Hangovers

Definition

A hangover is a group of unpleasant signs and symptoms that can develop after drinking too much alcohol. The more alcohol you drink, the more likely you are to have a hangover the next day. But there's no magic formula to tell you how much you can safely drink yet still avoid a hangover.

However unpleasant, most hangovers go away on their own within 24 hours. If you choose to drink alcohol, doing so responsibly can help you avoid future hangovers.

Symptoms

Signs and symptoms of a hangover typically begin within several hours after the last drink. Depending on what you drank and how much you drank, you may notice:

• Fatigue
• Thirst
• Headaches and muscle aches
• Nausea, vomiting or stomach pain
• Poor or decreased sleep
• Sensitivity to light and sound
• Dizziness or a sense of the room spinning
• Rapid heartbeat
• Bloodshot eyes
• Shakiness
• Decreased ability to concentrate
• Mood disturbances, such as depression, anxiety and irritation

Causes

Hangovers are caused by drinking too much alcohol.

A single alcoholic drink is enough to trigger a hangover for some people, while others may drink heavily and escape a hangover entirely. In general, however, more than three to five alcoholic drinks for a woman and over five to six for a man will usually result in a hangover. About 75 percent of people who drink to intoxication will have a hangover the next day.

Various factors may contribute to the problem. For example:

• Alcohol stimulates your body to produce more urine. In turn, urinating more than usual can lead to dehydration — often characterized by thirst, dizziness and lightheadedness.
• Alcohol irritates the lining of your stomach, increases the production of stomach acid and delays stomach emptying. Any of these factors can cause abdominal pain, nausea or vomiting.
• Alcohol can cause your blood sugar to fall. If your blood sugar dips too low, you may experience fatigue, weakness, shakiness and mood disturbances.
• Alcohol causes your blood vessels to expand, which can lead to headaches.
• Alcohol can make you sleepy — but your quality of sleep will suffer. This may leave you groggy and fatigued.
• Alcoholic beverages contain ingredients called congeners — which give many types of alcoholic beverages their flavor and which can contribute to hangovers. Congeners are found in larger amounts in dark liquors, such as brandy and whiskey, than in clear liquors, such as vodka and gin.

Risk factors

Anyone who drinks alcohol can experience a hangover, but some people are more susceptible to hangovers than are others. A genetic variation that affects the way alcohol is metabolized may make some people flush, sweat or become ill after drinking even a small amount of alcohol.

Research hasn't clearly shown whether light drinkers or heavy drinkers are more likely to experience hangovers.

Factors that may make a hangover more likely include:

• Drinking on an empty stomach
• Using other drugs, such as nicotine, along with alcohol
• Having a family history of alcoholism
• Drinking darker colored alcoholic beverages
• Drinking champagne or alcohol mixed with carbonated beverages

When to seek medical advice

Hangovers go away on their own. Consult your doctor if you're concerned about your alcohol use or you can't control your drinking. Treatment is available.

Complications

Hangovers themselves aren't usually associated with complications — but drinking too much alcohol can cause serious problems. In addition to impaired judgment and coordination, short-term memory loss and fatigue, regularly drinking too much alcohol may lead to:

