally occurring compound that’s far less toxic than the acetaldehyde it stems from. A 2010 study found it could induce one hell of a headache in rats. Then there’s congeners – compounds found in alcoholic drinks that are a byproduct of distillation and fermentation. A 2010 paper showed that drinks with no congeners (vodka) caused a comparatively minor hangover compared to bourbon, which has a huge number of congeners due to the oak barrels it’s aged in.
“It’s all fuzzier than you’d imagine, and entirely possible that it’s a combination of the above, along with other factors not yet considered.”
Low blood sugar has also been suggested as a cause, but that would mean that a hearty dose of sugar the next day should solve the problem, and it doesn’t. Cytokines – proteins secreted by cells in the immune system – are another possibility. Normally, these are released by the body to battle an infection, but it seems alcohol can trigger them and, as Wired notes, if you inject these into a healthy person, the symptoms that follow – nausea, headaches, chills, fatigue and gastrointestinal distress, to name a few – sound eerily familiar.
It’s all fuzzier than you’d imagine, and entirely possible that it’s a combination of the above, along with other factors not yet considered. There’s also an issue with these studies: scientific research’s old friend, ethics. As anesthesiologist Jason Burke told Scientific American: “When you actually look at the severity of the hangovers in most of these studies, they’re not that bad,” he explained, adding that triggering truly monster hangovers wouldn’t be considered ethical by review boards approving medical experiments.
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