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Anyone who has overindulged in alcohol has likely experienced the symptoms of a hangover. Hangovers after drinking tend to be unpleasant. For someone who only drinks occasionally, they fade and there is minimal long-term damage. But frequent alcohol drinkers who often develop hangover effects tend to suffer a decline in their quality of life.

What Causes Hangovers after Drinking?

Hangover effects occur when someone consumes too much alcohol. They tend to vary from person to person but usually worsen with higher alcohol intake.

Several things cause hangovers, including:

  • Alcohol is a diuretic, which means it triggers urination. Frequent urination without replenishing bodily fluids leads to dehydration
  • Alcohol irritates your stomach by increasing the production of acid, which can lead to pain, nausea, vomiting, and diarrhea
  • Alcohol causes a drop in blood sugar, which can trigger weakness, fatigue, shaking, and in some cases, seizures
  • Alcohol causes blood vessels to expand, which is why many people experience a headache as a symptom of a hangover
  • Mild withdrawal, which can cause someone to feel restless or anxious

Additionally, alcohol triggers inflammation, in part due to how it is metabolized. The process results in the creation of acetaldehyde, a toxic byproduct that contributes to inflammation throughout the body. The enzyme alcohol dehydrogenase (ADH) metabolizes the ethanol (the type of alcohol in alcohol) into toxic acetaldehyde. From there, the liver enzyme aldehyde dehydrogenase (ALDH) metabolizes acetaldehyde into acetate, a less toxic compound that breaks down into water and carbon dioxide.

Another reason why drinking too much alcohol leads to a hangover is because of congeners, an ingredient produced during the fermentation process. Dark liquors tend to have higher amounts of congeners, which is why many people find their hangovers after drinking whiskey to be worse than when they drink clear liquors like gin and vodka. Congeners include, but are not limited to:

  • Acetone
  • Fusel oil
  • Furfural
  • Methanol's metabolites
  • Polyphenols
  • Histamines
  • Esters
  • Tannins
  • Amines
  • Amides

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Symptoms of a Hangover

Hangover symptoms vary from person to person and are at their peak when blood alcohol concentration returns to about zero. Symptoms typically last about 24 hours or longer. The severity of symptoms is also based on the amount and type of alcohol consumed.

In general, hangover symptoms include:

  • Fatigue and weakness
  • Extreme thirst
  • Headaches aches
  • Muscle aches
  • Nausea or vomiting
  • Stomach pain
  • Poor sleep
  • Increased sensitivity to light and sound
  • Dizziness or room spinning sensation
  • Shakiness
  • Concentration problems
  • Mood disturbances
  • Rapid heartbeat

Although drinking higher amounts of alcohol tends to worsen hangover symptoms, some people are at risk regardless of how much they consume. Other factors affecting the severity of a hangover include:

  • Drinking alcohol without consuming foods
  • Using other drugs, such as nicotine, along with alcohol
  • Sleeping poorly after drinking
  • Family history of alcoholism which might indicate an inherited problem with the way a person’s body processes alcohol
Is a Hangover Ever an Emergency?

Most of the time hangovers after drinking are not cause for serious medical concerns. They tend to fade on their own and ease as you rest and rehydrate your body. But there are occasions in which serious hangover symptoms could indicate alcohol poisoning, which is life-threatening.

You should seek immediate medical attention if any of the following symptoms occur after drinking alcohol:

  • Cold or clammy skin
  • Confusion
  • Vomiting
  • Seizures
  • Slow breathing or irregular breathing
  • Blue-ish or pale skin
  • Low body temperature (hypothermia)
  • Difficulty remaining conscious or passing out and struggling to awaken
  • Unconsciousness

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Hangover Health Effects

In addition to feeling awful, hangovers tend to interfere with your ability to concentrate. They reduce dexterity and affect your memory. Even people who are not frequent alcohol drinkers suffer when they have a hangover. Hangovers after drinking trigger:

  • Absenteeism
  • Workplace injuries
  • Conflicts
  • Difficulty completing tasks
  • Falling asleep at work or school

Treatment and Prevention of Hangovers after Drinking

There are no science-backed treatments for hangovers. The majority of “remedies” available are myths. Over-the-counter pain remedies can ease certain hangover symptoms, but mixing these medications with alcohol can worsen other symptoms and in some cases, be dangerous.

To ease the discomfort of a hangover, you should get plenty of rest, rehydrate with water, and abstain from alcohol.

The only definitive way to treat a hangover is to avoid getting one in the first place by not overindulging in alcohol. The less alcohol you drink the less likely you are to develop a hangover. It’s also important to make sure you eat while drinking, drink a glass of water between each alcoholic beverage, and choose alcohol that is less likely to trigger hangover symptoms.

Experiencing hangovers after drinking a few times in your life is enough for most people to abstain from consuming excess alcohol. But if you notice you are experiencing hangover symptoms frequently or you develop a hangover every time you drink alcohol, it could be an indication of a problem with alcohol. It’s best to speak to your doctor so you can determine what’s causing your hangover symptoms.

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Resources

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“Hangovers.” National Institute on Alcohol Abuse and Alcoholism (NIAAA), 25 Apr. 2019, https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/hangovers

“Alcohol Poisoning - What to Do.” Utexas.Edu, 2020, https://healthyhorns.utexas.edu/alcoholpoisoning_whattodo.html

“Hangovers - Diagnosis and Treatment - Mayo Clinic.” Mayoclinic.Org, 2017, https://www.mayoclinic.org/diseases-conditions/hangovers/diagnosis-treatment/drc-20373015

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