Strategies for a Hangover-Free Holiday Season
Old-fashioned remedies remain most effective prevention for hangovers
By Elizabeth Heubeck, MA
WebMD Weight Loss Clinic - Feature
Reviewed By Brunilda Nazario, MD
'Tis the season to celebrate -- but beware! One too many glasses of eggnog at the office holiday party, or a bit more bubbly than you anticipated on New Year's Eve, and you're likely to find yourself feeling less than cheerful the day after.
Want to prevent a hangover from dampening your holiday spirits? Read on to discover tried-and-true remedies that work, new methods meant to halt hangovers before they strike, and why too much alcohol causes so much misery in the first place.
If, while nursing a horrific hangover, you've ever asked yourself, "How a couple of seemingly harmless drinks could have led to such misery?" consider this: "Alcohol is poison. The hangover is your body recuperating from being poisoned by alcohol and its metabolites," Aaron White, PhD, assistant research professor at Duke University Medical Center, tells WebMD. Symptoms vary, but can include one or all of the following:
- Raging headaches. "Alcohol intoxication seems to produce dilation of the blood vessels that surround the brain, which may contribute to the headache in some people. Alcohol also has an effect on some neurotransmitters, increasing levels of serotonin or histamine that may trigger headaches," says Bruce Hetzler, PhD, psychology professor at Lawrence University.
- Dehydration. Ever wake up after a night of heavy alcohol consumption and wonder why you're tongue is stuck to the roof of your mouth? Dehydration, also partly to blame for headaches and nausea, is the culprit. It causes excess urination by stopping the release of a hormone that helps the body hold on to fluid. Also sweating, vomiting, and diarrhea that sometimes accompany excess drinking can cause a person to become dehydrated. The signs of dehydration can be dizziness, lightheadedness, thirst, and weakness -- symptoms that are felt during a hangover.
- Fatigue. The day after a night of drinking and revelry, you're probably wiped out. That's because alcohol disrupts sleep. Alcohol can work as a sedative to help promote sleep. But alcohol has an effect on sleep quality. "People who drink alcohol tend to have sleep maintenance insomnia -- you wake up too soon and then you can't get back to sleep," White says. That's not the only problem. "You don't spend as much time in 'slow wave', or REM, sleep," White explains. Vital for normal emotional and physical functioning, REM sleep (the dream phase) typically comprises between 20% and 25% of total sleep time.
A breakthrough study this year by Irish researchers Adele McKinney and Kieran Coyle showed that memory and psychomotor (fine motor) performance remain impaired the morning after heavy drinking, even when blood alcohol levels have dropped to zero or near zero.
Other studies have also shown that alcohol can interfere with normal 24-hour rhythms -- such as normal variations in heart rate and blood pressure seen at night. A racing heart can in extreme cases lead to a heart attack. Increased blood pressure and heart rate during a severe hangover can double the risk of a heart attack, reports Jeffrey Weise, associate professor of medicine at Tulane Health Sciences Center in New Orleans.
Who Is Susceptible to Hangovers?
Those two glasses of wine you had last night seemed innocent enough, or was it four? Most people who get hangovers have no intention of drinking too much. In fact, light to moderate drinkers are 70% more likely to get hangovers than heavy drinkers, according to Wiese.
Women bear a disproportionate burden of hangovers. "Alcohol produces a higher blood alcohol content in females than in males, due to several factors: weight, distribution of body fat, and the way our bodies metabolize alcohol," Hetzler tells WebMD.
Personality may also play a role in a hangover's severity. Recent research indicates that increased hangover symptoms occur more often in people who are neurotic, angry, and defensive.
But let's not fool ourselves. While certain characteristics may increase the risk of a hangover or worsen its effects, anyone who drinks to excess can incur the dreaded next-day menace.
Before the hangover hits, you can do some damage control. Here are some of the old-fashioned remedies you may have heard of that really work.
- Choose your beverage of choice wisely. "A couple of studies show that alcoholic beverages that are mainly just alcohol and water, like vodka and gin, produce less severe hangovers, while other compounds that contain congeners -- brandy, whisky, red wine, to name a few -- tend to produce more severe hangovers," Hetzler tells WebMD. What if you're a beer lover? "Beer has a relatively low congener level, although the heavier the beer, the more congener it contains," Hetzler says.
