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Introduction
During the course of the year we find ourselves going to all
kinds of events such as birthdays, office luncheons, annual holidays, parties, and
special occasions where alcohol is being served. Oftentimes along with feasting
we also consume too much alcohol. As a result, we wake up the next morning with
a hangover, which we then nurse for the next day or two. So as we approach the
end of 2012 and the next New Year’s Eve party, I wanted to offer this short
article for dealing with a hangover.
This is a quick guide to alleviating or completely avoiding hangover
symptoms through an understanding of alcohol itself, physiological changes
related to alcohol consumption, and a variety of suggested remedies for
specific hangover symptoms.
[Warning: First and foremost let me at least mention that
you should always try to drink responsibly and arrange having a designated
driver if you will be using your personal vehicle for transportation.]
Classes of Alcoholic
Beverages
Alcoholic beverages are
divided into three general classes: beers, wines, and spirits. Beer and wine
are produced by fermentation of sugar- or starch-containing plant material.
Beverages produced by fermentation followed by distillation have higher alcohol
content and are known as liquor or spirits. The alcoholic strength of beer is
usually 4% to 6% alcohol by volume (ABV), but it may be less than 2% or greater
than 25%. Beers having an ABV of 60% (120 proof) have been produced by freezing
brewed beer and removing water in the form of ice, a process referred to as
"ice distilling". Beer is part of the drinking culture of various
nations and has acquired social traditions such as beer festivals, pub games,
and pub crawling (sometimes known as bar hopping).
Wine is produced from
grapes, and from fruits such as plums, cherries, or apples. Wine involves a
longer fermentation process than beer and also a long aging process (months or
years), resulting in an alcohol content of 9%–16% ABV. Sparkling wine can be
made by means of a secondary fermentation. Fortified wine is wine (such as port
or sherry), to which a distilled beverage (usually brandy) has been added.
Unsweetened, distilled,
alcoholic beverages that have an alcohol content of at least 20% ABV are called
spirits. Spirits are produced by the distillation of a fermented base
product. Distilling concentrates the alcohol. For the most common distilled
beverages, such as whiskey and vodka, the alcohol content is around 40%.
Spirits can be added to wines to create fortified wines, such as port
and sherry.
A 2009 study provided
evidence that darker-colored liquors, such as bourbon, cause worse hangovers
than lighter-colored liquors, such as vodka. The higher amount of “congeners”
found in darker liquors compared to lighter ones was indicated as the cause.
Studies that attempt to compare hangover producing potential and hangover
severity of different alcoholic drinks suggest the following ordering (starting
with the least hangover-inducing):
Distilled ethanol diluted
in fruit juice, beer, vodka, gin, white wine, whisky, rum, red wine, and
brandy.
Alcohol and its Effects, the Basics
Now let’s cover some basics about alcohol. What is alcohol?
Alcohol is a distilled or fermented beverage that transforms a grain, fruit,
vegetable, or wood into ethanol. Ethanol, glucose, and sucrose are all in the
same group of alcohols. Ethanol is the most common form of alcohol one finds in
alcoholic beverages.
Alcohol is a psychoactive
drug that has a depressant effect. Alcohol also stimulates insulin production,
which speeds up glucose metabolism and can result in low blood sugar, causing
irritability and (for diabetics) possible death. Alcohol intoxication affects
the brain and causing symptoms such as slurred speech, delayed reflexes,
vomiting or unconsciousness. Alcohol also limits the production of vasopressin
(ADH) from the hypothalamus and the secretion of this hormone from the posterior
pituitary gland. This is what causes the intense thirst that goes along with a
hangover.
Now
when alcohol builds up in the
bloodstream faster than it can be metabolized by the liver, we enter a physiological
state known as drunkenness or inebriation. Alcohol is metabolized by
a normal liver at the rate of about one ounce (one two-ounce shot of spirits, a
normal beer, a regular sized glass of wine) every 90 minutes. An
"abnormal" liver with conditions such as hepatitis, cirrhosis, gall
bladder disease, and cancer will have a slower rate of metabolism.
