The hangover is an interesting beast. Like Bigfoot, Sasquatch, and any other huge, hirsute crypto-hominid, nearly every culture and every nation has an extensive literature (whether it’s entombed in writing or not) on the subject of hangovers. After all, alcohol is the universal intoxicant, and hangovers are the inevitable consequence of overindulgence.
Or are they?
Mike, a reader, recently wrote to me with the tale of the missing hangover:
What is a hangover, exactly, why do they happen, and how can we prevent their occurrence or mitigate their severity?
Well, the obvious, absolutely foolproof way to prevent hangovers is to abstain from alcohol , but that’s not the focus of this post. We can avoid drink altogether and never get a hangover, sure, just like we can avoid any of the potentially negative consequences (unplanned pregnancy, disease) that accompany sexual intercourse by abstaining from any and all sex – but where’s the fun in that? People are going to drink, even healthy, Primal people, and it doesn’t help to simply say, “Don’t drink.” People drink. Let’s figure out how to manage this fact.
Your basic, garden variety hangover manifests in several classic symptoms: headaches, dry mouth, spacey-ness, fatigue, depressed mood, physical weakness, lack of concentration, sweating, anxiety, sensitivity to light and sound, irritability, extreme thirst, extreme hunger, among others. Some only get the headache and the fatigue, while others are sidelined with the whole shebang. Either way, a hangover absolutely and unequivocally sucks. Its only benefit may lie in its capacity as negative reinforcement for the next time you decide to binge.
Diuresis and Dehydration
The presence of ethanol (alcohol) in the body induces diuresis, or an increase in urination. We’ve all noticed this. You’re having a few with friends and having to head off to the bathroom in between each drink, where you find yourself expelling more liquid than you’re taking in. What gives? Ethanol inhibits the secretion of antidiuretic hormone (ADH, or vasopressin) by the pituitary; this is the hormone that keeps you from wetting yourself, and without it, the kidneys send water straight to the bladder, bypassing absorption by the body. When you urinate from ethanol-induced diuresis, it’s mostly water (notice the color – it’s very light), along with electrolytes necessary for proper bodily function. This leads to dehydration, which in turn leads to headaches (the thirsty body draws water from the brain, constricting it), fatigue, dizziness (lack of potassium and sodium will do that to ya), and dry mouth. Sound familiar?
Toxic Acetaldehyde Build-up
Another source of hangover woes comes from acetaldehyde, which is created when an enzyme called alcohol dehydrogenase breaks down ethanol in the liver. Acetaldehyde is far more toxic than ethanol itself, so the body then releases acetaldehyde dehydrogenase and glutathione to break down the acetaldehyde. If you stick to just a few drinks and space them out accordingly, your body’s natural enzyme production can keep up. If you start binging, though, glutathione stores become overwhelmed and the liver must produce more. Meanwhile, acetaldehyde, which is between 10-30 times more toxic than ethanol , accrues in your body. Certain groups are underequipped to deal with alcohol, however. Women, for example, produce smaller amounts of acetaldehyde dehydrogenase and glutathione than men, making them more susceptible to hangovers. Many people of East Asian descent possess incredibly efficient alcohol dehydrogenase genes, thus increasing the amount of acetaldehyde produced from ethanol. Roughly half of those folks have inefficient acetaldehyde dehydrogenase genes, however, thus decreasing the amount of acetaldehyde that can be broken down. When these people drink, acetaldehyde accumulates faster and stays there longer, leading to an instant hangover.
During fermentation and distillation, congeners – or byproducts of the processes – are produced. Congeners can include acetone, acetaldehyde, tannins, and even flavorants used to distinguish drinks. As a general rule, darker liquors contain higher levels of congeners, with brandy ranking highest. One study showed that whiskey drinkers suffered worse hangovers than vodka drinkers when both groups were given equal amounts of alcohol, with the higher levels of whiskey congeners taking the blame. Red wine , which tends to be high in tannins, is another famous hangover-inducer. The basic effect of ethanol-induced diuresis is enough to cause a hangover, but it seems that congeners can make things even worse.
Okay, so we’ve established why hangovers hurt as much as they do, but what can we do about them?
Basic Preventive Measures
There are some tried and trued methods of preventing hangovers from even occurring in the first place. Depending on your sensitivity to liquor (and, possibly, the congener levels in your drink of choice), you can usually avoid most hangover related problems by following some basic guidelines:.
More Advanced Preventive Measures
You can’t always avoid hangovers. For some, they are inevitable, along with death and taxes. If you’ve got a hangover, here are the basic ways to improve your situation, and I won’t mention the stuff annoying people always suggest, like “time” or “prevention” (however accurate they may be).
What Not to Do