Tips to prevent a hangover

By Dr. Ananya Mandal, MDJan 2 2011

Festive season usually means hangovers. Most experts advise fluid replacement and adequate hydration as the sure shot cure.

Dr. Andrew Yacht, director of the division of general medicine and vice chair of medicine for education at Maimonides Medical Center in New York City said, “Alcohol clearly causes hangovers, but why it causes hangovers isn’t very well understood…Part of the suspected cause is dehydration and an electrolyte and hormonal imbalance. Some of the symptoms may be caused by low blood sugar. Or, it may be that the direct toxic effects of alcohol are causing the symptoms.”

Dr. Brandon Browne, a staff physician in the department of emergency medicine at Scott & White Healthcare in Round Rock, Tex added, “Alcohol is a diuretic, which means that it helps the body get rid of fluids. When you have a severe hangover, you’re often severely dehydrated, and the body can’t get rid of the by-products of metabolizing alcohol (metabolites). And those metabolites are irritating.”

Yacht explained, “The darker the alcohol, the more potential there is for a hangover. The theory is that the congeners - a by-product of distillation that imparts colour, taste and aroma - found in rum, red wine, brandy and whisky make a hangover more likely than if you drink clearer alcohol, such as vodka, white wine or gin.” In a study published earlier this year in Alcoholism: Clinical & Experimental Research, researchers found that when people drank enough to be intoxicated, drinking bourbon produced a more severe hangover than did drinking vodka. But Yacht cautioned, “It all comes down to volume.” No matter what the type of alcohol, if you drink too much, you will get a hangover.

U.S. National Institute on Alcohol Abuse and Alcoholism lists the symptoms of a hangover that include thirst, fatigue, inability to sleep, weakness, headache, muscle pain, irritability, nausea, vomiting, tummy ache, dizziness, hypersensitivity to light and sound, decreased concentration and focus etc.

Hangovers are not the only side effects of alcohol. Binge drinking leads to accidents, crashes, violence, sexual assaults, alcohol poisoning and over time, binge drinking can lead to liver disease, certain cancers, heart disease, and other chronic diseases.

Some tips to prevent and control a hangover include eating a meal before drinking. “Food helps slow the metabolism of alcohol,” said Yacht. A person should drink water, juice or another non-caffeinated beverage in between each alcoholic drink. This will slow alcohol consumption and also help to replace some of the lost fluids, he said. Browne also recommended, “Don’t drink large amounts of alcohol quickly. If you do, the liver gets slammed with alcohol and the alcohol gets absorbed more rapidly.”

Remedies for hangover usually do not work both the doctors said. Aspirin, ibuprofen or acetaminophen also do not help. The U.S. Food and Drug Administration also warns that if you consume more than three alcoholic beverages every day, consult with your doctor before taking acetaminophen at all. On a brighter note Yacht adds, “No matter what you do, a hangover will eventually get better.”

However Aaron Michelfelder, a family physician from Loyola University Health System in Maywood, Illinois disagrees saying, “A hangover is brain damage…Some of it is going to heal, and some will be permanent. Prevention is the best medicine, particularly with hangovers.” His advice is clear, “A hangover is similar to taking a sledgehammer and hitting your head…Do what you need to do not get a hangover. It’s unpleasant and it’s hard on your body.”