Hangovers: Science behind the pain

Hangovers: Science behind the pain


6 minute read

Introduction

Everyone can agree that hangovers are miserable. We often are dealt with the same common tradeoff: a night of fun and occasional overindulgence comes with a morning (or day) of inconvenience. We collectively dread hangovers but often lack knowledge of how hangovers actually work and why they create the effects that they do. Hopefully with an understanding of the inner workings of hangovers, we can begin to observe how supplements can be used to combat hangovers! It's real. Not a silver bullet but a great way to prepare your body for what comes the day after a long night of partying. Let's dive into the biochemistry behind how we become intoxicated, what causes a hangover, and a quick look at ways that a hangover could be minimized.

The Chemistry of Intoxication

Ethanol is readily absorbed due to its high water and fat solubility while allowing it to impact multiple organ systems in the body. It proceeds to impair neural communication by binding to GABA receptors in neurons and generating a sedative effect. That pleasurable feeling of “drunkenness” that we often feel emanates from ethanol’s interaction with the central nervous system. As expected, there is a proportional relationship between ethanol absorption and level of intoxication. Drink more, think less. It is important to note that everyone has a different level of ethanol absorption, leading to different levels of blood-alcohol concentration in individuals despite having the same number of drinks. 

What Causes a Hangover?

Researchers believe that there is one chemical compound that holds most of the blame for hangovers: acetaldehyde. This compound is produced when ethanol is metabolized, and it remains in the body as a toxic and reactive compound. Acetaldehyde reacts with many metabolic compounds, triggering the symptoms of a hangover that we all know. It is easiest to examine the chemistry of a hangover by looking separately at how each common symptom comes about. 

First, that dizziness and dryness of the mouth that appears in the morning is almost entirely attributable to dehydration that comes with drinking. Alcohol is a diuretic — it’s known to create a large increase in the production of urine by decreasing the release of antidiuretic hormone (vasopressin), or blocking its action in the kidneys, and decreasing the amount of water that is reabsorbed. This is the foundation of why you don't want to "break the seal". You are often told to drink water intermittently during your night of drinking as it combats this dehydration. This is not the main reason you “feel bad” the next day, but it is a contributing factor. 

Second, that weakness and fatigue of a hangover is due to a decrease in the NAD⁺/NADH ratio as NAD⁺ appears as the oxidizing agent for the metabolism of ethanol to acetaldehyde (bad) then to acetic acid (less bad). It is not important to understand the entire process but the consequences of the ratio decreasing. This as well as the depletion of glutathione (GSH) are strongly associated with feelings of being hungover. Two major consequences arise:

  1. Accumulation of lactic acid, the same compound released after you work out that makes your muscles ache and feel weak
  2. Decline in glucose concentration in the blood

Third, the possible stomach aches and nausea the morning after drinking result from stomach inflammation in which drinks with low alcoholic content produce more stomach acid and drinks with high alcoholic content affect the lining of the stomach. 

Fourth, the appearance of headaches is more difficult to observe compared to other symptoms, however it is commonly understood that the dilation of blood vessels that occurs from ethanol alongside the increase in the presence of compounds in the central nervous system, alongside the sapping of certain nutrients, namely B-vitamins, simultaneously produce a headache. 

Fifth, the feeling of “hangxiety” (also called GABAa rebound) resulting from alcohol acting on certain receptors in the brain that cause sleepiness. This displaces another chemical in your brain (GABA) that goes on to become activating/excitatory (in the form of glutamate). Other general symptoms of a hangover also arise due to this disturbance in our circadian rhythm from GABAa rebound. The sleep after a night of drinking is often quite short and the times in which we reach our lowest and highest body temperatures are altered.  

It is also important for us to understand that other compounds that are produced from consuming popular alcoholic beverages, like spirits and beer, lead to different intensities of hangover symptoms. For instance, it was found that increased levels of methanol and fusel alcohols that come from consuming brandy, red wine, or rum lead to more severe hangover symptoms.

Ways to Combat a Hangover

There are many popular methods we all have tried in order to relieve ourselves of a hangover: drink tea or a lot of water, eat a carbohydrate-heavy breakfast, etc. A lot of these end up working sooner or later, mostly because your body has caught up on metabolizing acetaldehyde, but we still end up having to experience the symptoms of a hangover. Of course, there are ways to combat each symptom separately through supplementation. 

  • Dehydration: not much to do here except drink water
  • NAD⁺/NADH ratio decrease: add in precursors like cysteine or ALA
  • Stomach aches and nausea: ginger is the best natural product out there for this
  • Headaches: that B-vitamin complex on your counter? This is what its been waiting for
  • Hangxiety: DHM, through and through

Conclusion

Hangovers come and go so frequently that we sometimes forget how harmful they really can be for our productivity and well-being. Therefore, it is important for us to look at how hangovers occur so we can find ways to minimize their effects proactively. Still, while we are often preoccupied with resisting our hangovers, we lose sight of the health issues that may arise from frequent drinking. Alcohol brings toxins into the body which leads to a weakened immune system, increases in blood pressure, liver disease, and much more. Knowing this, we must be careful by drinking responsibly to avoid the short-term health risks and prioritizing our health to avoid the long-term health risks. Drink responsibly. 

References

  1. Roth, K. (2007), Die Chemie des Katers: Alkohol und seine Folgen. Chemie in unserer Zeit, 41: 46-55. https://doi.org/10.1002/ciuz.200700409
  2. Epstein M. Alcohol's impact on kidney function. Alcohol Health Res World. 1997;21(1):84-92. PMID: 15706766; PMCID: PMC6826793.
  3. Masia R, McCarty WJ, Lahmann C, Luther J, Chung RT, Yarmush ML, Yellen G. Live cell imaging of cytosolic NADH/NAD+ ratio in hepatocytes and liver slices. Am J Physiol Gastrointest Liver Physiol. 2018 Jan 1;314(1):G97-G108. doi: 10.1152/ajpgi.00093.2017. Epub 2017 Oct 12. PMID: 29025729; PMCID: PMC5866369.
  4. Pawan GL. Alcoholic drinks and hangover effects. Proc Nutr Soc. 1973 May;32(1):15A. PMID: 4760771.
  5. World Health Organization. (‎2018)‎. Global status report on alcohol and health 2018. World Health Organization. https://apps.who.int/iris/handle/10665/274603. 

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