Almost anyone has ever had a drunken day after a party. Waking up is accompanied by many inconveniences and discomforts, which follow us for a good part of the day. Nausea, headaches and stomach aches are the most common symptoms of a hangover, or "veisalgia" for the medical term. The fact remains that the only valid insurance, in order not to risk finding yourself in this uncomfortable situation, is to control your alcohol consumption. However, if we go beyond the “reasonable” limits, how can we reduce or even avoid the associated inconvenience the next day? What happens to our body when we drink too much alcohol? Will we ever be able to remedy this medically?
A hangover is nothing more or less than acute alcohol intoxication, our body has been “poisoned” by alcohol. Veisalgie is the learned name for hangover:from the Norwegian kveis , which means "discomfort following debauchery" and from the Greek algia (pain). It brings together a multitude of causes and effects, making it difficult to find the miracle cure. Not to mention that everyone's reaction to excessive alcohol consumption is different. The response varies greatly depending on intrinsic factors (which depend on the individual), environmental and temporal factors.
Despite the omnipresence of alcohol in certain cultures, and has been for many centuries, research on hangovers has only really been effective since the beginning of the 2000s. This is why knowledge on the subject remains rather vague. , the mechanisms of this acute alcohol intoxication remaining poorly understood.
First, let's go back to what triggers this feeling of discomfort the day after a drunken evening. Throughout the current scientific literature, several types of explanations emerge, although none of them can fully explain this post-party state, and its persistence after the elimination of alcohol from the body. Indeed, the climax of the hangover is felt when the blood alcohol level is at 0g/L. Excessive alcohol consumption attacks almost all parts of the body and the attacked organs are forced to defend themselves.
One of the main causes put forward, as an explanation for hangovers, is alcohol-induced dehydration. This substance is diuretic, as a recent publication from Harvard University points out. It should be noted that on average, four glasses of alcohol make you lose almost a liter of water. When dehydrated, the body draws water from certain organs, including the brain. We then observe atrophy of the brain as well as a reduction in the size of the meninges (protective envelopes surrounding the brain). It is their atrophy that causes headaches. The dehydrated body also has a significant lack of electrolytes, which could explain the cramps and muscle pain felt after parties.
Lack of sleep seems to be another factor contributing to the occurrence of feelings of discomfort related to this alcohol intoxication. Indeed, as specified in a study by the National Institute on Alcohol Abuse and Alcoholism, if alcohol abuse ends up creating severe drowsiness, sometimes falling asleep suddenly, the resulting quality of sleep is strongly affected by the 'alcohol. More specifically, sleep is then less deep and interrupted by a multitude of fairly long waking phases. This degraded sleep thus contributes to fatigue as well as the lack of coordination and concentration felt the day after evenings.
It also appears from this that alcohol consumption causes a drop in blood glucose levels, which is linked to dehydration. However, if this state of hypoglycemia was entirely responsible for the hangover, glucose intake should be the solution, which is far from the case according to several studies.
Ultimately, the hangover could be the result of an inflammatory response in the body. A team of Korean researchers has thus noted that a hangover is accompanied by high levels of cytokines, soluble messengers ensuring communication between cells and the immune system, testifying to a runaway of the latter. If this inflammatory response was the factor inducing the hangover mechanism, then taking an anti-inflammatory would suffice to clear it up, such as ibuprofen. Which again is far from being the case.
As a result, a hangover seems to be the conjunction of several intertwined causes, and not the result of a single factor.
In the event that the evening is well watered, it seems preferable, firstly, not to mix alcoholic beverages — all do not act with the same intensity —, and secondly, to favor white alcohols (wine white, lager, gin, etc.).
Indeed, for the same amount of alcohol, some choices are better than others for reducing unpleasant symptoms upon waking. A study published in 2010 compared the effects of bourbon and vodka on the intensity of the hangover following their consumption. Nearly 100 young adults had volunteered. Those who had consumed bourbon seemed to experience more severe symptoms upon awakening than those who had consumed vodka.
The congeners would be responsible for it. These are the substances present in alcoholic beverages, resulting from alcoholic fermentation, or added during the production process in order to improve the organoleptic properties. These substances are, among others, amines, amides, polyphenols, histamine, methanol and tannins. They can have toxic effects and influence the rate at which the alcohol breaks down. Congeners are mainly present in brown alcohols (whisky, cognac, etc.). For example, bourbon contains 37 times more than vodka.
It is therefore not the mixture of alcohols that makes the day after a boozy party even more uncomfortable, but the types of alcohol consumed. As long as you drink several different alcoholic drinks in the same evening, it would seem wiser to choose drinks low in congeners.
When we drink an alcoholic drink, the ethanol it contains is absorbed very quickly in the gastrointestinal tract (all the organs of our digestive system, from the mouth to the anus), then goes to the liver . This organ takes care of it thanks to alcohol-dehydrogenase (ADH) enzymes, which break it down into several by-products. The digestion of alcohol requires an enormous effort from the liver. The latter, when at its peak, can eliminate approximately 35 ml of pure ethyl alcohol in one hour (equivalent to approximately one beer, a glass of wine or 50 ml of vodka).
It is therefore wise not to give him more work by absorbing foods that are too rich in fat. Therefore, it is also not advisable to take more alcohol to pass the hangover. A vicious circle would be set up irremediably, the beginnings of a future addiction from which it is difficult to get out.