- Eat before you drink. "The alcohol is absorbed more slowly when you have food in your stomach," White tells WebMD. Exactly what should you eat? Whatever you want. "It's a myth that one type of food is better than another," he says.
- Pace yourself. White suggests having a nonalcoholic drink between each alcoholic beverage, which helps to maintain a low blood alcohol level, and keeps you hydrated.
- Replenish lost fluids. Before you put your head on the pillow, guzzle some water or other nonalcoholic drink, but avoid caffeine. Like alcohol, it has a diuretic effect and may contribute to hangover symptoms.
- Take over-the-counter pain relief before the headache hits. Experts warn, however, to avoid acetaminophen (Tylenol), a common aspirin alternative. "Too much acetaminophen is toxic to the liver. Alcohol can disrupt the metabolism of acetaminophen, making it even more toxic to the liver," White says. Although the risk of liver damage from the combination is minimal, it's possible, he explains.
New Hangover Prevention Strategies?
You may have seen ads for products that promise a night of excessive drinking with minimal hangover residue, simply by popping some pills or even changing the way you consume alcohol. But do they work?
As for the hangover prevention pills, many in the medical community remain unconvinced of their effectiveness. "They haven't been carefully studied," Hetzler says.
A few "hangover helper" pills contain a single key ingredient designed to ward off the unpleasant aftereffects of alcohol. Artichoke extract is one of them. While the product manufacturer touts this natural substance's effectiveness against hangovers, scientists at the UK's Peninsula Medical School found artichoke extract ineffective at curbing alcohol's aftereffects.
Of all the hangover helper pills, HPF Hangover Prevention Formula? -- an herbal supplement containing derivatives of the prickly pear cactus -- has shown the most promise. Researchers found it reduces three of nine hangover symptoms: nausea, dry mouth, and loss of appetite. It's believed to work by reducing the body's inflammatory response that alcohol causes.
But skepticism remains high.
"The supplement [HPF Hangover Prevention FormulaTM] is designed mostly to address allergic reactions that cause headaches. It does nothing for things like abstract memory impairment linked with learning, nothing for the central nervous system suppression, the diuretic effect, etc.," asserts Patrick Breslin, an alcohol and drug prevention facilitator at Western Wisconsin Technical College.
"The only evidence is their [manufacturers'] own internal reports. To the best of my knowledge, there's no evidence that there's any supplement you can take that will prevent a hangover. These claims have not stood up to scientific scrutiny by unbiased researchers," White tells WebMD. Incidentally, the study that demonstrated the prickly pear derivative's defense against hangovers was supported by the product's manufacturer.
If hangover prevention pills don't work, there's also a whole new way to consume alcohol intended to curb the nasty aftereffects of consumption. The alcohol-vapor machine, or "alcohol without liquid" (AWOL) device, works by turning shots of liquor into an inhaled alcohol mist. The vaporized alcohol then mixes with oxygen and is inhaled through a tube, creating an immediate high and, according to product claims, no hangover.
But is it safe? With AWOL, alcohol bypasses the liver, which normally filters the body's toxins, and goes directly into the brain -- even before reaching the bloodstream. That means someone heavily under the influence of AWOL could very likely pass a breathalyzer test if, in fact, the alcohol hadn't yet reached the bloodstream.
That's why Diageo, the world's leading beer, wine, and spirits company and an industry leader in promoting responsible drinking, recently announced that it supports proposed New York State legislation banning AWOL machines until further research clarifies possible risks. And, at least one New York City suburb has banned AWOL due to concerns over possible health risks.
So where does that leave those of us who want to dodge the hangover, despite having imbibed a bit more than planned? Resort to old-fashioned remedies. "Two aspirin, a glass of water, sleep, and a multivitamin in the morning -- if you can stomach it -- are probably the best things to do," Hetzler suggests.
SOURCES: Aaron White, PhD, assistant research professor, Duke University Medical Center. Bruce Hetzler, PhD, psychology professor, Lawrence University. Jeffrey Wiese, MD, associate professor of medicine, Tulane Health Sciences Center, New Orleans. Patrick Breslin, Alcohol, Tobacco, and Other Drug Problem Prevention Facilitator, Western Wisconsin Technical College. Adele McKinney and Kieran Coyle, researchers, department of mental health, Queens University Belfast.
©2004 WebMD Inc. All rights reserved.
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