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SKEPTOID BLOG:

The One And Only Effective Hangover remedy (except for abstaining).

by Stephen Propatier

December 31, 2013

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Donate 10 9 8 7 6 5 4 3 2.... 1 Trick to avoid a hangover. The internet and national news is abuzz every New Years Eve with advice on how to minimize a hangover after overindulging. Most of it is useless advice. Some of the advice is accurate, but not likely to make much of a difference.

Sorry to be the wet blanket but there is no trick that is effective to prevent a hangover when you overindulge. If you search online you will find no shortage of half truths, poor medical understanding, and bad advice. There is only one method to avoid a hangover.....

The only way to avoid a hangover is to limit the rate and volume of alcohol consumption, period the end. Factors related to drinking alcohol that could worsen your hangover are commonly reverse extrapolated to "prevent the hangover". Realistically the effect is probably minimal. Lets hit some of the highlights so that you can be armed with knowledge tonight and not let you or your friends be falsely reassured by the urban legends.
  1. Dehydration- There is no doubt that dehydration contributes to worsening a hangover but being well hydrated is not a prevention or a cure. The primary culprit in a hangover is your liver being overwhelmed with an acetaldehyde buildup. Continuing to drink even with a constant flow of water cannot significantly affect the primary culprit, the acetaldehyde buildup. If that is true why does drinking water help, and why does dehydration make you worse? You exhale and urinate 10% of the alcohol you ingest. Dehydration slows that down and you may lose some of that slight benefit. Lower blood volume will concentrate the acetaldehyde. That contributes to the headache and lowers the pH of the blood making you feel worse. Indirectly, concentration of metabolites and acidosis makes you nauseous and can contribute to vomiting the next day (the primary reason for vomiting is a toxic level of alcohol and and emergency dump by the body to remove some). Elevated and concentrated acetaldehyde with acidosis results in a snowball effect worsening dehydration/vomiting. Unfortunately, Re-hydrating suddenly also has a serious downside. When you drink alcohol the lining of your stomach is irritated by the alcohol toxicity. Suddenly introducing free water into your stomach to be directly absorbed is further irritating. The cells of the lining of your stomach suffer a sudden osmotic shift. That irritated stomach can trigger vomiting. If drinking water helps it is probably because you are replacing an alcoholic beverage with a non-alcoholic one, giving your liver time to catch up. Trying to down 4 bottles of water at the wee hours of the morning will not help much and will most likely end up in the toilet bowl one way... or the other.

  2. Clear Alcohol and High Quality Alcohol: In skeptoid episode 377 Brian brought up this strategy as a way to ameliorate a hangover. Truthfully cheap alcohol may(I stress may), contribute to dehydration and worsen a hangover. There are arguments related to conjoiners and alcohol dehydrogenase they are basically theoretical and do not have any reliable data. Methanol contaminants in home brews are extremely problematic. Although plausible there have been no reliable well controlled studies demonstrating the effectiveness of the "high quality" alcohol strategy. There are a tons of extrapolations about conjoiners and contaminants. Most are not very plausible. It is possible that these factors can worsen a hangover but there is no evidence that they directly improve acetaldehyde metabolism. The primary culprit of the hangover is unaffected.

  3. Stimulants/Hair of the Dog/supplements: Zero are effective at eliminating the primary or secondary effects of alcohol. Save your money stay away from the booze.

  4. Exercise: If you are trying to out-exercise your hangover, forget it. Increasing metabolism delays breakdown of acetaldehyde by depleting the metabolic resources for acetaldehyde metabolism. Similar poor response using exercise to break down the alcohol into acetaldehyde to reduce the primary effect of alcohol(sober up).

  5. Assorted other myth's: "Beer before liquor never sicker/liquor before beer never fear" or the reverse, low fat meal, high fat meal, gluten free meal, low carb meal, green tea et al.... Not plausible don't waste your time and not likely to have any effect, no better than any other home remedy. Primarily confirmation bias.

What does help a hangover?

Sorry no tricks here: Reducing the amount you drink or distributing a smaller volumes over time works best. Anything else is just slightly helpful at preventing you from suffering tomorrow. Food can slightly slow the absorption but if you drink too much it won't help prevent the hangover. If your stomach can handle it Anti-inflammatories like ibuprofen could help but they can trigger vomiting too, so be cautious. It is true that a certain percentage of the population will not get hangovers. Some people's liver are really good at metabolizing the toxic acetaldehyde quickly staying ahead of the curve.

If there was any proven method for stopping the toxic effects of alcohol, everyone would be told to use it. It would mean the end of needless deaths due to intoxicated people. Both directly in overdose and indirectly like drunk driving.

So have some fun take it slow, drink small amounts, and if you plan to travel in any way except as a passenger.... just don't. When it comes to curing your hangover save your money and your new years day, go with low end moderation of alcohol consumption. It will work. It is the only method that will work other than just abstaining.

Happy New Year.

References:
  • Paton, A. (2005). Alcohol in the body. British Medical Journal, 330, 85. doi: 10.1136/bmj.330.7482.85

by Stephen Propatier

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