We’ve all been there. The parched mouth. The throbbing headache. The degradation of basic cognitive abilities. The sulking in one’s own self pity. Yes, it’s the all feared hangover.
Considering the painful aftermath of binge drinking, it’s surprising to note that one out of six adults in the US binge drinks 4 times per month, consuming at least 8 drinks per binge. Perhaps this is partly due to the heavy promotion of alcohol in mainstream commercialism, which was reported to have spent $8 billion on advertising between 2002-2009.
But what’s hardly talked about in those clever marketing campaigns is the aforementioned aftermath of a ‘good’ night out, which finds many mercilessly clinging to their porcelain friend in the early hours of the morning.
What exactly is happening to our body during a hangover that causes the insistent headaches, nausea and lethargy? Many would likely claim the culprit of these symptoms to be dehydration, and while this may be a part of the equation, studies suggest other significant factors are at play.
Looking Inside The Body
Hangover symptoms have been attributed to several causes, including direct physiological effects of alcohol on the brain and other organs, alcohol withdrawal, and non-alcohol factors, such as the toxic effects of other biologically active chemicals (congeners) in the beverage and broken sleeping patterns.
Although current evidence suggests that more than one factor most likely contributes to the overall hangover state, the following sections address each of the proposed causes.
Your Stomach & Intestines Are Inflamed
Alcohol directly irritates the stomach and intestines, causing inflammation of the stomach lining (i.e., gastritis) and delayed stomach emptying, especially when beverages with a high alcohol concentration (i.e., greater than 15 percent) are consumed.
High levels of alcohol consumption can also produce a fatty liver, an accumulation of fat compounds called triglycerides and free fatty acids in liver cells. In addition, alcohol increases the production of gastric acid as well as pancreatic and intestinal secretions.
Any or all of these factors can result in the upper abdominal pain, nausea, and vomiting experienced during a hangover.
Your Brain Is Hungry
Because alcohol leads to a condition known as fatty liver (mentioned above), the buildup of lactic acid usually follows, which can inhibit glucose production in the blood. Furthermore, not eating sufficiently enough due to nausea can also inhibit glucose production.
Because glucose is the primary energy source of the brain, hypoglycemia can contribute to hangover symptoms such as fatigue, weakness and mood disturbances. Diabetics are particularly sensitive to the alcohol-induced alterations in blood glucose. However, it has not been documented whether low blood sugar concentrations contribute to hangovers symptomatically.
You Are Thirsty & Depleted
It’s a no brain-er that alcohol increases urination. The consumption of 50 g of alcohol in 250 milliliters (mL) of water (i.e. approximately 4 drinks) causes the elimination of 600 to 1,000 mL (or up to 1 quart) of water over several hours.
Alcohol inhibits hormone release from the pituitary gland, a hormone which normally causes the kidneys to reabsorb water and electrolytes, therefore instead of being reabsorbed, it’s eliminated in the urine. Sweating, vomiting and diarrhea also commonly occur during a hangover, and these conditions can result in additional fluid loss and electrolyte imbalances.
Your Brain Is Sending The Wrong Sleeping Signals
Although it’s known as a depressant, alcohol actually has counter-active sedative effects on the brain. Alcohol inhibits glutamate production, a stimulant whose job is to keep us awake. However, when our alcohol blood-levels reach zero (i.e., hangover time), our body reacts by overproducing this stimulant, resulting in broken sleeps as well as stomach irritation.
Your Brain Chemicals Are Out Of Whack
Although the complete etiology of alcohol induced headaches is still unknown, research suggests it has something to do with alcohol’s effect on the neurotransmitters histamine, serotonin and prostaglandins. Alcohol intoxication also results in vasodilatation, which may induce headaches.
You’re Actually Going Through Alcohol Withdrawal (AW)
Several lines of evidence suggest that a hangover is a mild manifestation of the AW syndrome in non-alcohol dependent drinkers. First, the signs and symptoms of hangover and mild AW overlap considerably.
One clinical scale used to assess the severity of a withdrawal episode in alcohol-dependent patients measures 10 withdrawal-associated items that are usually present during a hangover, including nausea and vomiting, tremor, sweating, anxiety, headache and sensory disturbances.
Furthermore, the observation that alcohol re-administration alleviates the unpleasantness of both AW syndrome and hangovers suggests that the two experiences share a common process.
Stay Away From The Dark Stuff: Other Compounds In Liquor That Perpetuate Hangovers
Most alcoholic beverages contain smaller amounts of other biologically active compounds. These compounds, known as congeners, contribute to the taste, smell and appearance of alcoholic beverages.
Research has suggested that beverages composed of more pure ethanol, such as gin or vodka, induce fewer hangover effects than do beverages containing a large number of congeners, such as whiskey, brandy, or red wine. However, further research must be conducted to quantify these findings.