After a few too many rough mornings during a recent alumni weekend, I started digging to see if I could find a better answer to preventing hangovers than “drink less” and “have water before bed.”
The goal wasn’t to let myself drink more (okay, maybe that was part of it), but rather to see how I could have a fun night without losing the entire next day. And to see if I could have wine during the week without the next day being less productive.
After a bit of digging into the biology and chemistry of a hangover, the solution is surprisingly simple.
To understand the solution, we need to understand the problem. Why do we get hangovers exactly?
The simple answer is “drinking too much,” but why does drinking too much create such brutal headaches, fatigue, and soreness among other symptoms?
It comes down to three bodily reactions:
Alcohol causes your brain to slow production of vasopressin, the hormone that tells your body to retain water. With decreased vasopressin, your body stops holding as much fluid and starts sending it straight to your bladder.
But this isn’t just what you’re drinking, it’s also the fluid already inside your body. And as you drink more, you reduce your vasopressin production further, causing even more water to rush out of your system.
This doesn’t help when most people are chronically dehydrated (yes, you too). Combine that with massive vasopressin reduction, and your body is letting go of what little fluid it has to begin with.
When your body becomes dehydrated, it has to ration the water it has left. Your heart and lungs are pretty important, so it focuses on those and a few other organs and starts sending water from places like your muscles and brain.
With less water, the brain starts to contract, pulling on the nerves around it creating a massive headache. Your muscles, depleted of water and electrolytes, become sore and fatigued as if you’d overexerted them the day before.
As that water is streaming out of you and into the toilet, it’s pulling electrolytes like sodium, magnesium, calcium, and potassium out with it, which you need for normal muscle and nerve function.
On top of this, you’re also pissing out glutamine.
Glutamine is a key source of cellular energy that your body produces some of under normal conditions, but when demand for it is increased (by rocketing it out of your bladder) your body throws a fit and starts shutting things down till it’s replenished.
While all of this is happening, our livers are freaking the fuck out and producing acetaldehyde, a highly toxic substance that can cause nausea, vomiting, headache, drowsiness, delirium, hallucinations, and loss of intelligence.
You know, all those things that happen when you’re hungover, and sometimes while you’re drunk.
Normally we can handle some acetaldehyde, but we only have so much of the processing enzyme acetaldehyde dehydrogenase, and when we drink too much the enzymes get overwhelmed and can’t process all of it quickly enough.
This is why some of the hangover symptoms don’t set in immediately. It takes a while for the acetaldehyde to build up enough to cause irritation, and the concentration will increase as you get further past the processing threshold.
For people with no acetaldehyde dehydrogenase (genetically or from anti-alcoholism drugs), the symptoms set in immediately, resulting in puking, headache, and other fun party-stoppers from as little as a glass of wine.
But wait, there’s more. Fermenting alcohol creates “congeners,” a combination of other substances (including other alcohols) aside from ethanol.
Many of the substances that make up congeners are toxic, and it’s been shown that the more congeners in a drink, the more they aggravate your hangover controlling for amount of alcohol consumed. This is also why hicks drinking unfiltered moonshine can go blind.
Darker alcohols have more congeners and produce worse hangovers, so red wine or whiskey will do more damage than vodka (here’s a rough ordering). In addition, since cheaper alcohols are filtered less, fewer of these impurities are removed causing you to get worse hangovers from bottom-shelf alcohol of any type.
This is why mixing alcohols makes your hangover worse. Different alcohols have different congeners, so the more types of alcohol you have, the more toxic substances you’re adding to your system.
Then comes the question of order.
Carbonated drinks and mixers significantly affect your rate of alcohol absorption into the bloodstream, which explains why champagne gets you drunk strangely quickly.
That also suggests that having carbonated drinks earlier in the night will get you more drunk later, so yes starting with beer before liquor could be a bad idea. But so could having carbonated drinks like gin and tonics.
The more intense hangover you feel from having sugary drinks isn’t a result of the sugar interacting with the alcohol, so much as it is a blood sugar crash.
When you wake up any morning feeling like crap, it’s partially from low blood sugar. Combine a low blood sugar with all of the other causes of a hangover, and you have an even worse one than before.
And drinking sweeter drinks can mask the alcohol and make you drink more, so it could be that over-consumption is at play.
Last, it could be an illusory correlation. When you’re drinking fruity drinks like margaritas, daiquiris, mojitos, and long island iced teas, you’re usually aiming to get more drunk than when you have a glass of scotch. Simply being more likely to have sugary drinks when we’re trying to get drunk may make us think they create worse hangovers.
To prevent hangovers then (aside from drinking less), we need to mitigate the effects of these four factors: vasopressin reduction, dehydration, congener consumption, and acetaldehyde production.
We can also add in a few things to combat the end-results, such as losing glutamine and electrolytes.
Ideally, we want to reduce the amount of vasopressin downregulation that happens when we drink so that we don’t have to be as worried about the dehydration.
One option is to get your hands on some desmopressin (to be clear, I’m not advising you to do this). It’s a synthetic hormone used to replace vasopressin to help treat bed-wetting in children. You’d probably have to order it overseas, or if you have kids, tell them you’re going to play an acting game with the local doctor.
The other option is to consume more potassium. Potassium has been shown to increase vasopressin production, so if you eat more white beans, spinach, or baked potatoes, you can potentially spike your vasopressin production before you go out drinking.
Even if you can increase your vasopressin, you’re still at risk of it going below normal and dehydrating you, so you want to take every precaution.
The best way to prevent dehydration is to make sure you’re hydrated before you go out, while you’re drinking, and before you go to sleep.
You can use regular water for this, but there’s a better option: oral rehydration solutions.
ORS is water with a specific ratio of salt and sugar (and ideally potassium and magnesium as well), to maximize how much of the water your body absorbs. It’s typically used to treat diarrhea in third world countries, but you’re going to use it to make sure your body is fully hydrated before and after the night.
All you need to do to make it is combine 1 liter of water, half a teaspoon of salt, and 6 teaspoons of sugar. Then drink away to your heart’s content.
Protip: prepare this before you leave for the night and put it by your bedside.
Alternatively, you can buy pre-made ORS and just use that. But it’s a lot cheaper to make it.
And while you’re at the bars, you can drink normal water, or try to sneak some salt and sugar from the table to make ORS on the fly. It’s a great conversation starter.
Last, if you want to go above and beyond, you can mix some glutamine in as well, to help reduce the fatigue symptoms that come from losing glutamine to dehydration.
Next, we have the problem of congeners. You’re going to be consuming them no matter what, so the key is to reduce them.
You’ll have the fewest congeners if you stick to a single, clear, top shelf liquor all night. You’ll have the most if you’re mixing a ton of bottom-shelf dark liquors together and ending the night with a bottle of red wine.
Just keep that in mind with your drink choices, and maybe lay off the rum and cokes.
This one you can do the least about. The acetaldehyde is going to be produced no matter what, and you can’t make more enzymes to handle it, so you’re mostly SOL.
That said, you can supplement with L-cysteine the night before, and the morning after drinking. L-cysteine has been shown to decrease acetaldehyde concentration during alcohol consumption, so if you mix some supplementary cysteine in with your ORS (or eat high-cysteine foods like soybeans, beef, lamb, and sunflower seeds), then you might reduce the effects of the acetaldehyde.
With all of that advice combined, here’s your anti-hangover solution.
Have fun, and let me know how it goes!