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Hangover: Causes, Cures and Prevention

23 Dec 2015
Alcohol

Ah yes, the dreaded hangover; the adult equivalent to that monster hiding under your bed. Just knowing that with one too many drinks the night before, it is going to be there waiting for you the very next day. Search the internet and you will find countless anecdotes about how to cure or prevent a hangover from downing a pint of pickle juice to magical “hangover” pills. Did you know, that some “hangover curing” practices can actually be risky to your health? For example, taking a pain-killer such as acetaminophen (more commonly known as paracetamol), can actually induce liver toxicity.

Causes

Whilst the actual cause of a hangover is not well understood there are various mechanisms thought to contribute including:

Disruption of sleep cycles:

Alcohol consumption can contribute to poor quality sleep, and disrupted sleeping patterns. It can also interfere with body temperature and disrupt carbohydrate metabolism, as well as increase cortisol (the stress hormone) leading to the dizzy/ “jet lagged” feeling the next day.

Gastrointestinal irritation:

Alcohol causes irritation to the stomach lining, and delays gastric emptying, as well as increases gastric acid production and intestine and pancreatic secretions. Additionally, alcohol consumption can increase fat in liver cells (i.e. fatty liver). All of these effects can lead to nausea, vomiting and/or pain in the stomach.

Alcohol metabolism and by products:

Alcohol can have deleterious effects on the body, as a result of the production of its intermediate metabolite, known as acetaldehyde, a chemically reactive substance (and a known carcinogen) that can lead to toxicity, causing symptoms similar to those experienced during a hangover such as tachycardia, nausea, vomiting and sweating. In most people, acetaldehyde is quickly converted to acetic acid, however in some people this process is impaired which leads to accumulation of acetaldehyde in the body.

Congeners:

During fermentation, along with ethanol, other biologically active substances thought to contribute to the appearance, taste and smell of alcoholic beverages, may be produced, known as congeners. One such congener, methanol, produces toxic by-products (formaldehyde and formic acid) which are extremely toxic to the body, and can lead to death when consumed in large amounts. Additionally, it is thought that ethanol, may actually inhibit the metabolism of methanol meaning that the effects of methanol may linger in the body, even after ethanol has been metabolised.

Cures and Prevention

When it comes to avoiding a hangover, the best defence is a good offence. Preparation really is key. Nevertheless, here are some ways to avoid feeling sub-optimal the next day (besides from refraining from alcohol all-together) and also some common “cures” that you should be cautious of.

Ensure that you have eaten and drunk an adequate amount in the day leading up to drinking:

The more food that you have in your stomach, the slower the alcohol is released into the bloodstream. On an empty stomach, unlike other nutrients, alcohol can be directly absorbed, this also goes with eating a small meal whilst drinking (which can also help to slow down the rate at which you drink), thus leading to a lower consumption of alcohol. Ensuring adequate hydration is also key, starting off dehydrated will only lead to further dehydration when your ADH hormone (see above) is inhibited by alcohol.

Sip on water throughout the night or better still have a glass of water between drinks:

Following on from ensuring that you start the night well hydrated, having a glass of water between drinks can help to prevent to inhibition of ADH caused by alcohol consumption and in turn prevent or reduce fluid and electrolyte losses.

Drink oral rehydration solution:

Commonly used for those experiencing gastro, diahrrea and/or dehydration. These solutions are developed to be an appropriate osmolality for rehydration, and can be particularly useful if the individual is vomiting or finding it difficult to consume food or fluids. For increased palatability, the solution may be refrigerated or frozen (alternatively you can purchase ORS in the form of icy-poles). Some of the more common brands include: Hydralite and Gastrolye or you can make your own.

Limit your intake of Congeners:

It is thought that alcoholic drinks that contain predominantly ethanol such as vodka and gin, are associated with a lower incidence of hangovers, compared to beverages containing a larger number of congeners, such as whisky, brandy and red wine.

Consume bland carbohydrates:

Although people often report cravings for salty, fatty foods on the day of the hangover (which may be your bodies way in trying to make you drink more, as salty foods drive thirst). It is thought that one of the reasons that some people feel dizzy and lethargic the next day is due to a depletion of glucose leading to low blood sugar. In addition, these foods may be better tolerated and reduce nausea. So omit the greasy takeaway and opt for some toast with vegemite instead.

Sleep it off:

As simple as this recommendation may seem, it is often one that is overlooked. Ensuring that you are drinking adequate fluids throughout the day, and eating small amounts of bland carbohydrates often, along with getting plenty of sleep, may just be the best way to get over your hangover.

DO NOT fall for “hair of the dog”:

This strategy will only delay your hangover, and prolong the effects that alcohol has on the body, such as dehydration. In addition, as it is thought that the metabolism of ethanol inhibits the metabolism of methanol you may be seriously putting yourself at risk.

Be cautious with pain medication:

Although “popping a panadol” is most people’s first line of defense when it comes to treating the hangover, this may be potentially damaging and even life threatening. Nonsteriodal anti-inflammatory drugs (NSAID’s) can be gastric irritants which may further irritate and inflame the stomach (along with alcohol), whilst acetaminophen (paracetamol) may cause liver toxicity (which is enhanced by alcohol metabolism).

Eat fresh fruit and drink fruit juice:

Fructose, the sugar found in fruit has been speculated to speed up the rate of alcohol disappearance, and is also a good source of potassium, one of the electrolytes and is a good source of Vitamin C - which is an antioxidant and also has a role in wound-healing. Additionally, the consumption of fruit juice may help with rehydration.

Replace B vitamins:

Various mechanisms in the body's processing of alcohol can contribute to the deficiency of B vitamins such as B6, B12 and folate following alcohol consumption. Whilst consuming a B vitamin complex, such a Barocca, will not rectify a night of drinking (or even alleviate a hangover for that matter), it will help to replace what was taken out or used in the processing of alcohol.

Rebekah Alcock
Accredited Practicing Dietitian
Recover Sports Medicine

If you have any questions regarding this post, or wish to book in to see our Accreddited Practicing Dietitian, please call us on 1300 858 774 or email contact@recoversportsmed.com.au

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