Hangovers -- the ultimate guide to causes and cures

Most scholars agree that consuming alcohol as social practice began between 8,000-12,000 years ago.

The first hangover presumably happened the next morning.

All these millennia later, however, and we still have very few explanations for why hangovers happen and how to get rid of them.

(Unfortunately, hangovers -- like art, porn and irony -- are hard to define, but you know it when you experience it.)

Still, with the imminent release of The Hangover, it seemed appropriate to discover the truth about post-inebriated suffering once and for all. We asked resident doctor Ken Spaeth to look into it for us. The results may surprise you.
Click here to get the reality behind why booze has periodically destroyed your will to live.

We also know that the other main problem after a night of hard drinking is what to do with the beer cans left behind. But don't worry -- we've got that covered too in our gallery below...



Hangover Causes

Dehydration: Popular wisdom holds that alcohol causes dehydration, and dehydration causes a hangover. There is some medical data to support this -- after excessive drinking, hormones, metabolic markers and even pH balance are often changed in ways consistent with dehydration. Yet these changes would only explain dehydration's primary symptom: feeling thirsty, and maybe the headache, while failing to explain the more loathsome symptom: feeling like crap. Most likely, the array of hangover symptoms arises from a number of different causes.

Metabolites: As the liver processes the alcohol you drink, acetaldehyde is formed, which many think is responsible for hangovers. When alcohol is used in small or even moderate amounts the liver can easily convert small amounts of acetaldehyde to acetic acid a.k.a. vinegar. However, when large amounts of alcohol are consumed, the liver can't keep up and acetaldehyde builds up in the body.

Lack of available glucose: The body and the brain rely heavily on glucose (sugar) as a primary source of fuel. Without it, the body can find other means, but the brain is less resourceful and so the central nervous system gets all out of whack. For reasons that are not well understood, excessive alcohol seems to disrupt the normal means of regulating glucose, thereby leaving the body uncharacteristically sugar-free.

Bad Sleep: High levels of alcohol disrupt normal sleep cycles shortening and blocking certain essential stages of deep sleep. So "sleeping off" binge drinking is actually less like sleep and more like getting knocked out, which is why you don't wake refreshed.

Congeners: These naturally occurring chemicals give alcohols their distinct colours and flavours. As the liver processes congeners, breakdown products are formed, including formic acid, acetone, methanol and many others. As the nasty names suggest, such compounds are harmful to the body. Beers contain relatively few congeners while red wine and brandy have higher levels. The more congeners, the worse the hangover. Put another way, it takes fewer drinks of high-congener alcohol to get a hangover.

Inflammatory response: Similar to what occurs when you come down with a virus infection, high levels of alcohol can activate the chemical signals in the immune system that give you that achy, tired, depressed feeling.


Hangover Cures



Friends, Web sites and spam e-mail all tout ways to cure you from the Morning After, but few have ever been looked at by the "party people" who do medical research. Oddly, most of the money for medical research goes to things like cancer, diabetes, etc., so the amount of research on hangover cures is extraordinarily limited. However, some cures can brag about at least a small amount of medical backing:

Linoleic acid: This is a compound found in certain plants and commonly available in health-food stores. It is a natural anti-inflammatory and has been shown to significantly reduce hangover symptoms.

Vitamin B6 (aka pyridoxine): Widely available, this vitamin has been shown to dramatically reduce hangover symptoms by half. The only catch is that you should be taking it before, during and after you start drinking.

Liv52: This herbal preparation made in India, when taken at the start of the pub crawl, can reduce the amount of acetaldehyde (see above).

Sweets and starches: The sugar found in fruits, the well-named "fructose," has been shown to lessen symptom severity, so have a nice piece of fruit. Some starch -- toast, crackers -- can help restore blood-sugar levels, which makes the brain feel better.

Drink carefully: Avoid alcohols with high levels of congeners (whiskey, red wine). Instead, opt for the lower congener selections such as vodka.

The Ultimate Cure: Abstinence. OK, drink less. Or just, wait it out as time will cure you -- eventually, usually within 12 hours, your body will restore your normal state of being.

Dr. Ken Spaeth is a Harvard-trained physician and a faculty member at Mount Sinai School of Medicine in New York. He is also co-author of "The Bioterrorism Sourcebook." You can e-mail him your questions at askdrken@aol.com.