The Frustrating Quest to Cure Hangovers
WHEN YOU WAKE UP feeling achy, nauseated, and tired after a night of heavy drinking, you might have some regrets. At least you can take solace in the fact that many before you have felt this pain. Hangovers have been a menace to men for centuries, described in scrolls and books from ancient Greece, Egypt, and India.
For just as long, people who imbibe, including some of the greatest thinkers, have sought hangover cures. Aristotle drank cabbage juice. Today, companies hawk hangover recovery supplements and hydration IV drips. But nothing has emerged as a blockbuster cure for hangovers (except staying sober, of course). Here’s why.
How Hangovers Attack Your Mind and Body
When you drink too much, multiple organs feel the pain. The symptoms of a hangover can be wide-ranging and include dehydration, muscle pain, head-aches, and more, making them tough to treat with a single remedy.
'This is one of the problems with hangovers–it’s a whole-person problem,' says Terrence Deak, Ph.D., Professor and Behavioural Neuroscience Area Coordinator at Binghamton University. 'It affects many features of physiology, including the brain, liver, intestines, and pretty much everything.'
Inflammation is the culprit behind much of the misery. Scientists at Imperial College London recently proposed a new definition for hangover symptoms – the result of systemic inflammation that correlates with the underlying damage being done.
When you drink too much too fast, it sets off a cascade of health problems. Alcohol kills cells in the lining of your gut and disrupts the beneficial bacteria that live there. Bad bacteria then leak from your gut to your bloodstream and activate your innate immune system, triggering inflammation. Then, the booze travels to your liver, where it breaks down into toxic byproducts like acetaldehyde and congeners, generating oxidative stress that damages otherwise healthy tissue. All that inflammation and all those toxins make you feel sick while harming organs like your heart and brain. It’s a Pandora’s box, and no one treatment can fix everything going on – at least not yet. For now, you can just relieve some of the symptoms.
'Regarding treatments, there's really poor-quality evidence for everything,' says Benedict Turner, MBChB, a surgeon and the first author of the Imperial College London research paper. 'The thing that has the best quality evidence in the literature is non-steroidal anti-inflammatory drugs, like aspirin and ibuprofen – those have the best evidence in terms of taking away symptoms.' But don’t take acetaminophen – it is hard on your liver, which is already going through enough when you have a hangover.
Non-steroidal anti-inflammatory medications help by turning down toll-like receptor 4, an immune system receptor that triggers inflammation when it recognises germs circulating in your blood. The ideal hangover remedy, however, would fortify your guts against the whole toxic cascade. No one has figured out how to do that yet.
One issue is that hangover is not a priority in terms of medicine, says Dr. Turner. The hangover simply isn’t at the top of list for government and industry groups that fund research. A hangover alone won’t kill you, though the binge-drinking that caused it could. And therein lies one of the problems – the idea of curing hangovers is a bit controversial. Some people choose to drink responsibly in part to avoid hangovers. What happens if that motivation goes away? A recent study in the journal Alcohol and Alcoholism showed that young adults who tried products touted as hangover remedies–none of which have been proven effective–were more likely to have problematic drinking habits and symptoms of alcohol use disorder than those who didn’t. One explanation is that people who believe these products work might drink more than usual because they don’t have the threat of a hangover to deter them, the researchers say.
Then again, a remedy that stops hangovers from starting in the gut, rather than just relieving symptoms, could in theory help people with troubling drinking habits. In one study, people with alcohol use disorder who received fecal transplants to improve their gut bacteria craved less alcohol post-transplant, raising the possibility that your gut bacteria plays a role in making you want to drink.
The Quest for the Next Breakthrough
Today, some university researchers and small pharmaceutical and supplement companies are developing treatments to curb hangover symptoms. Often, they use plant fibers, probiotics, or antioxidant-rich natural compounds thought to fight inflammation, support liver function, or bolster the gut’s defences.
Many of these products, like extracts of Noni fruit or proteins harvested from saltwater clams, are being tested in Petri dishes or mice. A few are being studied in clinical trials with small numbers of human participants, making their results hard to generalise. None of the experts we talked to recommended any of them.
How to Handle Hangovers Today
The first hangover remedy is obvious, but we have to say it: Don’t drink too much. You’re binge drinking when you bring your blood alcohol concentration to 0.08 percent, which would happen when a typical guy drinks five or more drinks in about two hours, says the National Institute on Alcohol Abuse and Alcoholism. When you drink, try the following strategies to reduce morning-after misery:
Eat a good meal.
More research is needed to find the best way to shield your gut from booze, but for now, your best bet is to eat a hearty meal packed with fibre and probiotic bacteria before you drink, says Dr. Turner. 'Things like soluble fibres will keep liquid in the gut, rather than letting it seep across into and diffuse freely into cells,' he says. He adds kimchi to his dinner before going out. And if you wake up with a hangover? Eat more fibre and foods with good bacteria. 'Helping your gut get back to normal as quickly as possible is likely to be the best thing you can do,' he says.
Drink smart.
While too much of any drink can give you a hangover, clear spirits like vodka tend to hurt less than dark ones like whiskey. That’s because dark liquors contain more congeners, byproducts that give your gut just one more toxin to work out. Once you pick your poison, pair it with the ultimate clear liquid: water. 'If you alternate alcohol with glasses of water, that water effectively dilutes the alcohol in your system and helps to flush it out more quickly, including the toxins,' says Deak.
Keep your alcohol stash boring.
If you keep your fridge, bar cart, or wine rack stocked with a variety of drinks, you might invite hangovers into your home. Researchers in Denmark found that when people could select from beer, wine, or cocktails, they drank more and ended up with worse hangovers on average than people who stuck to one type.
Remember that you’re not in Uni anymore.
The amount you drank decades ago, or even a few years ago, might hit different now. Your sensitivity to hangovers tends to increase with time, probably because inflammation increases with aging, says Deak. 'The inflammatory backdrop, how inflammation changes across the lifespan, might be an important predictor of alcohol sensitivity,' he says. Plus, your metabolism is probably slower than it was in your 20s, so it takes longer to digest alcohol, extending the misery.
Prioritise pooping.
Your trip – or, let’s be honest, trips – to the toilet after a bender are the final hoorah for your night out. 'The drinking isn't over until you defecate,' says Beom Sun Chung, Ph.D., Assistant Professor in the Department of Anatomy at Yonsei University in South Korea. Until then, you’re still doing “intestinal drinking,” where alcohol in your gut can absorb into your bloodstream, according to a trio of anatomy researchers at Yonsei University in South Korea – Tom Ryu, Keungmo Yang, and Chung. Their research shows that once people with hangovers poop, their blood levels of toxic alcohol metabolites drop. Add this to the list of reasons to get regular (and to eat fiber before and after drinking, too). Try a glass of prune juice, a classic constipation remedy, if you need help getting things moving.
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