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Alcohol Metabolism and How To Eliminate Hangovers

Updated on November 17, 2014

What is the Hangover?

The hangover is a physiological state that follows the consumption of more alcohol than the body is prepared to deal with. Drinking alcohol is a toxin so when you drink it, your body immediately tries to get rid of it. In so doing it uses several of the body's stores of chemical agents and micro-nutrients to convert alcohol into a harmless form that can be excreted in the urine. This work is done primarily in the liver but while the detoxification process is taking place, several parts of the body are being injured including the liver and brain. On top of that, all the resources being used to convert the alcohol are creating a deficit in the body, throwing off the delicate balance of vitamins, electrolytes, sugars, triglycerides, water and many others. The intermediary compounds that are formed along the way to excretion, coupled with the chemical imbalances and dehydration in the body collectively contribute to the run-down, nauseous, headache like feeling you get the morning after. Luckily there are ways to temper the hangover and some that may treat it too.

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What Causes the Hangover?

In order to understand what causes the hangover, we must first understand how alcohol is metabolized in the body. The body can't just eliminate alcohol when it's ingested. Instead it must employ various chemical reactions to catabolize or break down the alcohol into something which can be eliminated. This happens in a 2 step process.

When you drink alcohol, it comes into contact with your stomach lining and also your small intestines, both of which absorb the ethanol directly. Once in the bloodstream, the ethanol molecules enter cells and step 1 of the metabolism begins, which is to convert the toxic ethanol into the EXTREMELY toxic substance, acetaldehyde. Isn't that nice :) This compound is also a neurotoxin and kills brain cells AND while step 1 happens rather quickly, step 2 that gets rid of it happens more slowly leading to a build up of poison in your body :) Have I made you quit drinking yet? The main pathway facilitating this reaction is an enzyme called alcohol dehydrogenase, which uses nicotinamide adenine dinucleotide (NAD+). This unstable molecule also decays into radicals that are highly reactive and toxic themselves. Acetaldehyde and its products are part of the reason why you experience hangover. They cause oxidative stress all over the body and the "flush" you sometimes see patching your skin with redness when you've had too much is actually the visual representation of acetaldehyde buildup. You can see in those patches how much toxins you've got in your tissue. Step one consumes quite a bit of energy and NAD+.

Step 2 is to convert acetaldehyde into acetic acid using aldehyde dehydrogenase 2 or ALDH2 and more NAD+. Acetic acid is something your body can actually get rid of. Unfortunately by that point the worst is over because acetic acid isn't harmful and in fact can be used to recover a ton of lost ATP (energy) unless it's excreted in the urine, which unfortunately is highly likely since alcohol dehydrates you.

As a side note, about half of all East Asians and some American Indians have a defect in their genes that code for the metabolism of alcohol in both steps 1 and 2 making step 1 occur faster and step 2 occur slower (about 8% as efficient as others without the defect). That makes these people much more susceptible to the ill effects of alcohol including hangover. Just a warning in case you may be wondering why you can't hold your liquor or feel terrible after having 1 beer.

Summing up, by drinking alcohol you first signal the body to alter many of its activities just to cater to dealing with the alcohol load, which I won't discuss here but suffice it to say, it messes you up. It also produces highly toxic acetaldehyde directly from metabolism, which takes time to eliminate and causes damage and inflammation to many tissues while present. It requires a large supply of water to excrete the end products so if you don't drink excessive amounts of water with the alcohol (which few people would due because it makes you feel bloated) you'll become dehydrated and that in and of itself will cause dehydration induced discomfort associated with hangover. All the oxidative stress has to be combated by anti-oxidants like vitamin C and thiamine, causing a deficit of those nutrients. No wonder you feel like a dumpster the next morning.

Ok... So Tell Me How to Fix the Hangover

Preventing hangover isn't like flipping a switch. I don't want to sound like there's a bulletproof cure for the hangover. However you can try to address each of the problems that alcohol metabolism creates, which in theory should temper the ill effects or prevent them altogether, depending on how much you drink.


