This post is based largely on an article by Richard Webb titled “Hung over: What science says about why you feel so rough in the 7 December 2016 issue of the New Scientist.
First of all, alcohol is not the reason you feel so bad. The onset of a hangover means that the blood’s concentration of ethanol is zero. Moreover, there probably isn’t just one cause for all the hangover symptoms. It could be the impact on sleep quality of forcing your body to break down a large amount of fluid substance.
Dehydration is a side effect. The pounding head and mouth probably result from alcohol’s suppression of the antidiuretic hormone vasopressin. This increases the desire to urinate. During the hangover vasopressin snaps back to a higher level than normal, but there does not appear to be a correlation between that or any other drink-induced hormonal imbalance and the severity of the hangover.
The delayed onset of a hangover means that the metabolic products of ethanol are prime suspects. A study in Japan found that people with inactive genes for making enzymes that break down acetaldehyde, a highly reactive by-product of ethanol, experienced a hangover after fewer drinks. However, an earlier Scandinavian study showed that acetaldehyde concentration were generally low when a hangover was most severe suggesting that its effects are indirect or delayed. Perhaps it is acetate, which occurs further down the line as a product of acetaldehyde breakdown.
A recent study of the urine of a group of hung-over Dutch students found that ethanol concentration was correlated with severity of symptoms that include sleepiness, sweating, concentration problems, nausea, thirst, and to a lesser extent, confusion headache, weakness and regret. However, the same correlations were not present in a self-described hangover-immune group that had drunk a similar amount. These people also had less alcohol in their urine.
So it seems the the ability to rapidly metabolize alcohol is more important than the amount consumed in determining hangover severity. But this does not explain why we can have a severe hangover when we hardly drank anything, and at other times when we have drunk heavily experience only a mild hangover.
Some think that congeners, chemicals produced during fermentation, other than ethanol, that give each drink a distinctive aroma and taste, play a role. According to a study that compared hangover severity in bourbon and vodka, dark spirits are worse than clear ones in inducing severe hangovers. On the other hand, research in Japan found that higher levels of congeners of whiskies might inhibit the breakdown of ethanol and at least delay the onset of hangovers.
It should be clear that in all these studies there are uncontrolled confounding variables.
The advice offered by HM is to not drink so much. There is no cure and there is unlikely that one will be developed. Excessive alcohol consumption does not foster a healthy memory.
Read the below list of a 2011 survey of 1410 hung-over Dutch students. This is the order of frequency of hangover symptoms that should serve as a reminder to be cautious: Fatigue, thirst, drowsiness, sleepiness, headache, dry mouth, nausea, weakness, reduced alertness, concentration problems, apathy, increase reaction time, reduced, appetite, clumsiness, agitation, vertigo, memory problems, gastrointestinal complaints, dizziness, stomach pain, tremor, problems with balance, restlessness, shivering, sweating, disorientation, auto sensitivity, photosensitivity, blunted emotions, muscle pain, loss of taste, regret, confusion, guilt, gastritis, impulsivity, hot/cold flashes, vomiting, pounding heart, depression, palpitations, tinnitus, nystagmus (uncontrolled eye movement), anger, respiratory problems, anxiety, suicidal thoughts.
And whatever you do, do not drink and drive.
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