Ethanol's acute effects are
largely due to its nature as a central nervous system depressant, and are
dependent on blood alcohol concentrations. Here’s a breakdown of what effects
one can expect to experience from alcohol consumption according to the quantity
you consume:
20–99 mg/dL - Impaired
coordination and euphoria
100–199 mg/dL - Ataxia,
poor judgment, labile mood
200–299 mg/dL - Marked
ataxia, slurred speech, poor judgment, labile mood, nausea and vomiting
300–399 mg/dL - Stage 1 anesthesia,
memory lapse, labile mood
400+ mg/dL - Respiratory
failure, coma
In addition to respiratory
failure and accidents caused by effects on the central nervous system, alcohol
causes significant metabolic derangements. Hypoglycemia occurs due to ethanol's
inhibition of gluconeogenesis, especially in children, and may cause lactic
acidosis, ketoacidosis and acute renal failure.
Some effects of alcohol
intoxication are central to alcohol's desirability as a beverage. For example,
some desirable effects from small quantities of alcohol consumption are
euphoria and lowered social inhibitions. Other symptoms include slurred speech,
impaired balance, loss of muscle coordination (ataxia), flushed face,
dehydration, vomiting, reddened eyes, and erratic behavior. Other effects are
unpleasant or dangerous because alcohol affects many different areas of the
body at once.
This last point, the fact
that alcohol affects many different areas of the body at once, is crucial to understanding
the nature of a hangover. Why? Because everyone experiences different symptoms
from their hangover, each hangover has to be dealt with individually. Here are
2 reasons underlying hangovers with completely different characteristics.
Many people from East Asian
descent have a mutation in their genes that causes them to suffer from alcohol
flush reaction, in which acetaldehyde accumulates after drinking, leading to
immediate and severe hangover symptoms. Because for them a little alcohol goes a
long way, they are also less likely to become alcoholics.
Older people report that
their hangovers grow worse as they age. This is caused by declining supplies of
alcohol dehydrogenase, the enzyme involved in metabolizing alcohol.
So what we’ve come to is
the fact that there is currently no empirical proof for hangover prevention
except reducing the amount of ethanol consumed or waiting for the body to
metabolize the alcohol ingested. This only happens when the liver oxidizes the
alcohol. So what this means is that the most effective way to avoid any of the
symptoms of alcohol-induced hangover is to control or avoid drinking.
Thus, no two hangovers are
the same.
The Physiology of a Hangover
Excessive consumption of alcohol
causes a delayed effect called a hangover. The hangover starts after the
euphoric effects of ethanol have subsided. Hypoglycemia, dehydration,
acetaldehyde intoxication, and glutamine rebound are all theorized causes of
hangover symptoms. Hangover symptoms may persist for several days after alcohol
was last consumed. Some aspects of a hangover are even viewed as symptoms of
acute ethanol withdrawal, similar to the longer-duration effects of withdrawal
from alcoholism.
Because alcohol impairs the
ability of the liver to compensate for a drop in blood glucose levels,
especially for the brain, it can result in the depletion of the liver's supply
of glutathione, a detoxification agent, reducing its ability to effectively
remove alcohol and its byproducts from the bloodstream. Since glucose is the
primary energy source of the brain, this lack of glucose (hypoglycemia)
contributes to symptoms such as fatigue, weakness, mood disturbances, and
decreased attention and concentration related to a hangover.
The human body is a system
of systems so physiological changes in one system changes others. That’s why the
best approach is to try to handle several symptoms by resolving alcohol-related
issues in multiple body systems simultaneously. For example, when you ingest
alcohol, the salivary glands secrete enzymes to combine with the alcoholic
beverage to make it more suitable for processing in the stomach and intestines.
As the alcohol circulates throughout the digestive system and blood stream it
moves from one system to another. Just one drink affects the central nervous
system, the digestive system, the endocrine system, the muscular system, the
immune system, and the respiratory system, so with each additional drink the
effects compound and the potential dangers increase. Because the alcohol moves
around in the body rather than remaining in an organ, region, or system, its
produces a wide range of negative physiological effects.
