As of Friday, April 5, 2013
DEAR DOCTOR K: Why do I get a hangover when I drink? What’s the best way to get rid of it?
DEAR READER: Last night was great — friends, food, fun and wine. Lots of wine. But this morning your head is pounding and your mouth is dry. The lights are too bright and every noise sounds like a jackhammer. Breakfast? You can’t bear the thought of it.
There’s a lot we don’t know about hangovers — but we do know about the effects of alcohol on the body. And what we know may explain some of your hangover symptoms.
For example, alcohol:
— Dehydrates you. It interferes with the antidiuretic hormone (ADH), which prevents urination. So the more alcohol you drink, the more you urinate. This could explain your headache and dry mouth.
— Irritates the stomach lining. This could explain nausea or heartburn.
— Causes increased levels of acid in the blood, low blood sugar and a buildup of toxins. The effects could leave you feeling fatigued, drowsy or generally unwell.
— Alters normal body rhythms, including sleep and body temperature. That may be why you woke up, wide awake, at 3 a.m.
If you find yourself with a bad hangover, there’s no quick fix — and some common hangover remedies can be harmful. Acetaminophen (Tylenol) might help with a headache, but it can injure the liver. This is particularly true if you take high doses (more than 2 to 3 grams a day) and you’re a regular, heavy drinker. That’s because alcohol abuse injures the liver and makes it more vulnerable to damage from acetaminophen. Pain relievers such as ibuprofen (Advil) or naproxen (Aleve) may irritate your already unhappy stomach.
Even coffee might not be the best idea. Caffeine can counter some of your fatigue and lethargy, but it can worsen dehydration, heartburn and an upset stomach. So if you use caffeine to perk up, be sure to also drink four to five tall glasses of non-caffeinated fluid.
Here are two suggestions that may help prevent another hangover and are harmless enough to recommend:
— Eat something before or while you are drinking. Fatty foods, in particular, slow absorption of alcohol.
— Drink water or a sports drink before and between alcoholic beverages.
Think of a hangover as an unpleasant experience that serves a good purpose: to remind you to drink in moderation. Just having an occasional hangover does not mean you have a problem controlling your use of alcohol. However, if it happens often enough — arbitrarily, I’d say once every two to three months — it may mean you do have an alcohol problem.
The hangover itself doesn’t produce any lasting damage, at least that we know of. But hangovers do show that alcohol temporarily interferes with normal brain function, and people who drink enough to have frequent hangovers can get lasting brain damage from alcohol. So don’t just follow my advice about how to avoid a hangover; also consider if you might have a problem controlling the amount of alcohol you drink.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.