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Hangover

Hangover

Overview
A hangover describes the sum of unpleasant physiological effects following heavy consumption of alcoholic beverage
Alcoholic beverage
An alcoholic beverage is a drink containing ethanol, commonly known as alcohol. Alcoholic beverages are divided into three general classes: beers, wines, and spirits. They are legally consumed in most countries, and over 100 countries have laws regulating their production, sale, and consumption...

s. The most commonly reported characteristics of a hangover include headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...

, nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...

, sensitivity to light
Photophobia
Photophobia is a symptom of abnormal intolerance to visual perception of light. As a medical symptom photophobia is not a morbid fear or phobia, but an experience of discomfort or pain to the eyes due to light exposure or by presence of actual physical photosensitivity of the eyes, though the term...

 and noise, lethargy, dysphoria
Dysphoria
Dysphoria is medically recognized as a mental and emotional condition in which a person experiences intense feelings of depression, discontent and indifference to the world around them.Mood disorders can induce dysphoria, often with a heightened risk of suicide, especially in...

, diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

 and thirst
Thirst
Thirst is the craving for fluids, resulting in the basic instinct of animals to drink. It is an essential mechanism involved in fluid balance. It arises from a lack of fluids and/or an increase in the concentration of certain osmolites, such as salt...

, typically after the intoxicating effect of the alcohol begins to wear off. While a hangover can be experienced at any time, generally speaking a hangover is experienced the morning after a night of heavy drinking. In addition to the physical symptoms, a hangover may also induce psychological symptoms including heightened feelings of depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...

 and anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

.
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Encyclopedia
A hangover describes the sum of unpleasant physiological effects following heavy consumption of alcoholic beverage
Alcoholic beverage
An alcoholic beverage is a drink containing ethanol, commonly known as alcohol. Alcoholic beverages are divided into three general classes: beers, wines, and spirits. They are legally consumed in most countries, and over 100 countries have laws regulating their production, sale, and consumption...

s. The most commonly reported characteristics of a hangover include headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...

, nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...

, sensitivity to light
Photophobia
Photophobia is a symptom of abnormal intolerance to visual perception of light. As a medical symptom photophobia is not a morbid fear or phobia, but an experience of discomfort or pain to the eyes due to light exposure or by presence of actual physical photosensitivity of the eyes, though the term...

 and noise, lethargy, dysphoria
Dysphoria
Dysphoria is medically recognized as a mental and emotional condition in which a person experiences intense feelings of depression, discontent and indifference to the world around them.Mood disorders can induce dysphoria, often with a heightened risk of suicide, especially in...

, diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

 and thirst
Thirst
Thirst is the craving for fluids, resulting in the basic instinct of animals to drink. It is an essential mechanism involved in fluid balance. It arises from a lack of fluids and/or an increase in the concentration of certain osmolites, such as salt...

, typically after the intoxicating effect of the alcohol begins to wear off. While a hangover can be experienced at any time, generally speaking a hangover is experienced the morning after a night of heavy drinking. In addition to the physical symptoms, a hangover may also induce psychological symptoms including heightened feelings of depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...

 and anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

.

Hypoglycemia
Hypoglycemia
Hypoglycemia or hypoglycæmia is the medical term for a state produced by a lower than normal level of blood glucose. The term literally means "under-sweet blood"...

, dehydration
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...

, acetaldehyde
Acetaldehyde
Acetaldehyde is an organic chemical compound with the formula CH3CHO or MeCHO. It is one of the most important aldehydes, occurring widely in nature and being produced on a large scale industrially. Acetaldehyde occurs naturally in coffee, bread, and ripe fruit, and is produced by plants as part...

 intoxication, and glutamine
Glutamine
Glutamine is one of the 20 amino acids encoded by the standard genetic code. It is not recognized as an essential amino acid but may become conditionally essential in certain situations, including intensive athletic training or certain gastrointestinal disorders...

 rebound are all theorized causes of hangover symptoms. Hangover symptoms may persist for several days after alcohol was last consumed. Approximately 25-30% of drinkers may be resistant to hangover symptoms. Some aspects of a hangover are viewed as symptoms of acute ethanol withdrawal, similar to the longer-duration effects of withdrawal from alcoholism
Alcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...