The most commonly reported
characteristics of a hangover include headache, nausea, sensitivity to light
and noise, lethargy, dehydration, fatigue, body aches, vomiting, diarrhea,
flatulence, weakness, elevated body temperature and heart rate,
hypersalivation, difficulty concentrating, sweating, anxiety, irritability,
erratic motor functions (including tremor), trouble sleeping, severe hunger,
halitosis, and lack of depth perception. Many people will also be repulsed by
the thought, taste or smell of alcohol during a hangover. The symptoms vary
significantly from person to person, and it is not clear whether hangovers
directly affect cognitive abilities. The effects of a hangover subside over
time.
Just as with lesser cases
of low alcohol consumption, cases where excessive amounts of alcohol have been
consumed such as with alcohol poisoning treatment strives to stabilize the
patient and maintain a clear airway and respiration, while waiting for the
alcohol to metabolize. In general, health care professionals will provide
treatment for hypoglycemia (low blood sugar) with 50ml of 50% dextrose solution
and saline flush, administer the vitamin thiamine to prevent seizure, check
electrolytes to guide fluid replacement, apply hemodialysis (blood transfusion)if
the blood concentration is dangerously high, or provide oxygen therapy.
Ineffective or unproven
remedies
Recommendations for foods,
drinks and activities to relieve hangover symptoms abound, here are some that
have been found to be ineffective or unproven.
The "Prairie
Oyster" restorative, introduced at the 1878 Paris World Exposition, calls
for raw egg yolk mixed with Worcestershire sauce, Tabasco sauce, salt and
pepper.
And in 1938, the
Ritz-Carlton Hotel provided a hangover remedy in the form of a mixture of
Coca-Cola and milk. By some accounts, Coca-Cola itself is believed to have been
invented as a hangover remedy).
Alcoholic writer Ernest
Hemingway relied on tomato juice and beer.
The "Black
Velvet" consists of equal parts champagne and flat Guinness Stout.
A 1957 survey by a Wayne
State University folklorist found widespread belief in the efficacy of heavy
fried foods, tomato juice and sexual activity.
Activities said to be
restorative include a shower—alternating very hot and very cold water, exercise,
and steam bath or sauna (although medical opinion holds this to be very
dangerous, as the combination of alcohol and hyperthermia increases the
likelihood of dangerous cardiac arrhythmias).
A 1976 research came to the
conclusion that "The results indicate that both fructose and glucose
effectively inhibit the metabolic disturbances induced by ethanol but they do
not affect the symptoms or signs of alcohol intoxication and hangover."
Nevertheless, consumption of honey (a significant fructose and glucose source)
is often suggested as a way to reduce some of the effects of hangover.
Food and Alcohol Metabolism
Studies have found that
when food is eaten before drinking alcohol, alcohol absorption is reduced and
the rate at which alcohol is eliminated from the blood is increased. The
mechanism for the faster alcohol elimination appears to be unrelated to the type
of food. The likely mechanism is food-induced increases in alcohol-metabolizing
enzymes and liver blood flow. While this may not decrease your chances for
getting a hangover, it’s a good idea to eat before you drink, but know that
doing so will eliminate the alcohol from your system faster than normal.
Scientifically Based
Remedies
Earlier I said that because
alcohol affects many different areas of the body at once, each hangover has to
be dealt with individually. Why? Because everyone experiences different
symptoms from their hangover, different from everyone else, and even from one
state of drunkenness compared to another time of drunkenness. So the conclusion
here is that there is currently no empirical proof for hangover prevention
except reducing the amount of ethanol consumed or waiting for the body to
metabolize the alcohol ingested. What this means is that the most effective way
to avoid any of the symptoms of alcohol-induced hangover is to control or avoid
drinking.
