A hangover is a collection of symptoms that result from drinking too much alcohol. Hangovers develop after the blood alcohol level returns to zero. Symptoms generally begin around eight hours after alcohol intake stops and can last 24 hours or longer.
What causes a hangover?
While alcohol is the source of hangovers, it’s not the only cause. Alcohol has several different effects on the body that result in hangover symptoms. These are:
- Dehydration because it creates an increase in urine output and decreases the hormone that controls kidney function, sodium regulation, and blood pressure. This can lead to increased thirst, fatigue, and headaches.
- A rise in inflammation throughout the body and brain, which leads to difficulty concentrating. It also affects memory, and lowers appetite.
- A potential drop in your blood sugar because the body produces lactic acid during the process of breaking down the alcohol. Lactic acid lowers blood sugar.
- Irritation to the stomach is common because alcohol raises stomach acid and slows emptying, which leads to nausea, vomiting, or abdominal pain.
- Alcohol produces tiredness but prevents REM sleep from taking place. Without this level of deep sleep, people wake without feeling rested and still feel tired. It may seem as though they fall asleep faster but staying asleep is difficult or sleep is broken.
Who is at risk of a hangover?
Anyone who drinks alcohol is at risk of a hangover. Everyone is different and that means there is no specific amount that will cause a hangover for everyone. For some, one drink may cause some symptoms. For others, it may take several drinks, and some may not experience symptoms at all. At any time, if a person drinks to the point of intoxication, even at a very low level, they risk feeling symptoms of a hangover.
Intoxication can occur if more than one drink per hour is consumed. It takes the body approximately one hour to dispose of one average drink. Drinks with higher alcohol concentrations are harder for the body to process and increase the risk of a hangover.
The risk of hangover also elevates if:
- Alcohol is consumed on an empty stomach because it is absorbed faster
- Consumption of darker colored alcohols due to a higher amount of congeners*
- A family history of alcoholism can dictate how the body processes alcohol
- Use of nicotine or other drugs with alcohol
*Congeners are ingredients in alcohol that contribute to dark color and flavor. Congeners have a higher likelihood of causing hangovers. However, any alcohol can cause a hangover, regardless of color or alcohol concentration.
Symptoms of a hangover may vary but typically include:
- Abdominal pain
- Muscle pain or weakness
- Sleep disruptions
- Sensitivity to light and sound
- Increased thirst
- Difficulty concentrating
Hangovers do not generally require a diagnosis from a healthcare provider. In most situations, people know when they have a hangover related to drinking alcohol and are familiar with the associated symptoms.
Speak with your healthcare provider if you are concerned about symptoms, especially if this is becoming a frequent occurrence or it interferes with your work or relationships.
Managing hangover symptoms
While there are many proclaimed remedies, there is no cure for hangovers. Easing hangover symptoms the day after drinking may be the best course of action. Treat the symptoms you have by:
- Drinking water to hydrate.
- Extra sleep to help reduce the fatigue.
- Small meals and bland foods to minimize nausea.
- Rest and recover. Hangovers are ordinarily gone within 24 hours as long as you get adequate rest.
- Electrolytes found in sports drinks or broth can replace salt and potassium lost from extra urinating and dehydration.
- Avoid medications like acetaminophen that may cause liver damage when mixed with alcohol.
- Take a pain reliever like ibuprofen for aches, pains, or headaches.
Other suggestions have been claimed to reduce symptoms, though there may not be evidence to support their benefit:
- Vitamins B and zinc may reduce symptoms
- Drinking coffee or caffeine as a stimulant to improve symptoms quicker
- Alcohol during the hangover is claimed by some to reduce or avoid symptoms
- IV fluid replacement for hydration
How to prevent a hangover
The only true way to prevent a hangover is to drink alcohol safely. This may mean limiting the frequency and amount, or for some people, avoiding alcohol completely. Other tips to avoid hangovers include:
- Drink in moderation - limiting to one per hour
- Drinking water between alcoholic drinks may decrease the amount of alcohol you drink
- Drink on a full stomach
- Drink slowly, especially carbonated drinks and dark colored alcohols
- Do not consume enough to feel intoxicated
When to be concerned
Severe symptoms can indicate alcohol poisoning, which can be life-threatening. This may happen with heavy drinking. Seek emergency care if you are concerned or notice any of the following symptoms:
- Pale or blue skin
- Abnormal breathing
- Cold skin
- Severe vomiting, especially with altered alertness
A hangover can leave you feeling miserable. Luckily, symptoms are short-lived and resolve on their own within 24 hours. Unfortunately, there is no quick cure. Being mindful of the causes and not drinking excessively can help prevent hangovers.
National Institute of Alcohol Abuse and Alcoholism. Hangover
Mayo Clinic. Hangovers
Cleveland Clinic. Hangover
National Library of Medicine. Medline Plus. Hangover Treatment