Friday, January 1, 2010

Cure Your Hangover?

Now that 2009 is over and the parties are done, are you ringing in 2010 with a throbbing headache? Well, that’s the result of the toxic byproducts of the alcohol (call ethanol) that you drank last night.

The reasons we feel so terrible after a night of drinking are complex. Part of the alcohol itself is converted to an evil chemical poison called acetaldehyde and that is responsible for many of the symptoms we feel. In addition, alcohol causes dehydration and numerous metabolic disturbance, especially of the kidneys.

Alcohol causes the kidneys to stop reabsorbing water, sending it straight to the bladder instead. Your brain then gets dehydrated and begins to shrink, stretching it away from the inside of your skull. Cue that piercing headache. Most of us don't drink enough water anyway, so if you then add loads of alcohol, it's going to make it a lot worse. Drink any fluids you like and it will help.

If you want to know more about just what causes hangovers, you can read this excellent article at howstuffworks.com

But are their hangover cures that really work?

Try all the remedies you want -- the sauna, greasy food, juice -- and if you're looking for a cure then: "The answer is no," said Dr. Brian Grosberg, director of the Inpatient Headache Program at Montefiore Medical Center in New York City.

"No, no," agreed Dr. Joel Saper founder and director of the Michigan Head-Pain and Neurological Institute in Ann Arbor, Mich. "The best recourse is not to drink."

But headache experts have some good news for those who are afraid they'll accidentally overindulge next year. Most remedies people try for hangovers won't cure a headache, but some can actually prevent a hangover (better luck next year).

Below are some common hangover remedies and expert commentary on whether they have the potential to help the dreaded hangover headache.

A Prairie Oyster?

Unlike other alleged hangover cures, like egg sandwiches or coffee, prairie oysters are a concoction so revolting few bother to eat them, even if they have a hangover. Put a raw egg in a glass and add a dash or two of hot sauce, vinegar, Worcestershire sauce and some salt and pepper.

Drink it in a gulp and voila… nothing. Headache experts say this classic remedy does nothing for a hangover, although it may inspire some people to prevent one.

"Thinking about that would make me not want to drink," said Grosberg. "It would be a non-alcoholic drink that night if a prairie oyster would be something I had to drink later."
Prairie oysters and many other hangover remedies around the world, such as rubbing lemons in your armpits, may make you feel nauseous, but experts say such nasty remedies won't make the hangover headache worse.

"I think it's the absence of doing the things that are right [that make hangovers worse]," said Saper. He said people should never drink on an empty stomach and pay attention to your individual tolerance and headache susceptibility, which is genetic. "It's biologically vulnerability in the way we metabolize and process the various chemicals in our body," said Saper. "A hangover headache is going to occur more frequently in people who are vulnerable to headaches."


Not All Alcohol Headaches Are Hangovers

In fact, some people who are sensitive to certain types of alcohol are likely to get a headache from chemicals -- such as congeners in rum or tyramine in red wine -- even if they don't drink enough to get a hangover.

"There are clearly certain alcohol products that are much worse. Things like vodka are a lot easier on the system than some of the amber colored drinks," said Saper.

Grosberg noted a true hangover is much more than a headache from drinking alcohol, but a physiological event with a constellation of symptoms: reduced appetite, nausea, shakiness, quickening of the heartbeat, sweating, also mood changes, depression and anxiety.

"The headache happens when the blood alcohol level is falling," said Grosberg.


Bloody Mary: Hair of the Dog That Bit You

Either out of addiction or intuition, some people swear that sipping more alcohol the day after a night of drinking reduces a hangover.

Since a hangover headache appears when the blood alcohol level drops, Grosberg said the old "hair of the dog" hangover remedy may have some fleeting truth to it.

"The problem is what do you do the day after? After you had that alcohol?" said Grosberg, who pointed out people are only delaying the drop in blood alcohol level that causes a hangover headache. "I'm not sure it's something I'd recommend."

Caffeine: Red Bull, White Tea or Coffee, Please?

Much more palatable than the prairie oyster, many hung over individuals turn to black coffee for relief. Today, some people go for a can of Red Bull for the extra caffeine, or take the moderate route with a bit of white tea.

