Hangovers – causes, symptoms and prevention

A number of factors can contribute to hangovers:

Hangovers

For many people, a night of drinking can lead to a painful morning after and the dreaded effects of a hangover. What does science tell us about this phenomenon? What causes the typical symptoms of a hangover? And the question perhaps as old as hangovers themselves—are there any real remedies?

What Is a Hangover?

A hangover refers to a set of symptoms that occur as a consequence of drinking too much. Typical symptoms include fatigue, weakness, thirst, headache, muscle aches, nausea, stomach pain, vertigo, sensitivity to light and sound, anxiety, irritability, sweating, and increased blood pressure. A hangover can vary from person to person.

Other Substances That Contribute to Hangover Symptoms

Alcohol is the main culprit in a hangover, but other components of alcoholic beverages might contribute to hangover symptoms or make a hangover worse.

• Congeners are compounds, other than ethyl alcohol, that are produced during fermentation. These substances contribute to the taste and smell of alcoholic beverages. Darker spirits, such as bourbon, which tend to have higher levels of congeners than clear spirits, could worsen hangover symptoms for some people.
• Sulfites are compounds that are added to wine as preservatives. People who have a sensitivity to sulfites may experience a headache after drinking wine.

What Causes Hangover Symptoms?

A number of factors can contribute to hangovers:

• Mild dehydration:Alcohol suppresses the release of vasopressin, a hormone produced by the brain that sends signals to the kidneys causing them to retain fluid. As a result, alcohol increases urination and excess loss of fluids. The mild dehydration that results likely contributes to hangover symptoms such as thirst, fatigue, and a headache.
• Disrupted sleep:People may fall asleep faster after drinking alcohol, but their sleep is fragmented, and they tend to wake up earlier. This contributes to fatigue, as well as lost productivity.
• Gastrointestinal irritation:Alcohol directly irritates the lining of the stomach and increases acid release. This can lead to nausea and stomach discomfort.
• Inflammation:Alcohol increases inflammation in the body. Inflammation contributes to the malaise that people feel when they are sick, so it may play a role in hangover symptoms as well.
• Acetaldehyde exposure:Alcohol metabolism, primarily by the liver, creates the compound acetaldehyde, a toxic, short-lived byproduct, which contributes to inflammation in the liver, pancreas, brain, gastrointestinal tract, and other organs.
• Mini-withdrawal:While drinking, individuals may feel calmer, more relaxed, and even euphoric, but the brain quickly adjusts to those positive effects as it tries to maintain balance. As a result, when the buzz wears off, people can feel more restless and anxious than before they drank.

Because individuals are so different, it is difficult to predict how many drinks will cause a hangover. Any time people drink to intoxication, there is a chance they could have a hangover the next day.

When Does a Hangover Peak and How Long Does It Last?

Hangover symptoms peak when the blood alcohol concentration in the body returns to about zero. The symptoms can last 24 hours or longer.

Are Hangovers Dangerous or Just Painful?

Hangovers can be both painful and dangerous. During a hangover, a person’s attention, decision-making, and muscle coordination can all be impaired. Also, the ability to perform important tasks, such as driving, operating machinery, or caring for others can be negatively affected.

Common Myths About Hangovers

Myth: Certain actions, such as drinking coffee or taking a shower, can prevent or cure a hangover.

Fact: The only way to completely avoid a hangover is to not drink alcohol at all or to keep alcohol intake to a minimum. There is no cure for a hangover other than time.

Myth: The order of drinks will affect a hangover—as captured in the expression, “beer before liquor, never sicker.”

Fact: In general, the more alcohol a person drinks, the worse the hangover will be. This is true regardless of whether a person drinks beer, wine, distilled spirits, or a combination of these.

Myth: Having an alcoholic drink in the morning after a night of drinking will help avoid a hangover—a practice known colloquially as “a hair of the dog that bit you.”

Fact: While this might temporarily minimize some symptoms, it could contribute to and prolong the malaise and other symptoms of the hangover.

Are There Any Remedies for a Hangover?

Although many remedies for alleviating hangovers are mentioned on the web and in social media, none have been scientifically proven to be effective. There is no magic potion for beating hangovers—and only time can help. A person must wait for the body to finish clearing the toxic byproducts of alcohol metabolism, to rehydrate, to heal irritated tissue, and to restore immune and brain activity to normal. There is no way to speed up the brain’s recovery from alcohol use—drinking coffee, taking a shower, or having an alcoholic beverage the next morning will not cure a hangover.

Some people take over-the-counter pain relievers (often acetaminophen) before going to bed to minimize hangovers. It is important to recognize that the combination of alcohol and acetaminophen can be toxic to the liver. Like alcohol, certain over-the-counter pain relievers, including aspirin and ibuprofen, can increase acid release and irritate the lining of the stomach. Proceed with caution when using these medications before or after consuming alcohol.