, as determined by studying the increases in brain reward thresholds in rats (the amount of current required to receive from two electrodes implanted in the lateral hypothalamus
Hypothalamus
The Hypothalamus is a portion of the brain that contains a number of small nuclei with a variety of functions...

) following ethanol injection. Dehydration is caused by alcohol's ability to inhibit the effect of anti-diuretic hormone
Vasopressin
Arginine vasopressin , also known as vasopressin, argipressin or antidiuretic hormone , is a neurohypophysial hormone found in most mammals, including humans. Vasopressin is a peptide hormone that controls the reabsorption of molecules in the tubules of the kidneys by affecting the tissue's...

 on kidney tubules, which leads to a hyperosmolar state, which in turn causes shrinking of (by loss of water) the brain cells which causes hangover.

Symptoms


An alcohol
Ethanol
Ethanol, also called ethyl alcohol, pure alcohol, grain alcohol, or drinking alcohol, is a volatile, flammable, colorless liquid. It is a psychoactive drug and one of the oldest recreational drugs. Best known as the type of alcohol found in alcoholic beverages, it is also used in thermometers, as a...

 hangover is associated with a variety of symptoms that may include dehydration
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...

, fatigue, headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...

, body aches, vomiting
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...

, diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

, flatulence
Flatulence
Flatulence is the expulsion through the rectum of a mixture of gases that are byproducts of the digestion process of mammals and other animals. The medical term for the mixture of gases is flatus, informally known as a fart, or simply gas...

, weakness
Weakness
Weakness is a symptom represented, medically, by a number of different conditions, including: lack of muscle strength, malaise, dizziness, or fatigue. The causes are many and can be divided into conditions that have true or perceived muscle weakness. True muscle weakness is a primary symptom of a...

, elevated body temperature and heart rate
Heart rate
Heart rate is the number of heartbeats per unit of time, typically expressed as beats per minute . Heart rate can vary as the body's need to absorb oxygen and excrete carbon dioxide changes, such as during exercise or sleep....

, hypersalivation
Hypersalivation
Hypersalivation is excessive production of saliva. It has also been defined as increased amount of saliva in the mouth, which may also be caused by decreased clearance of saliva....

, difficulty concentrating, sweating, anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

, dysphoria
Dysphoria
Dysphoria is medically recognized as a mental and emotional condition in which a person experiences intense feelings of depression, discontent and indifference to the world around them.Mood disorders can induce dysphoria, often with a heightened risk of suicide, especially in...

, irritability
Irritability
Irritability is an excessive response to stimuli. The term is used for both the physiological reaction to stimuli and for the pathological, abnormal or excessive sensitivity to stimuli; It is usually used to refer to anger or frustration....

, sensitivity to light and noise, erratic motor functions (including tremor
Tremor
A tremor is an involuntary, somewhat rhythmic, muscle contraction and relaxation involving to-and-fro movements of one or more body parts. It is the most common of all involuntary movements and can affect the hands, arms, eyes, face, head, vocal folds, trunk, and legs. Most tremors occur in the...

), trouble sleeping, severe hunger, halitosis
Halitosis
Halitosis is a term used to describe noticeably unpleasant odors exhaled in breathing. Halitosis is estimated to be the third most frequent reason for seeking dental aid, following tooth decay and periodontal disease.- General :...

, 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.

Causes


Ethanol has a dehydrating
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...

 effect by causing increased urine production (diuresis
Diuretic
A diuretic provides a means of forced diuresis which elevates the rate of urination. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way.- Medical uses :...

), which causes headaches, dry mouth, and lethargy. Dehydration also causes fluids in the brain to be less plentiful. This can be mitigated by drinking water
Water
Water is a chemical substance with the chemical formula H2O. A water molecule contains one oxygen and two hydrogen atoms connected by covalent bonds. Water is a liquid at ambient conditions, but it often co-exists on Earth with its solid state, ice, and gaseous state . Water also exists in a...

 before, during and after consumption of alcohol. Alcohol's effect on the stomach lining can account for nausea.

