It’s almost New Year’s Eve, and just as many people are looking for a surefire way to avoid a hangover to ring in 2018, the only tried and true approach that is guaranteed to work is this: abstinence. But short of this drastic option, there are a number of ways to reduce your chances of a having to make a trip to the ER, or even the need for a home visit by a nurse to place an IV in your arm to deliver fluids and a mixture of vitamins to soothe your aches and pains. Fighting a hangover So while there are a plethora of hangover products on the market that tout the ability to reduce the chances of, or prevent a hangover altogether after a night of heavy drinking, in truth the only proven way to prevent a hangover is not to imbibe. One product, Morning Recovery taps a chemical extract known as DHM (dihydromyricetin) from the Japanese Raisin tree which includes vitamin B, milk thistle, prickly pear and taurine. Morning After claims that the combination of these ingredients can reduce the side effects of alcohol withdrawal that leave you feeling groggy and nauseated. They also claim that DHM helps the liver detox faster, while also blocking alcohol from binding to receptors in the brain. While DHM has worked successfully in a rat model to prevent alcohol from bonding to receptors in the brain of intoxicated rats, there is no evidence to suggest it may work in humans. A human trial and control group is needed to determine its effects. Another product Mentis, developed by two Yale graduate students, aims to prevent a hangover from developing in the first place by a proprietary combination of vitamins and anti-inflammatory compounds. It’s taken before you start your night of drinking. Their goal is to prevent buildup of acetylaldehyde, the toxic metabolite of alcohol, as well as the adverse inflammatory and immunologic effects of alcohol. There is also interesting research published in 2013 by Yunfeng Lu and colleagues in Nature Nanotechnology showing proof of concept of deploying nanospheres to detoxify the byproducts of alcohol metabolism before they actually cause symptoms. This may hold promise in the future, but has yet to reach market. Yet, with all of the product marketing over the past several decades, it’s important to realize that there are no FDA approved products for hangovers on the market and appear to be none on the horizon. With this in mind, I advise drinking non-alcoholic drinks such as club soda, ice tea, and spritzers as alternatives to alcohol to avoid the chance of developing a hangover in the first place. If you have an alcoholic drink, do so in moderation. It is also wise to eat before you start drinking since having food in the stomach slows the absorption of alcohol in the body. A meal which incorporates some fat and protein may help absorb alcohol. Also, it's a good idea to snack throughout the evening to not only reduce the effects of alcohol, but also keep your blood sugar level steady. It’s advisable to drink slowly and make every other drink a non-alcoholic one. Water is the best substitute. Pedialyte, Powerade and Gatorade contain added sodium, potassium as well as sugar which can help replete your body of lost electrolytes. After a hangover headache develops, drinking Sprite, which contains the compound taurine, may help to alleviate its intensity. Some research also suggests that taking Prickly Pear extract may also help reduce the degree of buildup of toxic metabolites of alcohol in your bloodstream. Immunologic markers reflect that this extract may actually help to ease nausea and aches to some degree. While a jolt of caffeine may help get you going the morning after, caffeinated drinks in general increase heart rate and actually contribute to dehydration. Try to avoid darker alcohols as they contain more congeners, which are toxic chemicals and byproducts of the fermentation process. Red wine, bourbon and whiskey have high congeners which increase the risk of a hangover headache. Gin, vodka, and white wine have lower levels of congeners, and are less likely to lead to a headache. It’s best to take a nonsteroidal anti-inflammatory (NSAID) such as ibuprofen before going to sleep, and drink several glasses of water. This can alleviate some of the pain associated with a hangover headache. Avoid acetaminophen, which can compound liver injury after a heavy night of drinking. There is no magic pill to prevent a hangover. Drinking less than you normally do, or abstaining altogether is the only proven way to reduce the chances of getting a hangover. The hangover itself is actually a form of alcohol withdrawal. Headache, nausea, dizziness, difficulty concentrating result from not only the toxic byproducts of alcohol metabolism, but your alcohol level dropping as you sober up. Basics of the Hangover Headache Acetylaldehyde is the byproduct of alcohol metabolism that is responsible for causing a hangover headache. It leads to nausea, vomiting, dizziness, light sensitivity, and the headache itself. Immunologic factors may also play a role in the pathogenesis of a hangover. Elevated levels of cellular compounds known as cytokines such as IL-10 and Interferon Gamma may be partly responsible for the achy feelings, headache and nausea. Inflammation resulting from byproducts of alcohol ingestion are also believed to affect crosslinking of cells and tissues. The long term effects are unclear. Additionally, a phenomenon known as “glutamine rebound” from depleted glutamate stores in the liver is responsible for disrupted sleep patterns in the setting of a hangover. REM sleep is affected significantly, leading people to wake up periodically throughout the night. Source