But headache experts warn that caffeine can cut both ways when it comes to a hangover. In the right circumstances, it may help a headache, but in other circumstances it can start a headache.

"One of the things that happens is you dehydrate with a hangover. Alcohol is like a diuretic. It brings water through your system and you pee more," said Saper.

Since caffeine is also a diuretic, it might make the dehydration and resulting hangover headache much worse. If you try coffee, Saper suggested you also drink extra water to stay hydrated.

People who drink a lot of caffeine every day may also make their headaches worse. According to Saper, these people are typically caffeine-tolerant and may not see a benefit when they reach for coffee with a hangover.

But don't give up on the caffeine therapy too fast. Experts say it can help in people who drink minimal amounts of caffeine on a daily basis.

Neurologists don't completely understand the mechanism of a hangover, but Grosberg says a leading theory is that alcohol dilates blood vessels in the brain, leading to a throbbing headache.

In that case, "caffeine can provide relief because it causes a constriction of blood vessels," explained Grosberg.

Exercise to Cure a Hangover?

Yes, exercise. Some people swear a quick run will soothe a hangover. Sure, it can release endorphins, but headache experts warn it's not for everybody.

"That's an individual variability -- there are people who cannot exercise when they have an evolving headache," said Saper.

Saper explained if a person already has dilated blood vessels that are causing a headache, then increasing your heart rate with exercise may just make some people feel worse.

Exercising with a hangover could put you in worse shape in terms of dehydration, too, if you don't drink enough water to compensate for the sweat. The same could be said if someone didn't drink enough water after going for a schvitz -- time in a sauna or steam room -- which is said be a good cure for a hangover.

"On the other hand, there are people who can change their physiology by exercising, then it can ward off a physiological event (like a headache)," said Saper. "It's different strokes for different folks: some people will swear by it, some people will swear at it."

One thing Saper warns against trying is trying absolutely nothing and refusing medication.

"Clearly, we know these headaches evolve," said Saper. "If you can catch these physiological events early, then you are going to have the chance to lessen or shorten the event."

Pain Meds For a Hangover? Be Careful

Many people shuffle to the medicine cabinet the first thing of a hangover morning, but that doesn't mean your usual pain medicine will be safe. Acetaminophen products (such as Tylenol) can have dangerous interactions with alcohol, according to the American Liver Foundation.

However, taking anti-inflammation pain medicines such as ibuprofen, naproxen or mefenamic acid can help the headache.

In fact, these drugs, called NSAIDS, may actually help prevent hangovers in some people, according to Saper and Grosberg. The drugs work by inhibiting a hormone called prostaglandin, which is released during drinking and cause nausea and headaches the next day.

"Although that should be done in conjunction with speaking to your doctor," said Grosberg.

The water you drink with the pills will also help rehydrate you. Alcohol is so dehydrating that doctors recommend drinking not just water, but something with minerals and electrolytes either before or after your hangover.

Some hangover sufferers have say that Gatorade helps, as does those Pedialyte Freezer Pops which are designed to rehydrate children suffering from diarrhea. Grosberg said drinking or eating these may very well help before or after the hangover begins.

However, one of the most frequent misconceptions about what to eat on a hangover morning is to try a big, greasy breakfast.

Big Greasy Breakfast to Cure a Hangover?

Always order a bacon and egg sandwich or home fries the next day after a hangover? Doctors say grease can help delay the absorption of alcohol and therefore protect against a hangover.

But, "I think eating it after the hangover -- you've probably already missed the time to slow down or delay the effects of the alcohol," said Grosberg. Instead of waiting until the day after to address the hangover, Grosberg recommends moderate drinking and prevention.

"All of it is acting on prevention, jumping on it quicker," he said.

Before you go out partying again, he also reminds people that it doesn't always take a lot of drinking to get a hangover.

"Usually, the hangover headache isn't dose-related. The hangover is much more common in people who drink light to moderate amounts and indulge than people who drink a lot, frequently," said Grosberg.

"If you don't drink a lot all day and you indulge, you're more likely to get a hangover than if you drink often and throw back a few more one night," he said.

Good luck and better luck next year ;-)


Thanks to ABC News for much of this article's information.