Another contributing factor is the presence of products from the breakdown of ethanol by liver enzymes. Ethanol is converted to acetaldehyde
Acetaldehyde
Acetaldehyde is an organic chemical compound with the formula CH3CHO or MeCHO. It is one of the most important aldehydes, occurring widely in nature and being produced on a large scale industrially. Acetaldehyde occurs naturally in coffee, bread, and ripe fruit, and is produced by plants as part...

 by the enzyme alcohol dehydrogenase, and then from acetaldehyde to acetic acid
Acetic acid
Acetic acid is an organic compound with the chemical formula CH3CO2H . It is a colourless liquid that when undiluted is also called glacial acetic acid. Acetic acid is the main component of vinegar , and has a distinctive sour taste and pungent smell...

 by the enzyme acetaldehyde dehydrogenase
Acetaldehyde dehydrogenase
Acetaldehyde dehydrogenases are dehydrogenase enzymes which catalyze the conversion of acetaldehyde into acetic acid. The oxidation of acetaldehyde to acetate can be summarized as follows:...

. Acetaldehyde (ethanal) is between 10 and 30 times more toxic than alcohol itself.

These two reactions also require the conversion of NAD+ to NADH
Nicotinamide adenine dinucleotide
Nicotinamide adenine dinucleotide, abbreviated NAD, is a coenzyme found in all living cells. The compound is a dinucleotide, since it consists of two nucleotides joined through their phosphate groups. One nucleotide contains an adenine base and the other nicotinamide.In metabolism, NAD is involved...

. With an excess of NADH, three enzymes of the Citric Acid Cycle
Citric acid cycle
The citric acid cycle — also known as the tricarboxylic acid cycle , the Krebs cycle, or the Szent-Györgyi-Krebs cycle — is a series of chemical reactions which is used by all aerobic living organisms to generate energy through the oxidization of acetate derived from carbohydrates, fats and...

 are inhibited (citrate synthase
Citrate synthase
The enzyme citrate synthase exists in nearly all living cells and stands as a pace-making enzyme in the first step of the Citric Acid Cycle . Citrate synthase is localized within eukaryotic cells in the mitochondrial matrix, but is encoded by nuclear DNA rather than mitochondrial...

, isocitrate dehydrogenase
Isocitrate dehydrogenase
Isocitrate dehydrogenase and , also known as IDH, is an enzyme that participates in the citric acid cycle. It catalyzes the third step of the cycle: the oxidative decarboxylation of isocitrate, producing alpha-ketoglutarate and CO2 while converting NAD+ to NADH...

, and alpha-ketoglutarate dehydrogenase) essentially shutting it down. Pyruvate (the end product of glycolysis) starts to accumulate, and the excess NADH drives lactate dehydrogenase
Lactate dehydrogenase
Lactate dehydrogenase is an enzyme present in a wide variety of organisms, including plants and animals.Lactate dehydrogenases exist in four distinct enzyme classes. Two of them are cytochrome c-dependent enzymes, each acting on either D-lactate or L-lactate...

 to produce lactate from pyruvate in order to regenerate NAD+ and sustain life. This diverts pyruvate from other pathways such as gluconeogenesis, thereby impairing the ability of the liver to compensate for a drop in blood glucose levels, especially for the brain. Because glucose is the primary energy source of the brain, this lack of glucose (hypoglycemia
Hypoglycemia
Hypoglycemia or hypoglycæmia is the medical term for a state produced by a lower than normal level of blood glucose. The term literally means "under-sweet blood"...

) contributes to symptoms such as fatigue, weakness, mood disturbances, and decreased attention and concentration.

Alcohol consumption can result in depletion of the liver's supply of glutathione
Glutathione
Glutathione is a tripeptide that contains an unusual peptide linkage between the amine group of cysteine and the carboxyl group of the glutamate side-chain...

 and other reductive detoxification agents, reducing its ability to effectively remove acetaldehyde and other toxins from the bloodstream. Additionally, alcohol induces the CYP2E1
CYP2E1
Cytochrome P450 2E1 , a member of the cytochrome P450 mixed-function oxidase system, is involved in the metabolism of xenobiotics in the body. In humans, the CYP2E1 enzyme is encoded by the CYP2E1 gene...

 enzyme, which itself can produce additional toxins and free radicals.

In addition, it is thought that the presence of other alcohols (fusel oils) and other by-products of alcoholic fermentation
Fermentation (food)
Fermentation in food processing typically is the conversion of carbohydrates to alcohols and carbon dioxide or organic acids using yeasts, bacteria, or a combination thereof, under anaerobic conditions. Fermentation in simple terms is the chemical conversion of sugars into ethanol...

