Hangovers and how to cure them

I do so love the morning after

I do so love the morning after

The fuzzy head, the aching liver, the nagging headache, and the taste of stale vomit. The morning after the night before. Sweating and moaning, you crawl to the bathroom, resting your head on the cool rim of the toilet bowl and between agonising retches you swear once more that you will never, ever, ever drink again.

Since before the dawn of civilisation, humans have been drinking alcohol and suffering the consequences. Modern drinks are comparatively clean, their production closely controlled, and there is a bewildering selection to choose from. However, the aftermath remains the same. Surely science, which has provided us with so many novel and tasty ways of getting drunk, can save us from the side-effects?

Well, help is at hand, in the form of the Virtual Reinhard’s complete guide to hangovers and their cure. Its the least I can do as a service to humanity. Pour yourself a stiff one, put a cold compress above your eyes, and read on.

Why Do Hangovers Happen?
Ah, the big question. And, unsurprisingly, the answer is fairly complex. If there was a single simple reason for all that pain, you can be sure that a catch-all cure would have been discovered long ago. As it is, there is a positive cocktail of effects, all of which conspire to make the day after a grim one.

This is the most well-documented consequence of drinking. Ethanol (the active ingredient in alcoholic drinks) is a diuretic (a substance that makes you want to pee), so you end up expelling more water than you drink. It acts on the brains pituitary gland and blocks production of a hormone called vasopressin, which usually directs the kidneys to reabsorb water that would otherwise end up in the bladder. Once this hormonal signal has been switched off, there is nothing to stop the bladder from filling up with all the water from the fluid that you drink. A supply of water is essential to the continued functioning of the body, and when various organs find that their normal supply of water has been cut off, they steal it from anywhere they can, including the cells of the brain.

Although the brain itself cannot feel pain, when it starts to shrink due to water loss, pain-sensitive filaments connecting the outside membranes to the inside of the skull become stretched, giving the symptoms of a headache.

Loss of Salts
Frequent visits to the toilet not only result in the loss of water, but also of the important salts dissolved in it. Potassium and sodium ions in particular are essential for the correct functioning of nerves and muscles. Any slight imbalance can result in nausea, fatigue, and headaches.

Loss of Sugar
Alcohol attacks the body’s store of glycogen, an important energy source kept in the liver, breaking it down to glucose which is then flushed out in the urine. Without this store of energy on call next morning, you are left feeling weak and wobbly.

Build-up of Free Radicals
The liver’s job is to destroy poisons, and when you start drinking it sets to work on destroying the ethanol. However, this process generates destructively reactive chemicals called free radicals. These are usually mopped up by an enzyme called glutathione, but during a binge, reserves can run low, leaving the free radicals to run riot through the liver.

Methanol is the simpler cousin of ethanol, and is found as a contaminant in cheap red wines, whisky and fruit brandy. This is effectively methylated spirit, the fuel alcohol that famously makes you blind if you drink too much of it. The liver attacks it as the poison it is, but one of the break-down products is formic acid, a particularly nasty chemical which ants use to spray at their attackers.

Other Poisons
Pure alcohol is metabolically fairly clean, and confirmed vodka drinkers will often bring this up as justification for their habit, and explanation for their resistance to hangovers. In many ways, they are quite correct. If you consider an alcoholic beverage to be water, ethanol, and a bunch of flavourings, then the identity of some of those flavourings is quite frightening. Red wine contains all sorts of interesting chemicals, leading to the complex flavourings typical of the drink, and although many of these impurities – such as arsenic – are poisonous, they are usually present in such dilute quantities as to be relatively harmless. However, if you concentrate the wine by distilling it (for instance, if you were making brandy or port), then as well as increasing the alcohol content, you are also concentrating the poisons. This is the reason that brandy and port (as well as cheap red wine) can give you the most monstrous hangovers. It is for this reason that people are often advised not to mix their drinks.

