Hangover Symptoms & Evidence-Based Treatment

Here is a quick overview of a hangover’s most common symptoms and why they occur:

• Lethargy

Alcohol causes vasodilation to several cardiovascular vessels throughout the body. One area of concern is increased blood flow to the pancreas; for example, pancreatic beta cells increase insulin production in response to higher blood flow. Increased insulin production results in a higher rate of lowering your blood sugar (i.e., hypoglycemia). Consequently, low blood sugar may cause exhaustion, fatigue, and muscle weakness.¹

• Acid Indigestion 

Also known as heartburn, increased consumption of alcohol causes the acid-producing cells in your stomach to increase. Consequently, the inner lining of your stomach and esophagus can become irritated, leading to pain and nausea. Moreover, alcohol-induced damage to the mucosal lining of the esophagus also increases the risk of esophageal cancer.¹⁰

• Nausea & Vomiting

Unfortunately, increased stomach acid can do more harm than just making you feel fatigued. Along with increased acid, alcohol may cause a drop in stomach emptying; consequently, resulting in nausea and vomiting.²

• Headache

As mentioned, alcohol results in vasodilation, even to the blood vessels in your brain. Initially, increased blood flow to the brain may lead to a euphoric, relaxed feeling given the drop in your blood pressure. However, as soon as you imbibe your first drink, your liver begins digestion ethanol, leading to several by-products. One major by-product of ethanol digestion is a molecule known as adenosine. Research has shown that Adenosine signaling may contribute to headache via the modulation of intracellular cyclic adenosine monophosphate (cAMP) production or 5’ AMP-activated protein kinase (AMPK) activity in neurons and glia to affect glutamatergic synaptic transmission within the brainstem. This is so common there is even a name for this type of headache: delayed ethanol-induced headache DEIH).³

• Dehydration 

Alcohol affects your kidneys by increased the rate of water loss, making it a strong diuretic. As you lose fluid through frequent urination, your body becomes low in water as well as vital vitamins and minerals. This directly causes your body to become dehydrated, leading to more severe concerns if not replenished.⁴ 

• Dizziness

Dizziness is a common symptom of the dehydration that comes with a hangover. When you’re dehydrated, your blood pressure drops, limiting blood flow to your brain and causes dizziness.⁵

• Cognitive Impairment

Alcohol, as well as its metabolites (e.g., adenosine, acetaldehyde), affect your brain in several regions:

1. Frontal Lobe: Loss of reason, caution, inhibitions, sociability, talkativeness, and intelligence
2. Parietal Lobe: Loss of fine motor skills, slower reaction time, shaking
3. Temporal Lobe: Slurred speech, impaired hearing
4. Occipital Lobe: Blurred vision, poor distance judgment
5. Cerebellum: Lack of muscle coordination and balance
6. Brain Stem: Loss of vital functions

Drinking alcohol, especially if you’re already dehydrated or becoming dehydrated, can make it harder to focus on specific tasks, react during situations, and make decisions. All these effects may make you feel much less alert, less able to remember things, and less able to make logical decisions when you’re hungover. Furthermore, a study done in 2017 demonstrated that these aspects of cognitive function were all highly impacted during a period of hangover symptoms.^6-8

• Mood Changes

The fluctuations in blood sugar that accompany drinking can lead to negative moods, including anxiety and anger, and mood instability. This can occur both during and after drinking. Drinking can also affect your mood if you already have a mental health condition or use alcohol as a coping mechanism for your emotional health. A 2017 study found that many people report feeling more aggressive or overwhelming emotions when they drink, especially if they have some alcohol dependence.⁹

• Tachycardia

At low levels, alcohol is known to increase your heart rate. The more you drink, the more your heart will respond. A 2018 study of 3,000 attendees of Oktoberfest in Munich, Germany, found that high alcohol levels, especially in younger people, are associated with symptoms like sinus tachycardia. This is a heart rate of over 100 beats per minute, well above the average heart rate. The study also suggested that heart rate increases as you drink more alcohol, and these increases can raise your risk of arrhythmia, an irregular heartbeat.^11,12

Research-Based Method for Alleviating Hangover Symptoms

Unfortunately, there are so many “old wives’ tale” methods on how to alleviate a hangover’s symptoms, it can be challenging to discern what is fact from false. So, although sucking on a penny or stuffing yourself with a Denny’s grand slam won’t alleviate the symptoms, there are a few evidence-backed ways that will help hangover symptoms. As I’ve mentioned, several hangover symptoms are a direct result of dehydration, mineral/vitamin loss, and cognitive impairment. You’d be right if you guess that the best way to reverse symptoms of a hangover is by reversing the three results mentioned above. One of the best ways, as shown by research, is through infusion therapy, also known as IV therapy.^13-15 This replenishes your body with all the essential components that it lost through alcohol consumption. Make sure to check with your provider as to what ingredients make up a hangover infusion bag. Ensure it is high in saline (for hydration), vital nutrients, and, if possible, an anti-emetic (anti-nausea).