 (also called congener
Congener
Congener has several different meanings depending on the field in which it is used. Colloquially, it is used to mean a person or thing like another, in character or action.-Biology:In biology, congeners are organisms within the same genus...

s), exaggerate many of the symptoms; this probably accounts for the mitigation of the effects when distilled alcohol, particularly vodka
Vodka
Vodka , is a distilled beverage. It is composed primarily of water and ethanol with traces of impurities and flavorings. Vodka is made by the distillation of fermented substances such as grains, potatoes, or sometimes fruits....

, is consumed instead. A 2009 study provided evidence that darker-coloured liquors, such as bourbon, cause worse hangovers than lighter-coloured 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; brandy. In a 2006 study, an average of 14 standard drinks (330 ml bottles) of beer was needed to produce a hangover, compared with only 7 to 8 drinks of wine or liquor. One potent congener is methanol
Methanol
Methanol, also known as methyl alcohol, wood alcohol, wood naphtha or wood spirits, is a chemical with the formula CH3OH . It is the simplest alcohol, and is a light, volatile, colorless, flammable liquid with a distinctive odor very similar to, but slightly sweeter than, ethanol...

. It is naturally formed in small quantities during fermentation and it can be accidentally concentrated by improper distillation techniques. Metabolism of methanol produces an extremely toxic compound, formaldehyde
Formaldehyde
Formaldehyde is an organic compound with the formula CH2O. It is the simplest aldehyde, hence its systematic name methanal.Formaldehyde is a colorless gas with a characteristic pungent odor. It is an important precursor to many other chemical compounds, especially for polymers...

; however, its metabolism is suppressed when ethanol is present in the bloodstream. This is thought to provide a mechanism for hangover that starts when blood alcohol content approaches zero and can be "cured" by alcohol.

Most people of East Asia
East Asia
East Asia or Eastern Asia is a subregion of Asia that can be defined in either geographical or cultural terms...

n descent have a mutation
Mutation
In molecular biology and genetics, mutations are changes in a genomic sequence: the DNA sequence of a cell's genome or the DNA or RNA sequence of a virus. They can be defined as sudden and spontaneous changes in the cell. Mutations are caused by radiation, viruses, transposons and mutagenic...

 in their alcohol dehydrogenase
Alcohol dehydrogenase
Alcohol dehydrogenases are a group of dehydrogenase enzymes that occur in many organisms and facilitate the interconversion between alcohols and aldehydes or ketones with the reduction of nicotinamide adenine dinucleotide...

 gene
Gene
A gene is a molecular unit of heredity of a living organism. It is a name given to some stretches of DNA and RNA that code for a type of protein or for an RNA chain that has a function in the organism. Living beings depend on genes, as they specify all proteins and functional RNA chains...

 that makes this enzyme unusually effective at converting ethanol to acetaldehyde, and about half of such people also have a form of acetaldehyde dehydrogenase
Acetaldehyde dehydrogenase
Acetaldehyde dehydrogenases are dehydrogenase enzymes which catalyze the conversion of acetaldehyde into acetic acid. The oxidation of acetaldehyde to acetate can be summarized as follows:...

 that is less effective at converting acetaldehyde to acetic acid. This combination causes them to suffer from alcohol flush reaction
Alcohol flush reaction
Alcohol flush reaction or Oriental Flushing Syndrome is a condition in which the face and/or body experiences flushes or blotches, due to an accumulation of acetaldehyde...

, in which acetaldehyde accumulates after drinking, leading to immediate and severe hangover symptoms. These people are therefore less likely to become alcoholics.

It is often said that hangovers grow worse as one ages; this is thought to be caused by declining supplies of alcohol dehydrogenase, the enzyme involved in metabolizing alcohol.

However, in a model of migraine, it was demonstrated that acetate is the primary metabolite of alcohol responsible for alcohol induced periorbital hypersensitivity. Furthermore, in the same model they recapitulated the effectiveness of caffeine, ketorolac for ameliorating this hypersensitivity. This model raises questions about the status quo hypothesis of hangover headache.

Possible remedies



Hangovers are poorly understood from a medical point of view. Health care professionals prefer to study alcohol abuse from a standpoint of treatment and prevention, and there is a view that the hangover provides a useful, natural and intrinsic disincentive to excessive drinking.

