Dear Doctor Column, December 31, 2007
Preventing Hangover Easier Than Treating One
Question:
What’s the best way to treat a hangover? Is there something I can do to prevent a hangover in advance?
Answer:
The best way to treat a hangover is to avoid getting one in the first place. Most health experts recommend keeping the number of drinks to two a day or less (one drink a day for women). In general, the more alcohol you consume, the greater the chance you’ll suffer a hangover, especially if you consume a lot in a short period of time.
A hangover typically begins several hours after a person stops drinking, when the blood alcohol level is falling. Symptoms usually peak around the time it hits zero and can persist for up to 24 hours. Symptoms range from a mild headache and upset stomach to a raging headache, nausea and vomiting, dizziness, shakiness, dry mouth, and extreme sensitivity to light and noise.
Unfortunately, if you wake up suffering from overindulgence, there isn’t much you can do to make yourself feel better. Although a lot of hangover remedies have been tried, there’s not much evidence that they do any good.
Scientists blame hangover symptoms on several different factors. The headaches may be related to alcohol's ability to dilate blood vessels. Thirst and dry mouth result from alcohol's diuretic effect, which stimulates the kidneys to excrete urine, leading to dehydration. The sweating, vomiting, and diarrhea that can accompany a hangover cause further fluid loss and electrolyte (body salts) imbalance.
Alcohol directly irritates and inflames the lining of the stomach and intestines and triggers increased production of stomach acid and pancreatic and intestinal secretions. Alcohol also alters the body's normal metabolic processes and can cause low blood sugar levels. Additionally, alcohol interrupts the normal stages of restful sleep and results in fatigue the morning after.
Other possible contributors to a hangover may be congeners in alcohol, which are by-products of distillation and fermentation: The more congeners a liquor has, the worse the hangover; cheaper brands typically contain more congeners, whereas more expensive high-end brands contain less. Vodka and gin have the least amount of congeners, while bourbon and red wine have more. Personal traits, such as temperament, personality, and family history of alcoholism, can also be co-factors.
Fortunately, time is on your side — time for the body to process and get rid of the alcohol (at a rate of about one-half ounce per hour). Contrary to popular myths, strong coffee, increased physical activity, “greasy” foods, or a cold shower do nothing to speed metabolism of alcohol, and therefore, do nothing to help a hangover. Having a “hair of the dog that bit you” drink the next morning only makes the problem worse.
However, eating bland foods containing complex carbohydrates, such as toast or crackers, can combat low blood sugar levels and possibly nausea. Sleep can ease fatigue, and drinking plenty of non-alcoholic, non-caffeinated beverages, such as water or fruit juice, can alleviate dehydration (caffeine is a diuretic and increases urine production).
Antacids may relieve nausea and stomach pains, and while aspirin and similar products, such as ibuprofen or other over-the-counter pain remedies, may reduce headache and muscle aches, it could increase stomach irritation. Acetaminophen (Tylenol) should be avoided because alcohol metabolism enhances its toxicity to the liver. People who drink three or more alcoholic beverages per day should avoid all over-the-counter pain relievers and fever reducers.
If you decide to drink, the following suggestions may help prevent a full-blown hangover:
- Drink slowly - sip rather than gulp.
- Alternate alcoholic and non-alcoholic drinks (particularly water), to minimize dehydration.
- Limit yourself to one drink an hour and no more than two drinks a day. One drink is equivalent to a 12-ounce can of beer, 5 ounces of wine, or a standard mixed drink made with 1 ounce of liquor.
- Eat a substantial meal before drinking.