Different styles of drink have different impurities, and some of them can react with one another in interesting ways. Some common aides memoire from English folklore are:

  • Don’t mix grape with grain (ie keep wine/port and brandy separate from beer/whisky)
  • Beer then wine, I feel fine; Wine then beer, I feel queer.

So What Can We Do About It, Then?
Since the causes are so manifoldly complex, it is not surprising that the cures are similarly diverse. However, now you know what causes each component of the hangover, you can pick and choose from among the following.

The traditional remedy, with folklore dictating that you should quaff a pint of water for every alcoholic drink that you have consumed. Undeniably this has some ameliorative effect, but because your kidneys’ water-absorption function has been switched off, most of it goes straight to your bladder, causing nocturnal trips to the bathroom and little else.

The other symptoms are often a lot easier to cope with if the damn headache would just let up. There are three main classes of over-the-counter painkillers, based on one of aspirin, paracetamol (acetominaphen in the US), or ibuprofen. Each of these does of course have its recommended daily dose and it is not wise to exceed this, particularly in the case of paracetamol which has been shown to amplify alcohol’s damaging effect on the liver.

However, it is not widely known that it is perfectly safe to take the maximum dose of all three kinds at once, since they operate in different ways.

Salt Solution
Research on small mammals has shown that a poisoned digestive system is much better at taking up an isotonic solution (ie, containing salts at the same concentration as that found in your body cells) than pure water. So, if you’re going to drink water, put a spoonful of salt in it, and a couple more of sugar to increase the concentration and mask the taste. While you’re at it, you might as well throw in some powdered painkillers.

Isotonic Sports Drinks
In theory these are a great idea, for since they are supposed to replace all the salts and sugars that are sweated out during athletic activity, surely the same thing that we are trying to achieve here? The problem is that, due to market forces, they are usually fizzy, and the last thing you need is a bellyful of bloating gas. However, if you don’t mind, or if you find a flat one, it’s definitely worth doing. One variation on this theme is a 50:50 mix of orange soda and a caffeine drink such as Red Bull.

Sold in the UK as a stomach settler, this is a powder that becomes a fizzy drink when added to water, and contains a painkiller and some anti-acid chemicals. Another common brand, although without the painkiller, is Alka Seltzer which comes in tablet form. For our purposes, these are best taken before going to bed, as the chances are that in the morning you won’t be able to keep them down. I

This can work marvels, especially if followed in the morning by a vitamin supplement such as Berocca. The ingredients listed for Resolve are:

  • Paracetamol (Painkiller)
  • Ascorbic acid (Vitamin C)
  • Citric Acid (Vitamin C)
  • Sodium bicarbonate, Potassium bicarbonate, Sodium carbonate (antacids)
  • Glucose, Saccharin sodium, Sucrose (sugars)

Sold in Australia specifically as a hangover cure, these tablets contain all the chemicals that are lost and destroyed in a drinking session, in the correct proportions. In its native land, Berocca is often handed out free to delegates every morning at week-long conferences. Many Australians would not consider going on a binge without a supply of Berocca to hand. It makes a pleasant fizzy drink tasting vaguely of berries.

Berocca is now available in the UK from Boots the Chemist in a rather horrible orange flavour, marketed as a pick-me-up for business meetings, but we know better!

Here are the ingredients of Berocca.

  • Thiamine nitrate (Vit B1)
  • Riboflavine sodium phosphate (Equivalent to vitamin B2)
  • Nicotinamide (I’d guess that this is a stimulant)
  • Calcium pantothenate (Equivalent to vitamin B5)
  • Pyridoxine hydrochloride (Vitamin B6)
  • Cyanocobalamin (Vitamin B12)
  • Biotin (Vitamin H)
  • Ascorbic Acid (Vitamin C)
  • Calcium carbonate (A source of calcium)
  • Sucrose (Sugar)
  • Sodium chloride (Salt)

N-acetyl-cysteine (NAC)
An amino acid supplement sold in health food stores, this is extremely good at mopping up the free radicals that have built up in the liver. NAC works because it is rich in cysteine, another amino acid that is used by the body in the manufacture of free radical-eliminating glutathione. For those in the know, this is a very effective hangover remedy, and is especially good if you need a clear head in the morning.