Within the limited amount of serious study on the subject, there is debate about whether a hangover might be prevented or at least mitigated; additionally, there is a vast body of folk medicine
Folk medicine
-Description:Refers to healing practices and ideas of body physiology and health preservation known to a limited segment of the population in a culture, transmitted informally as general knowledge, and practiced or applied by anyone in the culture having prior experience.All cultures and societies...

 and simple quackery
Quackery
Quackery is a derogatory term used to describe the promotion of unproven or fraudulent medical practices. Random House Dictionary describes a "quack" as a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or...

. There is currently no empirically proven mechanism for prevention except reducing the amount of ethanol consumed, or for making oneself sober
Sobriety
Sobriety is the condition of not having any measurable levels, or effects from, alcohol or other drugs that alter ones mood or behaviors. According to WHO "Lexicon of alcohol and drug terms..." sobriety is continued abstinence from alcohol and psychoactive drug use...

 other than waiting for the body to metabolize ingested alcohol, which occurs via oxidation through the liver before alcohol leaves the body. A four-page literature review in British Medical Journal
British Medical Journal
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...

concludes: "No compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover. The most effective way to avoid the symptoms of alcohol induced hangover is to avoid drinking."

Potentially beneficial remedies

  • Rehydration: "Effective interventions include rehydration, prostaglandin inhibitors, and vitamin B6".
  • Tolfenamic acid
    Tolfenamic acid
    Tolfenamic acid is one of the class of non-steroidal anti-inflammatory drugs . It is used to treat the symptoms of migraine.- Other possible uses :...

     (TA): A study concludes, "TA was found significantly better than placebo in the subjective evaluation of drug efficacy (p
    P-value
    In statistical significance testing, the p-value is the probability of obtaining a test statistic at least as extreme as the one that was actually observed, assuming that the null hypothesis is true. One often "rejects the null hypothesis" when the p-value is less than the significance level α ,...

     < 0.001) and in reducing the reported hangover symptoms in general (p < 0.01). In the TA group, significantly lower symptom scores were obtained for headache (p < 0.01), and for nausea, vomiting, irritation, tremor, thirst, and dryness of mouth (all p < 0.05)."
  • Vitamin B6
    Vitamin B6
    Vitamin B6 is a water-soluble vitamin and is part of the vitamin B complex group. Several forms of the vitamin are known, but pyridoxal phosphate is the active form and is a cofactor in many reactions of amino acid metabolism, including transamination, deamination, and decarboxylation...

     (pyritinol): Some studies have found large doses of Vitamin B6 (several hundred times the recommended daily intake) can help to reduce hangovers.
  • Chlormethiazole: "Chlormethiazole was found to lower blood pressure and adrenaline output and, furthermore, to relieve unpleasant physical symptoms, but did not affect fatigue and drowsiness. The cognitive test results were only slightly influenced by this agent, while psychomotor performance was significantly impaired. Subjects with severe subjective hangover seemed to benefit more from the chlormethiazole treatment than subjects with a mild hangover." "However, all 8 subjects had unpleasant nasal symptoms following chlormethiazole, and it is therefore not an ideal hypnotic for this age group."
  • Pedialyte
    Pedialyte
    Pedialyte is an oral electrolyte solution manufactured by Abbott Laboratories and invented by Gary Cohen, MD of Swampscott, Massachusetts, which is designed to replace fluids and minerals that are lost when a child has diarrhea with or without vomiting...

    : Pedialyte may be an effective remedy for hangovers due to its replacement of lost electrolytes.
  • Hair of the dog
    Hair of the dog
    "Hair of the dog" is a colloquial expression in the English language predominantly used to refer to alcohol that is consumed with the aim of lessening the effects of a hangover. The expression originally referred to a method of treatment of a rabid dog bite by placing hair from the dog in the...

