Hangovers have been destroying Monday mornings since ancient Assyrians fought them with crushed bird beaks and myrrh. Yet somehow that seems totally normal compared to our own go-to remedies of pickle juice, yeasted yogurt, and dried bull penis.
For centuries, hangovers weren’t really studied, so everyone from Assyrians to your idiot roommate could make up some outlandish cure, and science couldn’t say much. While still largely misunderstood, the science of hangovers has recently come a long way, and it might make you think twice about that Sunday morning Bloody Mary.
Step 1: Do damage control before you start drinking
You’re probably sick of alcohol being blamed for everything. Well, so is science. Enter congeners: naturally occurring compounds created (or added) during the fermentation of certain alcohols. And congeners can lead to some pretty nasty toxic effects.
What are these congeners, you ask? That “slightly oaky aftertaste” of your favorite red wine is classy and absolutely full of congeners. A good rule of thumb is "the darker the drink, the higher the congener content"... and the more your life will suck tomorrow. If you’d rather not curse the gods, then you should definitely stay away from bourbon. It has the highest congener count, making for the beastliest of beastly hangovers. You may feel like a legacy admission to Yale when you order a vodka soda, but it sure beats the hell out of feeling like the king of the dead tomorrow.
Congeners might also have something to do with the resurrective powers of your Sunday morning mimosas. After ethanol and its byproducts leave your system, congener products tend to stick around. One of the worst offenders is methanol, which some say is the real instigator in your hangover. Once you introduce some ethanol back into the system via that mimosa and Bloody Mary special, your metabolism puts methanol on hold, providing you with a few moments of sweet relief. This embargo is short lived, however, and does little more than postpone the inevitable pain that is to come when the remaining hangover sets in. It's probably better to tackle the pain head-on, since -- let's be real -- at some point you're going to get a hangover regardless of how careful you are with your consumption.
Step 2: Get hydrated, but don't assume it's going to cure you
The first ingredient of any hangover is alcohol (duh). The not-so-obvious question has always been how alcohol (aka ethanol) causes hangovers. Most have always just chalked it up to alcohol’s dehydrating effects. As a diuretic, alcohol increases urine production, and as your drink of choice, it replaces boring old water. Too much alcohol without water will leave you with a pounding head, an upset stomach, and a bleak outlook on life. Then again, salt and coffee can dehydrate you too, but you don't encounter anyone in the office battling a classic salt hangover.
Several studies have recently discovered that the physiological markers of dehydration have absolutely no connection to the cause or severity of a hangover. What this means is that your post-binge gallon of water and pickle juice may (or may not) ease the symptoms of dehydration, but they’re not attacking the hangover itself. Even if you’re quenched all night, there’s still hell to pay in the morning.
This isn’t to say that you should replace those water breaks with more tequila shots. Dehydration may not be the cause of your hangover, but you definitely don’t want to be suffering from both.
Step 3: Find some quick, but healthy, sugar
Food is patient. Food is kind. Food waits its turn to be digested. Alcohol is a diva and couldn't care less what food wants. Rather than waiting for digestive permission, alcohol absorbs its way right through your stomach lining and small intestine, and into your bloodstream. Demanding VIP treatment from the liver and brain, alcohol’s metabolism takes priority over all others, including glucose -- your brain’s main source of energy.
As alcohol screws with your glucose and insulin levels, your blood sugar drops and hypoglycemia sets in. Common symptoms of hypoglycemia include weakness, irritability, and headaches. Sounds like Sunday morning, doesn’t it? Several studies have indicated that severe hangovers are often accompanied by hypoglycemia, so it’s no surprise you hate the world right now.
However, accompaniment and causation are not the same thing. Much like dehydration, hypoglycemia is a close friend of the hangover, but it’s not the cause. And just like dehydration, hypoglycemia can usually be avoided. Eat some high-protein food before you drink to delay some (not all) alcohol from absorbing through your digestive walls. This helps prevent the rise and fall of blood sugar, and hypoglycemia will be one less demon to fight in the morning. Late-night taco runs might ward off the spirits still in your boozy stomach, but by that point, your blood sugar’s already screwed. So make the taco hut your first stop, and not your last. In the morning, you may crave bacon and eggs, but try getting some fruit or fruit juice to get your blood sugar up in a hurry.
Step 4: Take some aspirin with your coffee
Your liver gets to work right after you down that first tequila shot, and, with the help of a few enzymes, begins metabolizing alcohol into several byproducts. Acetaldehyde is the first of these, and has been linked to brain damage, electrolyte interference, and even cancer. Many experts have long blamed those nasty reactions as the foundation of your hangover misery, and there are entire populations lacking the enzymes required to process acetaldehyde.
As diabolical as acetaldehyde might be, recent research has indicated that the hangover buck doesn’t stop there. After acetaldehyde is formed, it's further metabolized into acetate. While certainly easier to say (and type) than acetaldehyde, acetate is no angel. One study found that when subjects were properly hydrated and acetaldehyde was suppressed, acetate buildup was mostly, if not solely, responsible for those ungodly hangover headaches.
But the silver-est of silver linings to this study is that caffeine and anti-inflammatories react to acetate. Meaning coffee and aspirin might actually be the answer to that head-crushing situation of yours.
There are a few caveats, of course. If caffeine gives you headaches when you’re sober, then it won’t be any different when you’re hungover (damn). And more importantly, in the eyes of hangovers, all painkillers are not created equal. Anything containing acetaminophen (like Tylenol) will wreak havoc on your already-weakened liver, and that little guy needs a break. Make sure you check the labels before you groggily pop the first pills you can find.
Step 5: Get your hands on migraine meds, if you can
In any healthy relationship, communication is key (PS: call your mom). At a microscopic level, your cells secrete little proteins called cytokines, which basically tell other cells what to do. Pro-inflammatory cytokines swell, heat up, and cause pain to alert the anti-inflammatory cytokines that something’s wrong.
Alcohol comes along and gives megaphones to the pro-inflamers and cuts the phone line on the anti-inflamer medics. Several recent studies have implicated this cytokine disturbance in hangover fatigue, nausea, and even cognitive impairment. Quick! What’s 374 + 37? Exactly.
The good news here is that tolfenamic acid, which is found in certain migraine medicines, has been shown to put a clamp on those screaming pro-inflamers. Sadly, it's not available in the US, but if you ever have a chance to travel abroad, stock up on some for a rainy, hangover-ruined day. Otherwise, your best bet here is to stick with aspirin.
Step 6: Know thyself (and don't smoke cigarettes)
The final culprits in the hangover game are an elusive bunch. Factors like age, sex, race, and family history have all been studied, but strong correlations have yet to be found. So a 59-year-old heavy-drinking Taiwanese woman, your hangover will probably be much different than that of a 22-year-old Canadian guy who rarely drinks.
At the same time, modern research has uncovered one surprising hangover connection. According to a recent study, smoking cigarettes while drinking might intensify hangover symptoms. Some would attribute this to nicotine’s own cytokine interference (remember those?), while others suggest people addicted to cigarettes might also be more likely to drink more. Either way, if you "only smoke when you drink," you’re gonna feel way worse in the AM.
Step 7: Be patient
If hangovers were simple, a quick fix would’ve been figured out centuries ago. Since research has only thrown more variables into the hangover equation, it makes sense that bull penis is just as appealing -- and works just as well -- as a bacon, egg & cheese bagel. Scientists are learning more and more about hangovers, but until every piece of the puzzle is solved, only two remedies are 100% effective at curing hangovers: drinking less and time.
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Nicholas Knock is a freelance writer for Thrillist who needs to call his mom. You can follow him on Twitter: @nickaknock.