dr david bull

Hangover Hell…….

In Opinion Pieces on October 19, 2012 at 3:48 pm

What is alcohol and how does it work?

Alcohol has been drunk for millennia. It’s the world’s most widespread recreational drug. Gin, my favourite tipple, has been made from juniper berries since before the middle ages. It’s been used as a remedy for the black death (not very effectively), as a calming tonic in battle, (probably not terribly useful), used in the British colonies to mask the bitter taste of quinine and was held responsible for the downfall of women, so-called “mother’s ruin”.

Alcohol is made by the fermentation of sugar using yeast. It’s an organic compound with the chemical composition C2H5OH.  Once drunk, it is easily absorbed through the stomach lining and enters the blood stream. From here, it travels around the body affecting various organs, the most noticeable one being the effect it has on the brain and nervous system. It’s broken down or metabolized by the liver. In small amounts alcohol is good for you. This means fewer than 20units a week for men and fewer than 15 units a week for women.



What effect does alcohol have on the brain?

The chemical composition of alcohol means that it can easily cross the blood brain barrier. The alcohol causes intoxication by affecting the chemical messengers of the brain. This happens when alcohol is absorbed faster than it can be metabolized.

It is dose dependent. So the more you drink, the greater effect it has. You can only metabolize about one unit an hour so if you drink more than this then you will be intoxicated.


Why do you feel better when drinking it?

As the alcohol affects the brain, it causes a sense of euphoria and reduces social inhibitions, which can land you in a lot of trouble! But as you begin to drink more, it starts to cause other effects. The more you drink the worse it gets.

  • Slurred speech
  • Decrease in balance
  • Difficulty walking in a straight line
  • Dehydration
  • Nausea and Vomiting
  • Tremor, confusion, fits, hallucinations
  • Coma
  • Death – a third of these are due to accidents whilst intoxicated.

Alcohol affects almost every system in the body. Long-term use can affect


  • Changes to the liver structure including fatty liver, hepatitis and cirrhosis
  • Decrease in liver function

Brain and Nervous System

  • Decreased memory and lack of concentration
  • Fits and falls
  • Encephalopathy (brain damage)

Stomach and Intestines

  • Obesity
  • Nausea, vomiting and diarrheoa
  • Stomach ulcers, bleeding
  • Pancreatitis
  • Cancer


  • Anaemia
  • Bleeding


  • Arrhythmias
  • Raised blood pressure
  • Sudden death

What is bad alcohol?

There are different purities of alcohol. The purer it is, the fewer the side-effects. Also if that wasn’t bad enough, it’s not just alcohol that the body has to deal with. Many drinks have other things mixed with them including a lot of coloured, sugary additives.

We now know that clear pure alcohol causes far fewer symptoms than sweet sugary cocktails made with inferior alcohol. It is also dose dependent, so the less you drink, the fewer the side-effects.


Why does alcohol affect different people differently?

Alcohol does affect people differently. This is partly due to our genetic make-up. Some of us can process alcohol better than others. For example, some East Asians have a mutation of their Alcohol Dehydrogenase enzyme (the enzyme that breaks down alcohol) which means that they get drunk very quickly as they can’t process it. Also as you get older, we have less of the enzyme and so can’t break the alcohol down as quickly as we could when we were younger. Interestingly about 25-30% of people may be resistant to getting hangovers – lucky them!


What gives you a hangover?

It’s all to do with the way alcohol is broken down by the body.

Alcohol is converted by an enzyme called alcohol dehydrogenase into a by-product called acetaldehyde. This is 10-30 times more toxic to the body than alcohol itself. The acetaldehyde is then further converted into acetic acid. This compound stops the body from producing glucose so the blood glucose falls. In addition, any additives to the drinks (like sugars, different compounds etc) produce by-products or congeners like methanol (this is also produced by poor distillation). This is converted to a very toxic chemical called formaldehyde which causes ketoacidosis (the body becomes very acidic). The more you drink, the more of these toxic chemicals you produce. Alcohol also affects the kidneys causing dehydration. A combination of all of these cause the symptoms.


What is a hangover?

Symptoms of a hangover include

  • Headache
  • Nausea and Vomiting
  • Sweating
  • Intolerance of bright light and noise
  • Sluggishness and lethargy
  • Thirst and dehydration
  • Tremor and shaking
  • Depression, anxiety
  • Raised heart rate and body temperature
  • Decreased sleeping, lack of coordination, smelly breath


Do old wives tales work?

Some do and some don’t.

The best way to target a hangover is to treat the causes one by one.

  1. Dehydration : Make sure you rehydrate well. Drink lots of fluids
  2. Electrolytes : These are severely depleted so drinking sports drinks,    dioraylte or  coconut water will help
  3. Eggs : These contain a chemical called cysteine. Helps to restore normal function
  4. Alcohol :This blocks the production of the toxic chemical formaldehyde so many people swear by “hair of the dog”
  5. Milk Thistle : This seems to reduce nausea and may help to regenerate the liver cells. It seems more effective when coupled with exposure to the sun (which makes vitamin D). Hence why some people say they don’t get hungover on holiday
  6. Brewers Yeast : This contains vitamin B6
  7. N-Acetyl-Cysteine : This reduces the level of the toxic product Acetaldehyde. Its best when combined with Vitamin B1
  8. Ginger/Tolfenamic Acid : This reduces nausea and the stomach upset
  9. Acetyl Leucine:  This may reduce the vertigo
  10. Cannabis : Legal in some parts of the US – the active ingredient THC reduces the nausea and headache. It also increases the appetite so that you eat which counteracts the low blood sugar.

Interestingly a number of studies have been done to find the best hangover cure. There is no conclusive proof that any of these work. The only proven way to stop hangovers is not to drink in the first place. Sorry!

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