    : The belief that consumption of further alcohol after the onset of a hangover will relieve symptoms, based upon the theory that hangover represents a form of withdrawal
    Withdrawal
    Withdrawal can refer to any sort of separation, but is most commonly used to describe the group of symptoms that occurs upon the abrupt discontinuation/separation or a decrease in dosage of the intake of medications, recreational drugs, and alcohol...

     and that by satiating the body's need for alcohol the symptoms will be relieved. Certainly the additional alcohol has a sedating and anaesthetic effect. While the practice is affirmed by tradition and by many hospitality providers, medical opinion holds that the practice merely postpones the symptoms, and courts addiction. Favored choices include Fernet Branca
    Fernet Branca
    Fernet is a type of amaro, a bitter, aromatic spirit. Fernet is made from a number of herbs and spices which vary according to the brand, but usually include myrrh, rhubarb, chamomile, cardamom, aloe, and especially saffron, with a base of grape distilled spirits, and coloured with caramel colouring...

     and Bloody Mary
    Bloody Mary (cocktail)
    A Bloody Mary is a popular cocktail containing vodka, tomato juice, and usually other spices or flavorings such as Worcestershire sauce, Peri-Peri Sauce, Tabasco sauce, beef consomme or bouillon, horseradish, celery, olive, salt, black pepper, cayenne pepper, lemon juice, and celery salt...

    .
  • Food
    Food
    Food is any substance consumed to provide nutritional support for the body. It is usually of plant or animal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals...

     and water
    Water
    Water is a chemical substance with the chemical formula H2O. A water molecule contains one oxygen and two hydrogen atoms connected by covalent bonds. Water is a liquid at ambient conditions, but it often co-exists on Earth with its solid state, ice, and gaseous state . Water also exists in a...

    : consumption of foods such as eggs, which contain cysteine
    Cysteine
    Cysteine is an α-amino acid with the chemical formula HO2CCHCH2SH. It is a non-essential amino acid, which means that it is biosynthesized in humans. Its codons are UGU and UGC. The side chain on cysteine is thiol, which is polar and thus cysteine is usually classified as a hydrophilic amino acid...

    , and water may be enough to replenish lost moisture and at least rehydrate the body, making a hangover shorter. A traditional hangover remedy in India is coconut water
    Coconut water
    Coconut water is the clear liquid inside young coconuts . As the fruit matures, the coconut water is gradually replaced by the coconut meat and air. A very young coconut has very little meat; the meat that it has is very tender, almost a gel...

    , the natural electrolyte
    Electrolyte
    In chemistry, an electrolyte is any substance containing free ions that make the substance electrically conductive. The most typical electrolyte is an ionic solution, but molten electrolytes and solid electrolytes are also possible....

    s of which will assist in rehydration of the body. A bacon
    Bacon
    Bacon is a cured meat prepared from a pig. It is first cured using large quantities of salt, either in a brine or in a dry packing; the result is fresh bacon . Fresh bacon may then be further dried for weeks or months in cold air, boiled, or smoked. Fresh and dried bacon must be cooked before eating...

     sandwich has also been claimed to effectively relieve hangovers.
  • Oxygen
    Oxygen therapy
    Oxygen therapy is the administration of oxygen as a medical intervention, which can be for a variety of purposes in both chronic and acute patient care...

    : There have been anecdotal reports from those with easy access to a breathing oxygen supply — medical staff, SCUBA divers
    Scuba diving
    Scuba diving is a form of underwater diving in which a diver uses a scuba set to breathe underwater....

     and military pilots — that oxygen can also reduce the symptoms of hangovers sometimes 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. However, one source states that (in an aviation context) oxygen has no effect on physical impairment caused by hangover.
  • Rosiglitazone
    Rosiglitazone
    Rosiglitazone is an antidiabetic drug in the thiazolidinedione class of drugs. It works as an insulin sensitizer, by binding to the PPAR receptors in fat cells and making the cells more responsive to insulin...

    : [Study in rats] "Rosiglitazone alleviated the symptoms of ethanol-induced hangover by inducing ALD2 expression..."
  • Acetylcysteine: There are claims that N-acetylcysteine can relieve or prevent symptoms of hangover through scavenging of acetylaldehyde, particularly when taken concurrently with alcohol. Additional reduction in acetaldehyde toxicity can be achieved if NAC is taken in conjunction with vitamin B1 (thiamine).

Ineffective or unproven remedies


Recommendations for foods, drinks and activities to relieve hangover symptoms abound. The ancient Romans
Ancient Rome
Ancient Rome was a thriving civilization that grew on the Italian Peninsula as early as the 8th century BC. Located along the Mediterranean Sea and centered on the city of Rome, it expanded to one of the largest empires in the ancient world....

, on the authority of Pliny the Elder
Pliny the Elder
Gaius Plinius Secundus , better known as Pliny the Elder, was a Roman author, naturalist, and natural philosopher, as well as naval and army commander of the early Roman Empire, and personal friend of the emperor Vespasian...