To help ease their hangover symptoms, some people turn to electrolyte-rich sports drinks or other products, or even intravenous (IV) treatments, in an effort to treat electrolyte imbalance caused by increased urination and fluid loss as a result of drinking. Research has not found a correlation between the extent of electrolyte disruptions and the severity of hangovers, or the impact of added electrolytes on hangover severity. In most people, the body will quickly restore electrolyte balance once the effects of alcohol subside.

Ultimately, the only surefire remedy for a hangover is to avoid getting one by drinking in moderation or choosing not to drink.

Hangovers – causes, symptoms and prevention

A hangover can leave you feeling miserable. Avoid the dreaded morning-after effects by understanding the symptoms, causes and how to prevent them.

A pounding headache. Feeling sick, tired, dizzy, irritable or dehydrated. If you’ve ever had a hangover, you will know some of the unpleasant effects that can linger on for a day or more after a heavy drinking session. Hangovers affect everyone differently, but there are things you can do to avoid getting one in the first place. Read on for our guide on the causes and symptoms of hangovers, the myths to be aware of, and the essential “dos and don’ts” that could prevent a hangover from ruining your day. Reduced workplace productivity and absenteeism caused by hangovers are estimated to cost the UK economy £4 billion every year. 1

Hangover symptoms

• Typically, most people feel hungover when they wake up the day after drinking alcohol, but you could get these symptoms before going to bed too, as the alcohol wears off.
• The most common hangover symptoms are tiredness, headache, nausea and problems with memory and concentration. 3 You might also have a headache or an upset stomach (including feeling sick, or being sick), or feel irritable, dizzy, sensitive to light, sweaty or anxious. 4
• The more alcohol you drink, the more likely you are to get severe hangover symptoms – particularly if you have a lot more than you typically drink in a single session. 5
• Sticking to the UK Chief Medical Officers’ low risk drinking guidelines – no more than 14 units a week, spread over three or more days, with several drink-free days and no bingeing – could help you avoid a hangover. It will also lower your longer-term risks of several cancers, liver and heart disease and help maintain healthy blood pressure.

Some people experience psychological symptoms such as feeling anxious after drinking, as the depressant ‘calming’ effect of alcohol wears off. These feelings of ‘hangxiety’ can affect anyone, but might be worse if you are already socially anxious. 6
Do you get ‘hangxiety’?

Altogether, hangover symptoms aren’t a good combination if you’re planning to make the most of the day and not spend it in bed. You might find a hangover can affect your relationships too – whether it’s lacking motivation to spend time with the kids, or saying something you shouldn’t to your partner or a friend.

Can you have a ‘permanent’ hangover?

A hangover is what you might experience as the alcohol wears off after a single session of drinking. Symptoms tend to peak around the time your body has reduced the amount of alcohol in your system to zero, and can last for up to 24 hours afterwards. If you find you have symptoms that are longer-lasting, or permanent, it’s possible that you are drinking at a high-risk level that could mean you are dependent on alcohol and experiencing withdrawal symptoms. 8 If you think you may have become dependent on alcohol, you should consult your doctor or another health professional before stopping drinking completely. Read our guide on what to do before stopping drinking, and how to get help and support if you need it. Drinking Check Almost half (47%) of UK employees suspected a colleague was hungover at work during 2021. 9

What causes a hangover

• Alcohol is toxic
• Dehydration
• Disturbed sleep
• Your genes, and choice of drink

Alcohol is toxic

Alcohol is toxic 10 –so every time you drink, your body has to work to get rid of it from your system.

On average, it takes the body about an hour to remove a unit of alcohol, but this can vary a lot depending on your sex, weight and other factors. 11 Some research suggests that substances created as by-products of your body getting rid the alcohol could create hangover symptoms by causing inflammation and temporary changes to your immune system. 12

Dehydration

Dehydration makes hangover symptoms worse.

Alcohol makes you pee more frequently, which can lead to dehydration if this fluid is not replaced. 13 Dehydration can make you feel thirsty, dizzy, lightheaded and tired, with a dry mouth and lips, and dark yellow and strong-smelling pee. Dehydration makes hangover symptoms worse 14 – it’s important to replace lost fluid by drinking extra water if you choose to drink alcohol.

Disturbed sleep

Drinking alcohol disturbs your sleep, causing you to spend less time in the important Rapid Eye Movement (REM) sleep-stage – meaning you wake feeling less refreshed. 15 A late night can mean you get less time in bed before you have to get up too – with some studies suggesting this plays a part in making a hangover worse. 16

Your genes, and choice of drink

Alcohol causes hangovers. But your genes and choice of drink might play a part.

Alcoholic drinks contain substances called congeners, which play a part in giving them their colour and taste.

Some drinks have more congeners than others – for example red wine generally has more than white – and there is some evidence these could make a hangover worse, for some people (although the reasons why aren’t fully understood). 17

There is also some evidence that some people’s genes make them more prone to hangovers than others. 18 But we do know for certain that the cause of a hangover is alcohol. If you want to avoid a hangover, you need to avoid alcohol in general, rather than any particular drink.