What is a hangover?
A hangover is the unpleasant physical and mental symptoms that are the result of drinking too much alcohol. Hangovers usually begin several hours after an episode of drinking, and vary in intensity depending on the person as well as the type and amount of alcohol consumed.
What are the symptoms of a hangover?
Symptoms of a hangover include:
- Nausea, vomiting, and stomach pain
- Headache and sensitivity to light and sound
- Red eyes
- Muscle aches and weakness
- Disturbed sleep
- Increased pulse and blood pressure; rapid heartbeat
- Dizziness and vertigo (a sense of whirling or irregular motion)
- Mood disturbances such as depression, anxiety, or irritability
In general, the severity of hangover symptoms is directly linked with the amount and duration of alcohol consumption. Some people can experience a hangover from as little as 1 to 3 drinks. Yet some heavy drinkers report no symptoms at all.
The body needs about 1 hour to metabolize (process) one drink. One drink is defined as:
- 12 oz. of beer (5% alcohol)
- 8 to 9 oz. of malt liquor (7% alcohol)
- 5 oz. of table wine (12% alcohol)
- 1.5 oz. of liquor (40% alcohol)
What causes a hangover?
Causes of hangover include:
1.) Direct effects from alcohol
- Dehydration: Alcohol is a diuretic, meaning that it increases the need to urinate (pee). Alcohol reduces release of the pituitary gland hormone vasopressin, which normally keeps the body’s fluid levels in correct balance. Having 4 drinks can cause you to pass up to 1 quart of urine over several hours.
- Electrolyte imbalance: As large amounts of urine are passed, the chemicals used by body cells for peak function are thrown out of balance.
- Gastrointestinal upset: Alcohol irritates the lining of the stomach and intestines, slows the rate of digestion, increases fatty compounds in the liver, and increases secretions of the stomach and pancreas.
- Low blood sugar: This effect is usually seen in alcoholics after binge drinking and not eating over a period of several days. As the body metabolizes alcohol it generates lactic acid as a byproduct, which reduces blood sugar production and blood sugar reserves stored in the liver.
- Disruption of sleep and other biological rhythms: Alcohol is a sedative, meaning that it promotes sleep. However, symptoms of a hangover interfere with restful sleep, and insomnia may occur as a rebound effect when blood alcohol levels decline. Alcohol also interferes with body temperature regulation, and the normal release of a number of hormones.
2.) Alcohol withdrawal
A hangover may be a milder form of alcohol withdrawal, as a number of the same effects and symptoms are seen in both. When alcoholics stop drinking they experience symptoms such as tremors, sweating, and rapid heart rate. The nervous system tries to counteract the depressant effects of alcohol over a long period of time by decreasing sensitivity to a neurotransmitter that inhibits nerve cell activity. At the same time it increases sensitivity to glutamate, which boosts cell activity. When alcohol is withdrawn, the nervous system needs time to adjust and reduce its sensitivity to glutamate. During this time the person feels hyperactive or in “overdrive.”
3.) Effects of alcohol metabolites
The body processes (metabolizes) alcohol in a two-step process. One of the intermediate byproducts of alcohol metabolism is called acetaldehyde. In large amounts acetaldehyde causes toxic effects such as rapid pulse, sweating, and nausea.
In most people, acetaldehyde is broken down before it can build up to a level that causes problems. However, some people have a genetic inability to carry out the metabolic process fast enough, and will feel the bad effects of acetaldehyde after drinking even a small amount of alcohol.
4.) Effects of factors other than alcohol
- Congeners: Congeners are compounds that contribute to the taste, smell, and appearance of alcoholic drinks. These are generated during fermentation, aging, or degradation, or may be added during the production process. They are thought to contribute to the intoxicating effects of alcohol as well as to the severity of a hangover.
- Use of other drugs: Using cigarettes, marijuana, cocaine, or other drugs while consuming alcohol has an unknown effect on hangover severity. But they can produce intoxicating effects of their own.
- Personal differences: Personality traits such as neuroticism, anger, defensiveness and guilt over drinking are linked with more hangovers. People at risk for developing alcoholism or with a family history of alcoholism also suffer more hangovers
How is a hangover treated?
Many folk remedies are said to prevent hangovers or reduce their severity and duration. Few of these remedies have any scientific basis.
For example, drinking more alcohol (the “hair of the dog”) is not a cure for hangover. Additional drinking only increases the toxicity of the alcohol already in the body, and can spur another episode of drinking.
- Eating bland foods containing complex carbohydrates, such as toast or crackers, boosts low blood sugar levels and possibly reduces nausea.
- Drinking water and other non-alcoholic beverages helps reduce dehydration.
- Getting enough sleep can counteract feelings of fatigue.
- Antacids can help settle nausea and upset stomach.
- Aspirin and other non-steroidal anti-inflammatories (such as ibuprofen or naproxen) can help headache and muscle ache but should be used sparingly since they can irritate the digestive system. Acetaminophen (Tylenol®) should NOT be taken during a hangover because it can be toxic to the liver when combined with alcohol.
- Time is the most important factor in recovery, as hangover symptoms ease up over a period of 8 to 24 hours.