Many traditional hangover cures, such as Prairie Oysters, omelettes and the Full English Fried Breakfast, involve eggs. Others swear by the efficacy of a downed raw egg in the morning. The reason that these work at all is that eggs also contain cysteine, and so help to mop up free radicals.

Hair of the Dog
For some particularly nasty hangovers, a tot of alcohol in the morning can be useful, although the bad news is that the effect is only temporary. It works because the liver attacks poisons in a certain order, with ethanol first. Once all the ethanol has been broken down, it starts on the methanol, which releases formic acid into your system and makes you feel particularly bad. Hitting the liver with another dose of ethanol causes it to stop processing methanol and start on the new threat, but the methanol will have to be processed sometime so you are only delaying the hangover until later.

Popular wisdom dictates a brisk walk in fresh mountain air to dispel those post-binge blues, but the problem is that when you really need it, the last thing you’re capable of doing is getting up off the floor, let alone going out into the outside world. The theory is that the increased oxygen flow improves the metabolic rate, and thus increases the speed at which the poisons are broken down. Be that as it may, SCUBA divers have long known that breathing compressed air does wonders in blowing away the fug on the first dive of the morning.

Kidney Dialysis
Since you cannot depend on your kidneys to filter your blood properly after a binge, you could get a machine to clean it for you. Admittedly most people don’t have access to a dialysis machine, but if you can stand getting hooked up by (presumably well-paid, private) nurses armed with needles while still drunk, you can be sober in four or five hours without any ill effects.

A good strong cup of coffee or tea will perk you up at any time of day, but that’s just the caffeine stimulating your tired body. It doesn’t actually cure anything, and if you’re at the stage when you can keep hot drinks down then you’re probably on the road to recovery anyway. In addition, caffeine is another diuretic, and you don’t want to be losing any more water at this stage of the game, so from this viewpoint it may be best to avoid tea, coffee, cola, Red Bull and the like. However, one way of treating a headache is to drink strong black coffee without sugar, but with a little bit of fresh lemon juice added. It tastes disgusting, but does actually work.

Incidentally, in the spirit of scientific enquiry, we did once attempt to start the morning with a hot cup of espresso poured over a tablet of Berocca. Although the end result was visually impressive – imagine a small brown-and-orange volcano – the taste was very possibly the worst in the history of comestibles. Don’t do it, or if you do, just do it as a party trick. Don’t try to drink it. No.

A good joint of marijuana the morning can make you feel a lot better, not only because you’re stoned but because dope is well known as a painkiller. Of course, whether this cure will get you to work in the morning is a moot point, but it could work at the weekend. The only proviso is that, if you don’t normally smoke cigarettes, don’t roll the joint with tobacco because in your delicate state it is likely to make you throw up. Naturally, this cure is only tenable in those jurisdictions in which marijuana is legal…

Pinching your hand
There is a nerve sac between the thumb and forefinger on your left hand which is reputed to be an acupressure point which can release tension in the head and neck. If you pinch it quite hard for 30 seconds every five minutes, normal tension headaches can be relieved. I can testify that is does actually work, and it’s certainly worth trying if you can’t keep down any painkillers.

A hot shower
Another way of relieving a headache is to sit in a really hot, really powerful shower, and get the full force of it on the back of your neck. This may need some juxtaposition of plastic chairs and shower settings, so it might be an idea to practice first while sober, but it is worthwhile because headaches are often caused by constricted blood vessels and tense neck muscles. A massage under a hot shower relaxes the tension.

Health Warning!
We take no responsibility for any ill effects caused by the remedies suggested here: you try them at your own risk. Nobody should mix their medicines; similarly nobody should drink ten pints of lager and then eat a curry. You have been warned.

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