Not to mention that the breakdown products of alcohol by the liver can cause inflammation and lead to the development of alcoholic fatty liver disease (with the accumulation of fat in the cells). This is the initial and earliest stage of liver damage that can lead to alcoholic hepatitis, or cirrhosis, in the most severe cases.
Finally, during alcohol intoxication and subsequent veisalgia, the body undergoes acidosis, i.e. it has more difficulty than usual in maintaining the acid/base balance necessary to its integrity. It is therefore not recommended to consume acidifying drinks or foods.
Apart from investigating the causes and underlying mechanisms of hangovers, there are many studies looking at a wonder drug for the effects of hangovers. Moreover, the global market for cures against hangovers represents nearly 1 billion US dollars, according to an estimate by an American firm. However, their effects are rarely supported by clinical studies. Currently, there is no treatment to prevent this post-festive state. However, let's take stock of the molecules that are promising or not.
In 2020, Finnish researchers observed the role of cysteine — an amino acid produced naturally by the human body — in reducing the symptoms of veisalgia. With a randomized study of 19 men and a placebo control group, researchers examined the effects of doses of 1200 mg (milligrams) and 600 mg of L-cysteine. Because the study was double-blind, neither the patient nor the prescriber knew whether the patient was using the active drug or the placebo. The volunteers had to consume alcohol over a period of three hours and then take either a placebo or the L-cysteine tablet. The study authors found that a 1200 mg dose of the amino acid L-cysteine helped reduce alcohol-related nausea and headaches, while a 600 mg dose helped reduce stress and anxiety. This amino acid would destroy acetone, a toxin produced during the digestion of ethanol, and involved in the symptoms of a hangover. But more research will be needed…especially since the study was funded by a company that sells cysteine.
Recently, a German study was interested in a cocktail of vitamins, minerals and plant extracts to contain and reduce the effects of a hangover. This cocktail includes plant extracts such as acerola, prickly pear, ginkgo biloba, willow and ginger, combined with vitamins and minerals such as magnesium, potassium, bicarbonate, zinc, riboflavin, thiamin and folic acid. The researchers analyzed data from 214 healthy subjects, aged 18 to 65, randomly separated into three groups. The first group received the supplement including herbal extracts, vitamins and minerals. The second group received the supplement without herbal extracts, only minerals and vitamins, while the third group received only a glucose-based placebo.
The results showed that compared to the subjects who received the placebo, those who received the vitamins, minerals and herbal extracts experienced an average 34% reduction in headaches and a 42% decrease in nausea. Interestingly, the group that received only the vitamins and minerals, without the herbs, showed no change. This is why, according to the authors, the fact that vitamins and minerals alone do not have more effects seems to show that alcohol does not really affect the levels of electrolytes present in the body.
Finally, in recent years, a plant originating from China seems to be a good candidate, already considered an anti-addiction plant. Indeed, it would make it possible to contain the undesirable effects linked to an evening that is a little too drunk. This is the root of Kudzu, and more particularly the puerarin (isoflavone) it contains. Kudzu acts mainly on the nervous system and neurotransmitters, by a "calming" action. It reduces stress and calms headaches. It is used in particular in alcohol withdrawal. A 2012 study from Harvard University found that people who consumed this herb seemed to drink more slowly and reduced their overall intake. This plant could therefore be a safeguard against excessive alcohol consumption.
There are many myths and homemade recipes to try to soothe the pains stemming from the aftermath of alcoholic parties. For example, in the United States, wealthy people have intravenous infusions made with various recipes to compensate for their abuses. In 2005, a study concluded, after analyzing several "miracle" home remedies, that none of them were effective.
The problem with taking paracetamol after excessive alcohol consumption is related to the metabolism of both agents. As mentioned previously, the liver secretes an enzyme ADH to take care of the ingested alcohol at the level of the gastric mucosa and the liver, to transform it into a molecule easier to eliminate by the body. However, if alcohol is consumed excessively, this enzyme is exceeded and another pathway of metabolism is set up. It involves a second enzyme, CYP2E1. The main pitfall in the combination of alcohol and paracetamol is that the latter is also metabolized in the liver by two processes:80% by conjugation with glucuronic acid, and 20% by the CYP2E1 enzyme.
Admittedly, the fraction of paracetamol also supported by CYP2E1 is low, nevertheless, it is transformed into a highly reactive metabolite, NAPQI, which can lead to oxidative stress. The latter, in normal times, is eliminated quite easily by the body thanks to glutathione. But things get complicated when we add excess alcohol to it. Indeed, the pathway of metabolism by CYP2E1 is favored by paracetamol (this enzyme being present in large quantities due to alcohol). Thus, a much larger amount of NAPQI is generated. And if the body is not able to eliminate it (because glutathione is not enough), it can lead to liver damage.
It is therefore better to favor ibuprofen, which will have an additional anti-inflammatory action, but with a different metabolization process, not overloading the liver, which is already busy.
To conclude, the main tips for coping with a hangover the day after a party are to rest, drink plenty of water and wait for it to pass, the miracle pill still does not exist... The first of the remedies against the hangover therefore remains moderation (or abstinence).
And as for the drinks promised to be hangover-free, they're either just in their infancy or they're a lie. In addition, they are rather expensive, like the Sentia, developed by Professor Nutt. The Sentia is made from a cocktail of plants, mimicking the effects of a slight intoxication.