Based on the evidence, we have formulated a specific IV infusion for rapid hangover symptom relief. Also, we save you the trip to a clinic for treatment (which is hard to handle with a hangover) and administer IVs in the comfort of your home or hotel room. If you have any questions on anything discussed in this post, please comment below! Also, give us a call at (480) 223-9323 to schedule your hangover infusion, or visit my website at https://vitalconnectionmd.com/iv-therapy/ if you’d like more information on IV therapy.

References

1. Huang Z, Sjöholm A. Ethanol acutely stimulates islet blood flow, amplifies insulin secretion, and induces hypoglycemia via nitric oxide and vagally mediated mechanisms. Endocrinology. 2008 Jan;149(1):232-6. doi: 10.1210/en.2007-0632. Epub 2007 Oct 4. PMID: 17916634.
2. Bode, C., & Bode, J. C. (1997). Alcohol’s role in gastrointestinal tract disorders. Alcohol health and research world, 21(1), 76–83.
3. Fried, N. T., Elliott, M. B., & Oshinsky, M. L. (2017). The Role of Adenosine Signaling in Headache: A Review. Brain sciences, 7(3), 30. https://doi.org/10.3390/brainsci7030030
4. Polhuis, K., Wijnen, A., Sierksma, A., Calame, W., & Tieland, M. (2017). The Diuretic Action of Weak and Strong Alcoholic Beverages in Elderly Men: A Randomized Diet-Controlled Crossover Trial. Nutrients, 9(7), 660. https://doi.org/10.3390/nu9070660
5. Lanier JB, Mote MB, Clay EC. Evaluation and management of orthostatic hypotension. Am Fam Physician. 2011 Sep 1;84(5):527-36. PMID: 21888303.
6. Irwin C, Leveritt M, Shum D, Desbrow B. The effects of dehydration, moderate alcohol consumption, and rehydration on cognitive functions. Alcohol. 2013 May;47(3):203-13. doi: 10.1016/j.alcohol.2012.12.016. Epub 2013 Jan 23. PMID: 23352231.
7. van Schrojenstein Lantman, M., Mackus, M., van de Loo, A., & Verster, J. C. (2017). The impact of alcohol hangover symptoms on cognitive and physical functioning, and mood. Human psychopharmacology, 32(5), e2623. https://doi.org/10.1002/hup.2623
8. Abrahao KP, Salinas AG, Lovinger DM. Alcohol and the Brain: Neuronal Molecular Targets, Synapses, and Circuits. Neuron. 2017 Dec 20;96(6):1223-1238. doi: 10.1016/j.neuron.2017.10.032. PMID: 29268093; PMCID: PMC6566861.
9. Ashton K, Bellis MA, Davies AR, et al Do emotions related to alcohol consumption differ by alcohol type? An international cross-sectional survey of emotions associated with alcohol consumption and influence on drink choice in different settings BMJ Open 2017;7:e016089. doi: 10.1136/bmjopen-2017-016089
10. Bode C, Bode JC. Alcohol’s role in gastrointestinal tract disorders. Alcohol Health Res World. 1997;21(1):76-83. PMID: 15706765; PMCID: PMC6826790.
11. The abstract ‘Acute alcohol consumption and effects on cardiac excitation, conduction, and repolarization. Results from the MunichBREW Study’ will be presented during the session Arrhythmias general – The unusual and unexpected which takes place on 18 March from 11:00 to 12:30 in the Agora – Poster Area.
12. Brunner, S., Herbel, R., Drobesch, C., Peters, A., Massberg, S., Kääb, S., & Sinner, M.F. ‘Alcohol consumption, sinus tachycardia, and cardiac arrhythmias at the Munich Octoberfest: results from the Munich Beer Related Electrocardiogram Workup Study (MunichBREW)’. Eur Heart J. 2017, 38(27): 2100–2106. DOI: 10.1093/eurheartj/ehx156.
13. Opitz, A., Hubert, J., Beste, C., & Stock, A. K. (2019). Alcohol Hangover Slightly Impairs Response Selection but not Response Inhibition. Journal of clinical medicine, 8(9), 1317. https://doi.org/10.3390/jcm8091317
14. Hogewoning, A., Van de Loo, A., Mackus, M., Raasveld, S. J., De Zeeuw, R., Bosma, E. R., Bouwmeester, N. H., Brookhuis, K. A., Garssen, J., & Verster, J. C. (2016). Characteristics of social drinkers with and without a hangover after heavy alcohol consumption. Substance abuse and rehabilitation, 7, 161–167. https://doi.org/10.2147/SAR.S119361
15. Verster, J. C., Vermeulen, S. A., Loo, A., Balikji, S., Kraneveld, A. D., Garssen, J., & Scholey, A. (2019). Dietary Nutrient Intake, Alcohol Metabolism, and Hangover Severity. Journal of clinical medicine, 8(9), 1316. https://doi.org/10.3390/jcm8091316