, favored raw owl
Owl
Owls are a group of birds that belong to the order Strigiformes, constituting 200 bird of prey species. Most are solitary and nocturnal, with some exceptions . Owls hunt mostly small mammals, insects, and other birds, although a few species specialize in hunting fish...

's eggs or fried canary, while the "Prairie Oyster
Prairie oyster (cocktail)
A Prairie Oyster is a drink consisting of a raw egg, Worcestershire sauce, hot sauce, salt and ground black pepper. The egg is broken into a glass so as not to break the yolk, which causes the drink to bear a similarity to the texture of an actual oyster...

" restorative, introduced at the 1878 Paris World Exposition, calls for raw egg yolk mixed with Worcestershire sauce
Worcestershire sauce
Worcestershire sauce , or Worcester sauce is a fermented liquid condiment; primarily used to flavour meat or fish dishes.First made at 60 Broad Street, Worcester, England, by two dispensing chemists, John Wheeley Lea and William Henry Perrins, the Lea & Perrins brand was commercialised in 1837 and...

, Tabasco sauce
Tabasco sauce
Tabasco sauce is the brand name for a hot sauce produced by US-based McIlhenny Company of Avery Island, Louisiana. Tabasco sauce is made from tabasco peppers , vinegar, and salt, and aged in white oak barrels for three years. It has a hot, spicy flavor...

, salt and pepper. By 1938, the Ritz-Carlton
Ritz-Carlton
The Ritz-Carlton is a brand of luxury hotels and resorts with 75 properties located in major cities and resorts in 24 countries worldwide...

 Hotel provided a hangover remedy in the form of a mixture of Coca-Cola
Coca-Cola
Coca-Cola is a carbonated soft drink sold in stores, restaurants, and vending machines in more than 200 countries. It is produced by The Coca-Cola Company of Atlanta, Georgia, and is often referred to simply as Coke...

 and milk (Coca-Cola itself having been invented, by some accounts, as a hangover remedy). Alcoholic writer Ernest Hemingway
Ernest Hemingway
Ernest Miller Hemingway was an American author and journalist. His economic and understated style had a strong influence on 20th-century fiction, while his life of adventure and his public image influenced later generations. Hemingway produced most of his work between the mid-1920s and the...

 relied on tomato juice and beer. Certain mixtures were developed specifically for the purpose. The "Black Velvet" consists of equal parts champagne and flat Guinness Stout, A 1957 survey by a Wayne State University
Wayne State University
Wayne State University is a public research university located in Detroit, Michigan, United States, in the city's Midtown Cultural Center Historic District. Founded in 1868, WSU consists of 13 schools and colleges offering more than 400 major subject areas to over 32,000 graduate and...

 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 steambath 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).

Other untested or discredited treatments include:
  • Globe artichoke
    Globe artichoke
    The globe artichoke is a perennial thistle of the Cynara genus originating in Southern Europe around the Mediterranean. It grows to tall, with arching, deeply lobed, silvery, glaucous-green leaves long. The flowers develop in a large head from an edible bud about diameter with numerous...

     (Cynara scolymus) extract: "Our results suggest that artichoke extract is not effective in preventing the signs and symptoms of alcohol-induced hangover."
  • Propranolol: "We conclude that propranolol does not prevent the symptoms of hangover."
  • Fructose
    Fructose
    Fructose, or fruit sugar, is a simple monosaccharide found in many plants. It is one of the three dietary monosaccharides, along with glucose and galactose, that are absorbed directly into the bloodstream during digestion. Fructose was discovered by French chemist Augustin-Pierre Dubrunfaut in 1847...

     and glucose
    Glucose
    Glucose is a simple sugar and an important carbohydrate in biology. Cells use it as the primary source of energy and a metabolic intermediate...

    : 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
    Honey
    Honey is a sweet food made by bees using nectar from flowers. The variety produced by honey bees is the one most commonly referred to and is the type of honey collected by beekeepers and consumed by humans...

     (a significant fructose and glucose source) is often suggested as a way to reduce the effect of hangovers.
  • Kudzu
    Kudzu
    Kudzu is a plant in the genus Pueraria in the pea family Fabaceae, subfamily Faboideae. It is a climbing, coiling, and trailing vine native to southern Japan and southeast China. Its name comes from the Japanese name for the plant, . It is a weed that climbs over trees or shrubs and grows so...