• Alcohol poisoning. Taken in large enough quantities, alcohol can cause a life-threatening coma by severely depressing the brain centers that control breathing and heartbeat.
• Alcohol dependence. People who experience frequent hangovers have a higher risk of alcoholism.
• Liver disorders. Drinking heavily can lead to alcoholic hepatitis, an inflammation of the liver. Eventually hepatitis may lead to cirrhosis, the irreversible and progressive destruction of liver tissue.
• Gastrointestinal problems. Drinking too much alcohol can damage the pancreas and inflame the lining of the stomach (gastritis).
• Nutritional problems. Heavy drinking interferes with the absorption of the B vitamins — particularly folic acid and thiamin — and other nutrients.
• Cardiovascular problems. Excessive drinking can lead to high blood pressure and damage your heart muscle (cardiomyopathy).
• Diabetes complications. Alcohol can cause your blood sugar to fall, which can be especially dangerous if you have diabetes and are taking insulin to lower your blood sugar.
• Sexual dysfunction. A man who drinks too much alcohol may not be able to sustain an erection.
• Neurological complications. Excessive drinking can affect your nervous system, causing numbness of your hands and feet (neuropathy), disordered thinking and dementia.
• Psychological complications. Excessive drinking can lead to or complicate depression, anxiety and other mental health conditions.
• Medication interactions. Mixing alcohol and over-the-counter or prescription medications can be dangerous. Alcohol can keep some drugs from doing what they're supposed to do, such as treating or preventing a particular condition. Alcohol can also increase the likelihood of unwanted or serious side effects.
• Birth defects. If you drink during pregnancy, your baby may be born with birth defects or fetal alcohol syndrome. This condition causes mental retardation and behavioral problems.
• Increased risk of cancer. Chronic alcohol abuse has been linked to a higher risk of cancer of the esophagus, larynx, liver and colon.

Treatments and drugs

From pulling your hair to drinking sauerkraut juice, home remedies for hangovers abound. Pharmacy shelves are often stocked with hangover remedies as well. But in the end, time is the only sure cure. Here are a few things you can do to help yourself feel better in the meantime:

• Fill your water bottle. Sip water or fruit juice to prevent dehydration. Resist any temptation to treat your hangover with more alcohol. It'll only make you feel worse. Be careful with caffeinated beverages, too. Caffeine acts as a diuretic, which may increase dehydration. Additionally, caffeinated beverages may make you think you're alert when you're really not.
• Have a snack. Bland foods, such as toast and crackers, may boost your blood sugar and settle your stomach. Bouillon soup can help replace lost salt and potassium. Foods and drinks that contain fructose, such as honey or fruit juice, may help your body burn the alcohol faster.
• Take a pain reliever. An over-the-counter pain reliever may ease your headache. But there are a few caveats. Aspirin can irritate your stomach. And if you sometimes drink alcohol to excess, acetaminophen (Tylenol, others) can cause severe liver damage.
• Go back to bed. If you sleep long enough, your hangover may be gone when you awaken.

Prevention

There are no surprises here. Despite various over-the-counter pills and tablets that claim to prevent hangovers, the only guaranteed way to prevent a hangover is to avoid alcohol. If you choose to drink, do so in moderation. The less you drink, the less likely you are to have a hangover.

It may help to:

• Eat first. Alcohol is absorbed more quickly if your stomach is empty. It may help to drink a glass of milk before drinking alcohol. Milk slows the absorption of alcohol by coating the lining of your stomach.
• Take it slow. Drinking isn't a contest. Pace yourself. Limit yourself to just one drink each hour.
• Choose carefully. Beverages with fewer congeners — such as vodka and gin — are less likely to cause hangovers than do beverages with more congeners — such as brandy and whiskey. Carbonated drinks, such as champagne, and drink mixers, such as club soda, may deliver more alcohol to your bloodstream than noncarbonated mixers, such as fruit juice.
• Be consistent. Drinking more than one type of alcohol over the course of an evening can contribute to a hangover.
• Sip water between drinks. Drinking one glass of water after each alcoholic drink will help you stay hydrated. It'll also help you drink less alcohol.
• Keep it low-key. Smoking, loud music and flashing lights can contribute to hangover headaches.

Also know your limits. Decide ahead of time how many drinks you'll have — and stick to it. Don't feel pressured to drink.

Some people take aspirin or a nonsteroidal anti-inflammatory drug (NSAID), such as Advil, Motrin or others, to prevent hangover symptoms, but be sure to ask your doctor if this is safe for you to do and what dosage is best for you. These medications may interact with other medications, and in the case of acetaminophen (Tylenol, others) may cause liver damage if too much alcohol is consumed.