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Hangovers - Causes,
Prevention, and Remedies
We
almost always consume alcohol in moderation. On rare occasions, some of
us overindulge. I thought it might be interesting to explore the topic
of remedies for “the day after.” Much of what follows is taken from the
internet; these aren’t exactly peer reviewed publications.
What causes hangovers?
(The following have been suggested by numerous sources)
1. Dehydration - Alcohol is a diuretic, ie a drug that increases
urination and flushes fluids from the body. Drinking coffee the next
morning may increase this problem as coffee is also a diuretic (however,
caffeine has a possible advantage, which will be discussed later).
2. Mild poisons in the drink - A hangover may be a toxic reaction or
even a mild form of alcohol poisoning. Complex organic molecules such as
methanol and acetone are found in some drinks and are said to be
responsible for hangovers rather than ethanol (alcohol). This view is
supported by researcher Dr. Ian Calder of the National Hospital for
Neurosurgery (London).
3. Too much alcohol depletes the body of necessary substances required
to stay healthy, including blood sugar, vitamins and minerals.
4. “There’s good evidence emerging that the chief cause of hangover is
acute withdrawal from alcohol,” says Mack Mitchell, M.D., vice president
of the Alcoholic Beverage Medical Research Foundation in Baltimore, and
assistant professor of medicine at Johns Hopkins University. “The cells
in your brain physically change in response to the alcohol’s presence;
when the alcohol is gone, you go through withdrawal until those cells
get used to doing without the alcohol.” Couple that with the effects
alcohol has on the blood vessels in your head (they can swell
significantly), and you end up living through a day after that you’d
rather forget.
Which form of alcohol is
worse?
From worst to best: bourbon, whiskey, brandy, rum, red wine, white wine,
gin and vodka. The British Medical Journal did tests that showed
drinking bourbon whiskey is twice as likely to cause a hangover than the
same amount of vodka.
What about Wine?
(The following has appeared in the popular press. Who knows if it's
true?)
1. A bad harvest. If you are drinking wine that comes from a country
where a small change in the climate can make a big difference to the
quality of wine (France, Germany, New Zealand), then in a bad season the
wine contains many more substances that cause hangovers.
2. Drinking it too young. Almost all red wines and Chardonnay are
matured in oak barrels so that they will keep and improve. If you drink
this wine younger than three years there will be a higher level of
nasties that can cause hangovers. If left to mature these nasties change
to neutral substances and don’t cause hangovers. As a rule of thumb,
wine stored in oak barrels for six months should be acceptable to drink
within the first year. If the wine is stored for twelve months or more
in oak barrels, it should then be aged at least four years. Some
winemakers have been known to add oak chips directly into the wine to
enhance flavors (especially in a weak vintage and especially in cheaper
wines); this can take years to become neutral.
How to Avoid a Hangover
A hangover once is a hangover never wanted again. But it doesn’t mean
that you have to avoid alcohol to have a fun night out and feel good the
next day. So how do you avoid it all?
1. Of course the best and safest way to prevent hangovers is to limit
yourself to 1-2 drinks.
2. Drink slowly. The slower you drink, the less alcohol reaches the
brain (even if you end up consuming more). The reason is simple math:
Your body burns alcohol at a fixed rate—about an ounce an hour. Give it
more time to burn that alcohol, and less reaches your blood and brain.
3. Drink on a full stomach. “This is probably the single best thing you
can do besides drinking less to reduce the severity of a hangover,” Dr.
Mitchell says. “Food slows the absorption of alcohol, and the slower you
absorb it, the less alcohol actually reaches the brain.” The kind of
food you eat doesn't matter much. Eating well before you go out, during
alcohol consumption, and sometimes after is important. Breads and pasta
particularly slow absorption of alcohol into the blood stream. So do
milk and other dairy products.
4. Take some extra vitamin C before retiring. Some even suggest taking
extra vitamin C for a few days before imbibing a lot.
5. Drink the right drinks. What you drink can play a major role in what
your head feels like the next morning, according to Kenneth Blum, Ph.D.
The chief villains are congeners. “Congeners are higher order alcohols.
(ethanol is the one we commonly call ‘alcohol’ but there are many
others.) They are found in essentially all alcoholic beverages,” Dr.
Blum says. “How they work isn’t known, but they’re closely related to
the amount of pain you experience after drinking.”
6. The least perilous concoction is vodka. The most perilous is bourbon.
Cognac and other brandies as well as single malt scotches are close
behind. These are followed by blended scotch and other whiskeys and
champagnes of all kinds (here it’s the bubbles that are the problem).
Red wine can be a problem, but for a different reason. It contains
tyramine, a histamine-like substance that can produce a killer headache.
Gin and white wine are almost as benign as vodka, but in sufficient
quantity, any form of alcohol can do you in. Avoid sweet tropical mixed
drinks such as zombies and pina coladas, Also, avoid eating sugary foods
such as cookies, cakes and chocolate. You tend to drink more than you
realize, because the sugar makes it difficult to sense how much alcohol
you are consuming.
7. Avoid the bubbly. And that doesn’t mean just champagne. Dr. Mitchell
and Dr. Blum agree. Anything with bubbles in it (rum and Coke is just as
bad as champagne) is a special hazard. The bubbles put the alcohol into
your bloodstream much more quickly. Your liver can’t keep up; the
alcohol overflow pours into your bloodstream.