     (Pueraria montana var. lobata): The main ingredient in remedies such as kakkonto
    Kakkonto
    Kakkonto is an herbal drink with its origin in traditional Chinese medicine. It is made from a mixture of ginger, cinnamon, Chinese peony, licorice, jujube, ephedra, and powder ground from the root of the kudzu plant, one of the 50 fundamental herbs...

    . A study concluded, "The chronic usage of Pueraria lobata at times of high ethanol consumption, such as in hangover remedies, may predispose subjects to an increased risk of acetaldehyde-related neoplasm and pathology. ... Pueraria lobata appears to be an inappropriate herb for use in herbal hangover remedies as it is an inhibitor of ALDH2."

See also

  • Binge drinking
    Binge drinking
    Binge drinking or heavy episodic drinking is the modern epithet for drinking alcoholic beverages with the primary intention of becoming intoxicated by heavy consumption of alcohol over a short period of time. It is a kind of purposeful drinking style that is popular in several countries worldwide,...

  • Blood alcohol content
    Blood alcohol content
    Blood alcohol content , also called blood alcohol concentration, blood ethanol concentration, or blood alcohol level is most commonly used as a metric of alcohol intoxication for legal or medical purposes....

  • Food drunk
    Food drunk
    Food drunk is a term used to describe the physiological state of a person after consuming large amounts of food.-Symptoms:Most commonly described as being both a satisfying and tiring feeling.-Historical meaning:...

  • Hair of the dog
    Hair of the dog
    "Hair of the dog" is a colloquial expression in the English language predominantly used to refer to alcohol that is consumed with the aim of lessening the effects of a hangover. The expression originally referred to a method of treatment of a rabid dog bite by placing hair from the dog in the...

  • The Hangovers
    The Hangovers
    The Hangovers are a subset of the Cornell University Glee Club, the oldest student organization at Cornell University, and were themselves founded in 1968. The Hangovers' repertoire consists mainly of popular songs arranged for a cappella by members and alumni of the group, but they also perform...


External links



  • "Alcohol Hangover: Mechanisms and Mediators" [PDF] by Robert Swift, M.D., Ph.D. and Dena Davidson, Ph.D., NIAAA Alcohol Health and Research World, January 14, 2002, retrieved November 22, 2004.
  • "The party's over: Advice on treating hangovers" by Dr. Thomas Stuttaford
    Thomas Stuttaford
    Dr Irving Thomas Stuttaford OBE, is a British doctor, author, medical columnist of The Times and former Conservative Member of Parliament. In 2002 he retired as Senior Medical Advisor for Barclays Bank.-Politics:...

    , The Times
    The Times
    The Times is a British daily national newspaper, first published in London in 1785 under the title The Daily Universal Register . The Times and its sister paper The Sunday Times are published by Times Newspapers Limited, a subsidiary since 1981 of News International...

    , December 13, 2004 retrieved August 24, 2005. A colorful article on hangovers, their cause and treatment along with reference to famous Soho
    Soho
    Soho is an area of the City of Westminster and part of the West End of London. Long established as an entertainment district, for much of the 20th century Soho had a reputation for sex shops as well as night life and film industry. Since the early 1980s, the area has undergone considerable...

     residents, such as Jeffrey Bernard
    Jeffrey Bernard
    Jeffrey Bernard was a British journalist, best known for his weekly column "Low Life" in the Spectator magazine, and also notorious for a feckless and chaotic career and life of alcohol abuse. He became associated with the louche and bohemian atmosphere that existed in London's Soho district...

    , Dylan Thomas
    Dylan Thomas
    Dylan Marlais Thomas was a Welsh poet and writer, Encyclopædia Britannica. Retrieved 11 January 2008. who wrote exclusively in English. In addition to poetry, he wrote short stories and scripts for film and radio, which he often performed himself...

     and Francis Bacon
    Francis Bacon (painter)
    Francis Bacon , was an Irish-born British figurative painter known for his bold, austere, graphic and emotionally raw imagery. Bacon's painterly but abstract figures typically appear isolated in glass or steel geometrical cages set against flat, nondescript backgrounds...

    .
  • Acetate contributes to hangover headache. Hangover headache (and what’s much better, cure as well) unveiled