This is a given. Alcohol is in a much higher percentage in your drink than it is in your urine. Your body needs more water than you're consuming. If it's not practical to have a gallon of water while you're at the club at least plan to drink a liter before you go to bed. Speaking from personal experience, as little as a single glass of water makes a noticeable difference I can feel in my mouth when I wake up the next day and the headache is much milder. Dehydration by itself has nothing to do with alcohol but is a consequence of it and has its own unpleasant symptoms so when you've already got 2 strikes against you don't add a third one by going to bed dry.

Metabolic Fuel

Since your body uses a lot of different nutrients to metabolize alcohol, these will quickly become depleted, if they weren't already. You may notice a benefit from consuming vitamin c, vitamin b complex, GLA and milk thistle extract before and after drinking (do this at your own risk and always follow dosages and/or your doctor's instruction). The first 2 provide raw materials for carrying the alcohol catabolism to completion and neutralizing the free radicals produced in the intermediary steps. The second 2 are hepatoprotectants, which is to say they protect the liver from inflammation related damage since the liver will be doing most of the work and is therefore one of the most vulnerable organs to the alcohol's toxicity. The fish oil containing GLA also protects brain cells, which, as you know will be dropping like flies all night.

Activity and Metabolism

Metabolism refers to the activities going on in the body and the assosciated rates at which these activities occur. You may have heard someone saying they have a fast metabolism, drawing attention to how lean and full of energy they are. Assuming that's a true statement, their bodies would be producing energy from stored fat more quickly than a heavier person with a similar lifestyle. That's an example that differentiates people on a genetic level but you can also increase your metabolism by stepping on a treadmill for example. The demands on your body increase because you have to run to keep up with the machine so your body increases the activity level of all power producing organs to meet those needs. It is logical that the processes limiting the rate of alcohol catabolism into safer compounds can be sped up by increasing activity levels at a systemmic level. So... if you're tearing it up on the dance floor instead of drinking yourself into a depressed coma in the corner, you're likely to burn off the alcohol more quickly. I'd like to point out that I'm aware of no such scientific correlation that can be used as a meter stick but the biochemistry implies that it is true and again from my own experience I can attest to it. Don't forget though that increased activity also puts stress on your body and dehydrates you so if you're too drunk to feel pain and too dehydrated, you won't notice any benefit that may have been attributed to all that jumping around.

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Eating a lot of heavy fatty food is actually going to help you here. This is no time to get all vegan on me now ;) The fact of the matter is, complex carbohydrates and fat are more difficult to digest than simple sugars and they won't pass right through your stomach. The alcohol will get soaked up by the big wad of food in your stomach so only a fraction of the actual alcohol will be absorbed into the stomach wall at any given time and it'll stay in the stomach longer, which is good because the stomach is less efficient at absorbing alcohol than the small intestines are. Oh, by the way, meat is a good source of tryptophan and vitamin b, both of which are used to synthesize NAD+, which you're going to need to break down the alcohol. So eat away.

About Coffee

A lot of people naively believe that alcohol just makes you tired and since coffee wakes you up, it cancels out the alcohol in some way. No, that is incorrect. What is correct is that coffee is a diuretic, meaning it makes you URINATE... something you don't want to do because you'll lose more WATER. If you need a pick me up, pop a Mentos or something. In any case, what do you want to be alert for? Driving? Hahaha try again! Seriously, skip the Starbucks and just go to sleep. You'll feel better.

About Drugs

You may be tempted to pop some Tylenol, Asperin, Benadryl or some other OTC drug (hopefully it's OTC...) to deal with the symptoms of the hangover. Don't do that. In short, they all make the hangover worse and/or are bad for you in the presence of alcohol. Tylenol for instance is already bad for the liver just on its own. Since alcohol is also bad on the liver, you're kicking the poor thing while its down except that you can't feel it just now because you've numbed your nervous system. You're going to feel bad and it's going to suck so suck it up like a man and spare your body any further trauma.

Be One With the Hangover

The best thing you can do, besides being responsible and taking some modest precautions, is to accept that hangovers are inevitable consequences of drinking enough to have the time of your life. If you plan on beating the hangover you've got the wrong attitude. You may as well just give up on drinking and partying while you're at it. Think of the hangover more as a kind of retributive justice, paying the pied piper so to speak. You should be happy with any improvement you get from trying these pieces of advice but don't be bitter if you're not throwin aces in the morning. When you get in a fight with Captain Morgan, the Captain always wins ;) Arrrr!!!


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