What causes a hangover?
Hangovers are NOT caused by an electrolyte imbalance, lactate, ketones or (this will surprise you) dehydration. While dehydration can have an effect, there are other factors at play.
A hangover—characterized by headache, nausea, diarrhea, loss of appetite, tremulousness and fatigue—can make you miserable even more than 24 hours after your blood alcohol concentration returns to zero. Weird, right? So, what causes a hangover? Inflammation.
Hangovers are an immune response. Newer studies have helped us see that hangovers are more severe when immune activity is high. This is key to hangover symptoms and where we’ll start with treatments that work.
The best studies on treating hangover symptoms look at anti-inflammatory medications like the over-the-counter NSAIDs, ibuprofen (Advil, Motrin) and naproxen (Aleve). Two tablets (200-400 mg) with water before you get into bed will help reduce hangover severity.
Remember, acetaminophen (Tylenol) is not an anti-inflammatory and won’t help nearly as much.
2) Treatments for upset stomach
After reducing overall inflammation with NSAIDs, you may still need to control symptoms like nausea and upset stomach. Ondansetron (Zofran) helps quite a bit for nausea. And Pepcid, Zantac or Alka-Seltzer may help with some of the sour stomach you feel the next day.
3) Prickly pear extract
Prickly pear extract, which comes as a supplement, has actually been studied (on medical students, which is funny) with results published in a scientific journal—and it works! Taking it two hours before drinking can decrease the severity of hangovers by 50% in some cases. Prickly pear extract likely works as an anti-inflammatory. You can buy the capsules online, but remember, supplements aren’t regulated so you have to hope you get the actual product.
A study on the herbal supplement, Liv.52, has been published in which taking the supplement helped for hangover symptoms. Liv.52 comes in a capsule that contains a mixture of several herbs, and like prickly pear extract, is not tested for safety, so you have to take a leap of faith on this. I’d go the NSAID route first.
5) Vitamin B6
Many incorrectly think of vitamin B12 as a remedy for hangover. Studies only show positive results for vitamin-b6. Here is how you take it: 400 mg of vitamin B6 when you start drinking, 400 mg three hours later, and 400 mg at the end of the night (good luck with remembering that).
Poor sleep and sleep deprivation can affect your hangover. In fact, how bad a hangover gets is directly related to how long and how well you sleep, not how much alcohol you consume (what?!). Sleeping off a hangover is a successful remedy. Don’t drink heavily on a night before you have to get up early to walk the dog, catch a plane, go to work, or know you are going to be sleeping on a friend’s uncomfortable couch. You get the idea.
7) Avoiding dark liquors
Avoid dark liquors to prevent severe hangovers. Dark liquors like red wine, brandy, whiskey, and bourbon, give you worse hangovers than clear liquors like vodka. Dark liquors contain congeners, which give these drinks their flavor and color but also increase your risk for a hangover. More congeners = more hangover. Mixing orange juice in with your liquor drinking can lessen the effect of congeners.
8) Avoiding aggravating activities
You’ll want to pay attention to what you do right before you drink and while you’re drinking to prevent a hangover later. Remember to eat. Don’t do strenuous activities while drinking (like participate in a beach volleyball tournament). And smoking while drinking can worsen hangover symptoms.
Hydration will help, but not completely relieve, hangover symptoms.
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