8. Be size sensitive. With few exceptions, there's no way a 110-pounder
can go one-on-one with a 250-pound drinker and wake up the winner. So
scale down your drinks. To come out even, the 110-pounder can handle
about half the alcohol of the 250-pounder.
9.
A new over-the-counter supplement called Zeo is now available. We sell
it. An Initial report from one of our employees (who shall remain
nameless) is that it seems to help.
10. Take Alka-Seltzer at bedtime. “There's no hard scientific data on
this, but my own clinical experience and that of a lot of others says
that water and Alka-Seltzer before going to bed can make your hangover
much less of a problem,” says John Brick, Ph.D. Others claim that two
aspirin tablets (which is really Alka-Seltzer without the fizz) can also
help. However, non-prescription pain relievers can be tough on the
stomach, especially when there is alcohol in the system. Plain water is
always a good idea for rehydration. Some recommend flat ginger ale.
Once you have a hangover, how can you minimize the effects?
From the medical professionals:
There is no one thing that cures a hangover except time. But there are a
few things you can do to relieve the symptoms—the headache, nausea, and
fatigue.
1. Drink fruit juice. “Fruit juice contains a form of sugar called
fructose, which helps the body burn alcohol faster,” explains Seymour
Diamond, M.D., director of the Diamond Headache Clinic in Chicago,
Illinois. A large glass of orange juice or tomato juice, in other words,
will help accelerate removal of the alcohol still in your system the
morning after.
2. Eat crackers and honey. Honey is a very concentrated source of
fructose. Believe it or not, sauerkraut juice is said by some to
neutralize congeners. (More proof that sometimes the cure is worse than
the disease!)
3. Get some pain relief. A headache is invariably a part of the package
that goes with a hangover. “You can take aspirin, acetaminophen, or
ibuprofen but you don’t want anything stronger,” Dr. Diamond says. “With
more potent pain relievers, you run the risk of habituation, and you
don’t want the first problem to start another problem.”
4. Willow bark is a natural, organic pain reliever, according to Kenneth
Blum, Ph.D., chief of the Addictive Diseases Division at the U. of Texas
Health Sciences Center at San Antonio. “It contains a natural form of
salicylate, the active ingredient in aspirin.”.
5. Drink bouillon. Broth made from bouillon cubes or any homemade soup
broth will help replace the salt and potassium your body loses when you
drink, Dr. Diamond says.
6. Replenish your water supply. “Alcohol causes dehydration of your body
cells,” says John Brick, Ph.D., chief of research at the Center of
Alcohol Studies of Rutgers State University of New Jersey. “Drinking
plenty of water before you go to bed and again when you get up the
morning after may help relieve discomfort caused by dehydration.”
7. Take B-complex vitamins. Drinking drains the body of these valuable
vitamins. Research shows your system turns to B vitamins when it is
under stress—and overtaxing the body with too much booze, beer, or wine
definitely qualifies as stress, says Dr. Blum. Replenishing your body
with a B-complex vitamin capsule can help shorten the duration of your
hangover.
8. Eat amino acids. Amino acids are the building blocks of protein. Like
vitamins and minerals, they can also be depleted by use of alcohol. Dr.
Blum says that replenishing amino acids plays a role in repairing the
ravages of a hangover. Amino acids are also available in capsule form at
most health food stores.
9. Have two cups of coffee. (I know this contradicts previous advice,
but you didn’t expect consistency, did you?) “Coffee acts as a
vasoconstrictor—something that reduces the swelling of blood vessels
that causes headache,” Dr. Diamond says. “Coffee can do a great deal to
relieve the headaches associated with hangovers.” But don’t drink too
much.
10. If you have a headache, cool/cold compresses may help.
11. Eat a good meal. If you can tolerate it, that is. A balanced meal
will replace the loss of essential nutrients, explains Dr. Blum. But
keep the meal light; no fats or fried foods. Toast, cereal, fruit and
yogurt are easier to digest than eggs and dairy. (Chicken soup, anyone?
It may not help, but it couldn’t hurt!)
PANEL OF ADVISORS: a) Kenneth Blum, Ph.D., is chief of the Addictive
Diseases Division of the University of Texas Health Sciences Center at
San Antonio; b) John Brick, Ph.D., is chief of research in the Division
of Education and Training at Rutgers State University of New Jersey’s
Center of Alcohol Studies in Piscataway, New Jersey; Seymour Diamond,
M.D., is director of the Diamond Headache Clinic and the inpatient
headache unit at Louis A. Weiss Memorial Hospital in Chicago, Illinois.
He also is executive director of the National Headache Foundation. He
has co-written several books on headaches. c) Van Lierer, Ph.D., is
director of research and owner of Decision Systems, a research and
development firm in Stanford, California. He is a former cognitive
psychologist at Stanford U; d) Mack Mitchell, M.D., is a vice president
of the Alcoholic Beverage Medical Research Foundation in Baltimore,
Maryland, and assistant professor of medicine at Johns Hopkins
University.
From the Nutritionists:
Try some of the following herbs before and after drinking to reduce
toxins and free radicals produced by them as well as herbs to nourish
the nervous system. V-8 juice along with cucumber is an excellent
carrier for your herbs and the two alone will help to replenish salts,
vitamins, minerals and water your body is screaming for.
1. Willow bark; 2) Scullcap; 3) Ginseng; 4) Chamomile; 5) Green Tea; 6)
Nux vomica; 7) Kava and Valerian (take these two only after all the
alcohol has cleared your system.)
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