Anatomy of a Hangover

Is there a cure for the tragic, albeit self-induced malady?

By Ian Lloyd Published November 2012, Volume 33, Number 5

“Never again is what you swore the time before.” These song lyrics from Depeche Mode
summarize our feelings about the curse of imbibing: the hangover. The symptoms are unmistakable: headache, body aches, nausea, fatigue and perhaps tremors. It is of little comfort to know that despite its widespread prevalence, medical science has not developed a cure for the hangover. Studies have shown that more than 75 percent of men and women have experienced a hangover at least once in their lives. Another 15 percent experience hangovers monthly. So what works and what doesn’t?  My answer might not make you feel better, but at least you will understand why you feel so rotten.

Despite widespread occurrence of hangovers, there has been little research done to find a cure.

What exactly causes veisalgia (the medical term for an alcohol hangover)? Sadly, no one knows. What science does know is that hangover symptoms have a notable impact upon society. “Specifically on lost productivity the last estimate for Canada was [published] in 2006,” tells Dr. Tim Stockwill of the Centre for Addictions Research of British Columbia. Dr. Stockwell is referring to a report written by Dr. Jürgen Rehm and associates for the Canadian Centre for Substance Abuse (www.ccsa.ca). In this 2006 report, $23 million dollars and 227,000 days in were lost to reduced activity due to short-term disability from alcohol abuse in the year 2002. In the United States this figure is closer to $148 billion. The toll is especially hard on college students. One study, published in the June 2000 edition of the Annals of Internal Medicine, found that 29 percent of students reported having to miss classes to recover from a hangover. Despite the widespread occurrence of this tragic, albeit self-induced, malady there has been little research done to find a cure.

The Cause, Mostly Theoretical

There are many theories about what causes a hangover. The most plausible theory is that excessive alcohol consumption causes dehydration and electrolyte imbalances. We all know that beer can act as a diuretic (something that makes you urinate more). “Excessive alcohol consumption can interfere with pituitary secretion of vasopressin”, explains Dr. Dan Martinusen, Clinical Pharmacist specializing in kidney disease for Vancouver Island Health Authority. Vasopressin, or antidiuretic hormone, normally helps the kidneys reabsorb water. With less of this hormone around, your kidneys are unable to conserve water causing you to make more trips to the washroom. This is why there are so many port-a-potties at beer festivals.

“The resulting diuresis (increased urine production) may lead to rapid dehydration and subsequent shrinking of the dura mater surrounding the brain.” Dura mater is a connective tissue lining that surrounds the brain and spinal cord connecting it to your bones. Dr. Martinusen further explains that one possible cause of headaches is contraction of this dura mater. He continues, “this is certainly a plausible theory for headache symptoms during an alcohol hangover.”  Electrolyte imbalances often follow excessive urine output. Sodium and potassium are carried away in the urine. Symptoms of mild dehydration include thirst, dry mouth, dizziness, nausea/vomiting and muscle cramping. Dehydration may be further worsened if vomiting, diarrhea or excessive sweating is present.

Ian Lloyd is a pharmacist and freelance writer.
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