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Saturday Lecture: Physiology/Tx of a Hangover

by coldwarrior ( 138 Comments › )
Filed under Academia, Open thread, saturday lecture series at January 1st, 2011 - 8:30 am

Don’t worry, this isn’t testable material. Oh, and Happy New Year!

Today we are going to look at the physiology of a  ‘hangover’ and possible treatments.

An alcohol hangover results from a constellation of adverse effects that alcohol and the metabolism of alcohol have on the body.

The misery begins when blood alcohol levels start to fall. Some experts to believe the hangover is a “kind of mini withdrawal,” says Robert Swift, professor of psychiatry and human behavior at Brown University and director of research at the Providence Veterans Adminstration Medical Center. Because alcohol is a sedative, your body reacts by releasing various neurochemicals to stimulate the brain. These chemicals cause a rapid pulse, nausea, tremors and light and sound sensitivity–the same symptoms that alcoholics experience when they stop drinking. The worst of the symptoms occur when blood alcohol levels reach zero, also known as “the morning after.”

How fast it takes you get to that zero level depends on your liver, which processes nearly all the alcohol you imbibe. And it can metabolize only small amounts of liquor each hour, explains liver specialist Dr. William Carey, professor of medicine at the Cleveland Clinic Lerner College of Medicine. But “every person is going to metabolize alcohol differently,” Carey says, with genetics and gender playing a role. On average, the liver metabolizes about one ounce of pure alcohol per hour. That’s about 12 ounces of beer, a five-ounce glass of wine or one and a half ounces of liquor.

Which leads to another theory that puts the blame for the hangover on pure physiology. Alcohol is first broken down in the liver into a toxic substance called acetaldehyde. Acetaldehyde is then further broken down into a harmless substance called acetate. At high doses, acetaldehyde causes nausea, vomiting, sweating and other symptoms akin to the hangover. Although there is no acetaldehyde in your system when you have a zero blood-alcohol level, some of the after-effects of the toxin may persist the morning after.

Congeners, by-products of the distillation and fermentation process, may also play a role in making holiday partiers miserable. Darker-colored liquors such as brandies, bourbon and red wine contain more congeners than lighter colored alcoholic beverages like gin or vodka. The big-bad of the various congeners is methanol, which is broken down by the body into formaldehyde. In the vernacular, formaldehyde is embalming fluid. When living people have this in their circulation, the clinical term for how they feel is “rotten,” Swift says.

Since alcohol is a diuretic, you’ll wake up dehydrated. That dehydration explains some of the symptoms such as headaches and a dry mouth. Alcohol also plays havoc with the body’s biorhythms, disturbing sleep patterns, despite it being a sedative. That lack of sleep contributes to the overall misery.

Meanwhile, the Aussies tell us this:

New Year’s revellers who need to cure a hangover should skip the conventional wisdom advising they swill coffee or another alcohol drink, and instead hit the gym.

The body gets rid of alcohol and its toxic by-products four ways: through breathing, via the liver or kidney and from sweating, said Aaron Michelfelder, a family physician from Loyola University Health System in Maywood, Illinois. Exercise speeds breathing, increases sweat, and moves alcohol-laden blood to the liver and kidneys more quickly.

“That’s why you should stay hydrated as well,” Michelfelder said in a telephone interview. “It takes a lot of water to process alcohol in your body.” 

Drinking plenty of water, especially between every glass of wine, whiskey or beer, has another benefit – it can reduce the overall amount of alcohol consumed, he said.

Michelfelder has a list of recommendations partygoers should heed as they hit the town on New Year’s that can help the body grapple with the tsunami of alcohol ahead. The first is, avoid a hangover altogether, he said.

“A hangover is brain damage,” he said. “Some of it is going to heal, and some will be permanent. Prevention is the best medicine, particularly with hangovers.”

The most important is to drink moderately and slowly, at most five drinks for men and three for women over a three-hour period. Other measures include taking an anti-inflammatory pill such as ibuprofen (CW notes: Tylenol (acetaminophen) IS NOT an anti-inflammatory. aspirin and ibuprofen are) and eating before any drinking occurs. The medicine may help avoid nerve damage from the alcohol, while the food may slow the absorption of alcohol. B vitamins may also help, he said.

Michelfelder’s most surprising advice involves what to do after the hangover has set in. Coffee is unlikely to ease the nausea, dizziness, cotton candy head and general malaise that stems from over-imbibing, though it may lift some symptoms of depression that can set in after the warm and pleasant effects of the alcohol wear off, he said.

“Hair of the dog,” the familiar standby of getting down just one more drink in order to stymie the ill-effects of a hangover, is particularly unhelpful, Michelfelder said. It will only make you feel worse, he said.

I thought this an appropriate way to start the new year as last night was amateur night and there will probably be more than the average number of hangovers out there. Anyone have their own very sure fire hangover cure…and please dispense with the ‘dont drink booze’ treatment as that is just plain crazy talk.