We've all been there after a few too many. Headaches, dehydration, anxiety and fatigue are just some of the symptoms we experience from too much alcohol, but what's actually going on in our bodies to make this happen? And more importantly... what can we do to help?
What is a hangover?
There are many factors that contribute to a hangover, ranging from simple dehydration to more complex disruptions in normal metabolism.
When we drink, our pituitary gland suppresses the release of something called anti-diuretic hormone, which in turn causes the kidneys to flush the system as a means to protect the body from alcohol. This process flushes water and electrolytes out of the system at the same time, causing dehydration and its accompanying symptoms. This can contribute to the hangover headache, but hangovers as a whole are more complex than just dehydration.
Alcohol is a toxic compound, but the byproducts of alcohol metabolism are said to be 10-30x more toxic than the drink itself. One of the most disruptive parts of a hangover is the accumulation of a compound called acetaldehyde, which is a byproduct of alcohol metabolism that in high amounts can cause sweating, pain, nausea, vomiting and fatigue. Hangovers are also driven by various effects on the immune system. Studies have found high levels of inflammatory cytokines (molecules that are a part of the immune system) accompany hangovers. Cytokines trigger things like fever and inflammation to battle infection, however alcohol also stimulates cytokine production, which contributes to hangover symptoms like muscle aches, headaches, fatigue and irritation.
Alcohol consumption also affects energy production. It is said to impair glucose metabolism which is why our blood sugar feels so out of whack after one too many, and it can also increase cortisol secretion, which is the body's fight or flight (stress) hormone. Short term this will feed into anxiety, sugar cravings, and sleep disruptions, and long term increase your chance of weight gain, exhaustion and impaired immunity.
What's the liver's role in all of this? And how can you support it?
Ok this gets a bit science-y - most alcohol is is metabolised by an enzyme in the liver cells called alcohol dehydrogenase (ADH). ADH is responsible for breaking alcohol down into acetaldehyde, which in itself is quite toxic to the body. Thankfully, this compound is then passed onto another enzyme called aldehyde dehydrogenase (ALDH), which quickly works to break down acetaldehyde into acetate which can then be excreted by the body. If you consume alcohol faster than you are able to metabolise it, there can be a build up of this acetaldehyde which is toxic to the body. As a guide, the body can process about 10g of alcohol per hour - that's one 125ml glass of wine or one unit.
Some people are more efficient than others at this process, and this is mainly down to genetic variations. Different people and populations have different concentrations of ADH and ADLH, which is one of the reasons why alcohol tolerance amongst individuals can be so varied. The antioxidant glutathione also plays a part in liver detoxification - especially the byproducts of alcohol metabolism. Glutathione runs out quickly, which too is dictated by our genes, BUT - is also influenced by our diets. Cysteine is a sulphur rich amino acid that is a key building block for Glutathione and is high in eggs, garlic, sunflower seeds, oats, turkey and soya beans. Asparagus, spinach, avocado, squash, melons grapefruits & peaches all contain glutathione, and cruciferous vegetables can also help increase levels. Milk thistle has been shown to increase glutathione production and also have a protective function on hepatocytes (liver cells) to help prevent damage from harmful toxins.
Why does alcohol cause sleepless nights?
Alcohol suppresses the production of Glutamine, which is one of the body's natural stimulants (it's known as an excitatory neurotransmitter). Once alcohol levels drop, the body tries to play catch up by over producing glutamine, which is what wreaks havoc on your system. This is what's known as a glutamine rebound, and it's the main culprit for why sleep is disrupted. With excess glutamine in the blood stimulating the brain, the body can't achieve deep sleep - this is often why you feel exhausted but wired in the middle of the night if you've been drinking. If the glutamine rebound is severe, it can also cause anxiety, tremors, feelings of restlessness and can irritate the stomach causing nausea the next day.
Does exercise help?
The short answer is yes. But exercise can be a double edged sword when you're hungover. The toxins produced by alcohol are mostly metabolised by the liver, but the remainder need to be excreted through breath, urine and sweat. Exercising when you're hungover allows the body to expel toxins via breath and sweat more rapidly, which should help your hangover. However, because you're dehydrated and the body isn't able to metabolise carbohydrate in the normal way, exercising while hungover can exacerbate dehydration, cause muscle cramps, electrolyte imbalances and increase your risk of muscle strains or injury. Don't get me wrong, I'm all for sweating it out. But the best way to do it is to make sure you've replenished electrolytes first - you don't need anything too sugary, but a fresh mixture of fruit sugars and salt will do the trick. I love the juice of 1/2 grapefruit (which will also support liver function) and some sea salt in a glass of water. Hands down the best kind of exercise to do for a hangover is cardio - you want something that will increase your circulation, respiration and get you sweating as much as possible to help your body expel toxins. Because your senses can be impaired from a hangover, I wouldn't recommend doing heavy weight sessions. You'll be at a higher risk of injury.
What are the hangover cures that actually work?!
Battling a hangover is all about fighting the root causes.
- Dehydration - many health experts advise aggressive hydration after a night out. This means water, electrolytes and a total avoidance of substances that exacerbate the fact (bye bye coffee....). Caffeine - although may instantaneously make you feel better - will only worsen your symptoms, so it should be avoided (I'm still working on this one...). Pink grapefruit juice with a little Himalayan sea salt and water is one of the best natural hangover helpers. Grapefruits help support liver detoxification but are also high in anti-oxidants and vitamin C, which will help the body neutralise toxins and the sea salt helps replenish electrolytes.
- Sweat! Cardio is one of the best ways to help excrete toxins (as discussed above), just make sure you hydrate and refuel afterwards to help stabilise electrolytes and blood sugar.
- To support alcohol metabolism - you want to load up on foods that support glutathione production and supplements to neutralise free radical damage + inflammation. Milk thistle, Vitamin C and a b complex can all help your body deal with alcohol. Take them before the night out and in the morning to help support your metabolism. Milk thistle is also hepato-protective and helps with glutathione production. You can also load up on cysteine rich foods (as mentioned above) and natural sources of glutathione.
- To reduce inflammation & pain - echinacea extract has been shown to inhibit the production of inflammatory cytokines, so if you're looking for a natural alternative rather than loading up on painkillers, this is your go to.
- To help reduce the symptoms of glutamine rebound - Magnesium is a calming or inhibitory neurotransmitter, which can help relax the system if you're overly wired or anxious.
- Impaired energy metabolism - this one is all about your nutrition. The body actually needs simple, one step nutrition - which means things that don't need to be digested very much before they's absorbed. A smoothie with glucose rich fruit, anti-inflammatory oils, cysteine and other amino acids as well as a few botanicals to fight inflammation is my go to in terms of advice. Alkaline Infusion and Green Light with added Alkaline Minerals from Energy Kitchen are great hangover remedies.
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