Drink a glass of water between drinks if you don’t want to get a hangover. Or, maybe take a pedialyte when you get home. Keep a bottle of gatorade next to your bed. There’s a lot of little “life hacks” people will give you to avoid a hangover after drinking. Or they’ll tell you, it’s low blood sugar, so the best way to cure a hangover is to make sure you get some electrolytes into your system the next morning (see again: Gatorade). You’d think after decades of this advice going around, that if it actually worked...people wouldn’t still be getting hungover all the time.
Unfortunately, myths about hangovers are hard to dispel. There’s a lot of reasons for that. Part of the blame actually goes to the US government. While they seem like a nuisance, hangovers are actually a serious issue: they’re not just bad for your health, but economists estimate that hangovers cost the US economy nearly a quarter trillion dollars annually, with most of that loss coming because of lost productivity from hungover workers. Despite these costs, it is nearly impossible for researchers in the United States to get funding to study hangovers. As a result, until the turn of the millenium, there was virtually no active research on the topic.
Luckily for us all, European and Asian governments have proven a bit more willing to fund research on the topic. Unfortunately for us all, most of that research doesn’t actually make its way into the hands of the medical community. With the exception of researchers in the field, when it comes to a subject like hangovers most doctors rely on what they were taught in medical school; unfortunately, that means most doctors are relying on information from the 1970s or 1980s, when theories like dehydration and low blood sugar were still popular.
Those theories have since been debunked. In the last 20 years, multiple studies have researched the link between dehydration, low blood sugar, and hangovers. They have found, again and again, that there is basically no link. Dehydration and low blood sugar can be accurately assessed by specific biomarkers; if they diverge significantly from normal, you can tell if a person is dehydrated, has low blood sugar, etc. Researchers looked into whether those biomarkers correlated well to the severity of a hangover; basically, they looked to see if the more dehydrated (or lower your blood sugar) you were, the worse your hangover.
What they found is that there was basically no relationship at all. You could be terribly hungover, and barely dehydrated, or terribly dehydrated, and only mildly hungover. The long story short, the two appeared to be entirely different biological processes; alcohol can absolutely make you dehydrated, but that dehydration does not make you hungover. Nor does low blood sugar. The two just have nothing to do with each other. So what actually does cause a hangover?
The answer seems to lie with your immune system. The easiest way to think about it is to think of it like a simple flu. When you get the flu, you’re nauseous, your body hurts, you get a headache...all symptoms that seem very reminiscent of a hangover. Yet none of those symptoms is actually caused by the flu virus. Instead, they are all caused by your immune system’s attempt to fight off that viral invasion. Research shows that a hangover functions quite similarly.
When you drink alcohol, the process of your body breaking it down creates a very toxic byproduct called acetaldehyde. While alcohol itself is mildly toxic, acetaldehyde is worlds worse. As a result, your liver, gut, and other organs (as acetaldehyde and alcohol enter your bloodstream and are transported through your body) become enflamed, leading your body to believe that it is under attack. So, your body’s defense mechanism, your immune system, springs into action to fight off the perceived invaders.
Once again, there are specific biomarkers that show how heavy your immune system has responded. High levels of these markers means a major response, low levels mean a low response. And unlike the biomarkers of dehydration and blood sugar, when researchers looked at the relationship between these immune biomarkers and the severity of the hangover...the relationship was strong. The larger the response, the worse the hangover. Just like your flu symptoms, the symptoms of a hangover appear to be caused by the immune system’s attempt to fight off what it thinks is an attack.
So next time you go out, feel free to drink a glass of water between drinks, take a Pedialyte, or have a Gatorade on hand. Just don’t expect it will do anything to stop your hangover the next morning.