HAPPY NEW YEAR!! (Shhhhh…let’s talk about hangovers)

Is there any better day to discuss HANGOVERS? Here’s hoping your New Year’s Eve overflowed with more fun than alcohol, but just in case…let’s talk.

What causes hangovers? Well, drinking too much alcohol- duh! But on a physical level, we also know that:

  • Alcohol tells the kidneys to make more urine (by turning off the anti-diuretic hormone, for the curious) so yes, this dehydrates your body
  • Dehydration (from anything- sweating, vomiting, diarrhea, etc.) can cause headaches and muscle aches, or make you lightheaded (especially when you go from lying down to sitting up, or sitting to standing)
  • Alcohol causes your blood vessels to dilate (seen superficially as red, flushing faces) and these enlarged blood vessels also worsen positional lightheadedness and independently cause headaches
  • All this dehydration makes your heart pound harder and faster to to circulate less fluid through increased space (those enlarged blood vessels)- adding a racing heart to alcohol hangover symptoms
  • Adding COFFEE (or any form of caffeine) is only going to worsen your hangover symptoms by further irritating your stomach and making you pee more- don’t do it!
  • Nausea comes from multiple sources: direct irritation of the stomach lining, increased stomach acid production, delayed stomach emptying, and an irritated, inflamed liver. The good news here is that we are talking about HANGOVERS (when blood alcohol levels have faded back to zero) so at least if you are throwing up at this point, you should be fully conscious, with normal gag reflexes (therefore this is super unpleasant but not dangerous, as it is for someone acutely intoxicated.)
  • Feeling shaky (plus weak, headachy and tired)? Alcohol also lowers your blood sugar, which will cause all these symptoms
  • Breakdown products of alcohol called CONGENERS increase the severity of hangover symptoms, so note that the darker the alcohol, the more the congeners (vodka has less than dark whiskey)
  • More alcohol = more alcohol side effects, which seems OBVIOUS, but take-home message is doing shots causes way more hangovers than drinking beer or wine, largely because we naturally fill up and drink less total alcohol when we are drinking the latter.
  • Though the details are not fully understood, alcohol also triggers an inflammatory response from our immune systems, which can cause achy muscles, cloudy thinking and headaches

What might help once you’ve got a hangover?

Truthfully? Rehydration, pain relief and time. Despite hyperbolic claims to the contrary, there is no other simple cure. However, these tips may help:

  • Sip on room temperature water or sports drinks straight from the cup/bottle/can- do NOT use a straw, because that introduces more air into your stomach, which can worsen your nausea.
  • OTC antacids like TUMS or MAALOX can help nausea caused by increased stomach acid or direct irritation of the stomach lining
  • If you are nauseated, remember that OTC pain relievers like ibuprofen (Advil/Motrin) can further irritate your stomach…so ideally wait until you can keep down a few crackers (or toast or a granola bar) before adding them to the mix
  • Sipping on broth-based soups (think chicken noodle) have the bonus of a high salt content, which helps you retain any fluid you get in your body
  • Finally, if you have extreme nausea, vomiting, dehydration and headache…head to your doctor. Prescription anti-nausea medications and IV fluids are the closest thing we have to a “magic cure” for hangovers, though obviously you don’t want to rely on this option!

BOTTOM LINE: Hangovers are made from dehydration, stomach/liver irritation and inflammatory responses; treatment is rehydration, acid neutralization, pain relief and time. But the better answer is that ounce of prevention. Cheers to 2020!

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