In this article, we’ll cover the causes of hangovers and how to deal with them. Acetaldehyde, inflammatory reactions, methanol, and other factors contribute to hangovers, and we’ll discuss the various remedies that can be used to control them, as well as suggest effective ways to deal with them.

Introduction

As many office workers can attest, December is a time of year when commitments abound. Many of these appointments end with drinks, or even begin with drinks. As the drinking days become more frequent, everyone has experienced a hangover at one point or another. I’m a particularly weak drinker, so when I’m out with my seniors and coworkers, I often find myself throwing up or pounding my head with a headache while trying to keep up with their pace. If you look up “hangover” in the dictionary, it’s described as “a state of intoxication that lasts until the next day. Specific symptoms of a hangover include vomiting, headache, loss of appetite, sensitivity to light and sound, rapid heartbeat, tremors, and sweating. But why do these hangovers happen, and if we know the cause, is there anything we can do about it? These personal questions motivated me to write this blog post. In this article, I’ll explain how acetaldehyde, the most widely recognized cause of hangovers, works in the body to produce them. I’ll also discuss the different causes of hangovers, including the inflammatory response hypothesis, the direct action of alcohol, the homologue hypothesis, and the lactic acid hypothesis, and whether and how we can control them.

What causes a hangover?

Hangovers are caused by a combination of factors, most notably acetaldehyde. Acetaldehyde is a metabolite produced when ethanol is broken down by alcohol dehydrogenase in the liver. It stimulates the vagus nerve, affecting motor, perceptual, and visceral functions, and is believed to cause hangover symptoms by stimulating the afferent nerve fibers of the sympathetic nervous system, which are activated in response to external stress. Acetaldehyde forms covalent bonds with various proteins in the liver, altering its function and structure. For example, it binds to tubulin, which forms microtubules in hepatocytes, reducing microtubule polymerization and interfering with protein secretion. Acetaldehyde also causes hepatocytes to swell, forming adducts and inhibiting enzyme activity. These adducts promote the production of antibodies against acetaldehyde epitopes, which triggers an immune response and exacerbates or perpetuates alcohol-induced liver damage.
It has been hypothesized that hangovers are a form of inflammatory response, as the symptoms of a hangover are similar to those of a pathogenic invasion of the body. According to one study, when you drink too much, ethanol triggers the production of signaling substances called cytokines, which activate the immune system. Cytokines are substances that trigger an inflammatory response, and increased levels of cytokines, especially interleukin-10, interleukin-12, and interferon-gamma, lead to a state similar to a body ache. Some studies have shown that when cytokines are injected into healthy people, they produce hangover-like symptoms. This has led to the suggestion that heavy drinking can trigger an inflammatory response in the body, which can lead to a hangover.
Ethanol itself, before it’s metabolized into acetaldehyde, can also cause a hangover. Ethanol can irritate the stomach lining, causing nausea and vomiting, and it can also lower blood sugar and dilate blood vessels, causing headaches.
Congeners in alcohol can also cause hangovers. Congeners are compounds that are produced during the fermentation process of alcohol, and methanol is the main culprit. In an experiment conducted by Dr. L.F. Chapman in 1970, a group of people who drank a lot of congeners were 11 times more likely to have a hangover than those who did not. Methanol is produced in small amounts during alcohol fermentation, and the formaldehyde and formic acid produced are toxic and damage cells.
Alcohol metabolism can cause excessive lactate production, which can lead to lactic acidosis, which can cause the muscle cramps associated with hangovers. Psychological factors such as mood also play a role in determining the severity of a hangover.

How to deal with a hangover?

Now that we’ve looked at the different causes of hangovers, let’s discuss how to deal with them. First, to reduce the symptoms of a hangover caused by acetaldehyde, you need to prevent the production of acetaldehyde or metabolize it quickly. Many hangover remedies on the market choose the latter option. When you take a hangover cure that contains an acetaldehyde dehydrogenase inhibitor, the acetaldehyde is rapidly broken down into acetic acid, which relieves the hangover. However, this method can lead to excess acetic acid production, which can increase the risk of fatty liver and hyperlipidemia. Therefore, it may be healthier to inhibit the production of acetaldehyde itself. However, the downside is that it doesn’t address the effects of ethanol itself.
The second option is to take anti-inflammatory drugs to reduce the inflammatory response. In fact, migraines, a symptom of a hangover, are caused by an increase in the concentration of prostaglandins, which cause an inflammatory response. The anti-inflammatory drug tolfenamic acid, which inhibits this, is effective in treating migraines. Finnish scientists have tested tolfenamic acid in heavy drinkers and found significant hangover relief. Prickly pear cactus extract may also help relieve headaches, nausea, and fatigue.
The solution to the third culprit, methanol, is somewhat paradoxical: drink a little more to cure it. The idea is that a hangover occurs when methanol is metabolized, and consuming more ethanol inhibits the metabolism of methanol and relieves the hangover. However, this method requires caution, as it will again promote the production of acetaldehyde.

The bottom line

A hangover after drinking too much alcohol is a painful experience that everyone has had at one time or another, and it’s surprising that there is a lack of academic research on the subject worldwide. After researching several sources, we found that the main causes of hangovers include acetaldehyde, ethanol, cytokines, and congeners. I realized that there are ways to control each of these causes to alleviate hangover symptoms. Combined, the various remedies can significantly reduce hangovers. Dan Rogers, author of Proof, the science of booze, published in the journal Nature, says, “Even if there are drugs that have some effect on hangovers, they are useless if you drink too much. The most effective hangover prevention is not to drink at all.” With this rather obvious warning, we’ll end this blog post.