But what are we supposed to
do if we get a hangover? Sometimes it’s not possible to wait for the effects of
the hangover to wear off, while coping with the symptoms. We need a way to
effectively deal with this situation. You’re right, we do. Here’s the
realization I’ve come to about how to handle the symptoms of a hangover.
The primary realization is
that a hangover is not a thing, instead it’s a series of symptoms related to
excessive alcohol consumption. That’s key.
The second important point
is that in order to deal with any one hangover experience effectively you have
to deal with the exact symptoms you’re going through during a specific
hangover. Although there are many common symptoms experienced by most people
routinely, sometimes new symptoms appear that were never part of previous
hangovers. This is why it’s best to handle the symptoms vs. trying to recover
from a “hangover.”
So below is a list of
practices, substances, and products that deal with specific symptoms that
should help you fight the effects of hangover whenever they occur. You may also
want to go back and re-read this article as there were remedies – such as
eating before drinking, timing one’s intake per ounce of ingestion, and
preventing vomiting by abstinence in order to protect the stomach lining from
erosion by alcohol – mentioned earlier that will not appear in this list.
Rehydration: Effective
interventions include rehydration, prostaglandin inhibitors, and vitamin B6.
Milk thistle: A small
dosage before and after alcohol consumption has been found to alleviate the some
of the effects of a hangover such as headaches, sluggishness and nausea. Milk
thistle works to regenerate liver cells and when combined with an excessive
vitamin D intake from the sun, subjects have experienced rapidly decreasing
hangover effects.
Tolfenamic acid is
useful for nausea, vomiting, irritation, tremor, thirst, and dryness of mouth.
Vitamin B6
(pyritinol) can help to reduce some, but not all, of the symptoms of hangovers.
For this Brewers' yeast or a B6 supplement are recommended.
Chlormethiazole was found
to lower blood pressure and adrenaline output and, furthermore, to relieve
unpleasant physical symptoms, but did not affect fatigue and drowsiness.
Subjects with severe subjective hangover seemed to benefit more from the
chlormethiazole treatment than subjects with a mild hangover."
Pedialyte may be an
effective remedy for hangovers due to its replacement of lost electrolytes.
Candy or sugar: to raise
lowered blood sugar levels caused by alcohol intake. Other options for
sweeteners to use are honey, brown sugar, maple syrup, agave nectar, and
fructose.
Alcohol: There is a belief
that consumption of additional alcohol in decreasing quantity over a period of
hours after the onset of a hangover will relieve symptoms. This is based upon
the theory that the hangover represents a form of withdrawal and that by
satiating the body's need for alcohol the symptoms will be relieved. Certainly
the additional alcohol has a sedating and anesthetic effect, which also helps
with symptoms. The professional medical opinion holds that the practice merely
postpones the symptoms, and courts alcohol dependence and addiction.
Medical marijuana: It is
commonly believed that THC, the active chemical in marijuana, is an effective
hangover remedy. THC may help ease the main symptoms of hangovers: nausea and
headache. The advantage is two-fold; as once a sufferer's nausea has abated,
and his appetite is stimulated, hypoglycemia becomes easier to resolve.
A traditional hangover
remedy from India is to drink coconut water for the natural electrolytes which
will assist in rehydration.
Acetyl-leucine sold under
the brand name of Tanganil is believed to help pull you out of the
"whirling pit" or spinning sensation felt by people under the
influence of alcohol. This is caused by a dysfunction between the nerves which
control the notion of balance in the ears and the brain. Tanganil is the
standard remedy prescribed to people suffering from chronic vertigo.
Oxygen: There have been
anecdotal reports from those with easy access to a breathing oxygen supply —
medical staff, SCUBA divers and military pilots — that oxygen can also reduce
the symptoms of hangovers caused by alcohol consumption. The theory is that the
increased oxygen flow resulting from oxygen therapy improves the metabolic
rate, and thus increases the speed at which toxins are broken down.
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Marc
http://stereothesis.bandcamp.com/
Nice one! like it! Thanks! researchpaperspot
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