Why do we get hangovers? and why does drinking more help (even for normal headaches)?

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Why do we get hangovers? and why does drinking more help (even for normal headaches)?

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A hangover is a combination of 2 factors, dehydration and essentially your body going through alcohol withdrawal.

Alcohol is a diuretic meaning it pulls water out of your body. So hydrating before bed and in the morning helps with the dehydration elements.

The “hair of the dog” thing where you have a Bloody Mary or something in the morning helps with the withdrawal aspects of it

A hangover is comprised of essentially 4 things (and hangovers can be different depending on genetics and how much of each of these played a role in your partying):

1. **Dehydration** – alcohol floats around in your blood affecting different parts of the body. One of those places is in the part of the brain which regulates fluid balance through a hormone called “Antidiuretic hormone”. Alcohol tells that part of the brain to chill, so you release less. ADH normally goes to the kidneys and tells them to turn the taps down so you pee less (so on a hot day where you’re exercising your ADH will be high and you won’t make as much pee, for example), but now that there’s less of it, your kidneys turn the taps up and you pee more. That’s part of why when you drink a lot, you pee a lot.
2. **Low sodium** – Kidneys are complicated, but the ELI5 is that water follows sodium. Kidneys push sodium into tubes, water follows it, tubes go to the bladder, and that’s pee. As you’re drinking, you’re bringing lots of water in… but not very much sodium (unless you’re snacking, always a good idea to snack while drinking). As a result, as you pee, you lose sodium. If you overdid it, then by the time you wake up your sodium levels might be a bit on the low side, and that causes headaches/fatigue/cramps/feeling generally bad. That’s why one of the classic hangover cures is beans on toast (good amount of sodium, protein, and other goodies that you might now be deficient in).
3. **Poison** – Let’s use some pictures. So when you drink, the alcohol level in your blood spikes and your liver immediately starts to break it down, but this is at a [fixed rate](https://www.frontiersin.org/files/Articles/15770/fpsyt-03-00004-r2/image_m/fpsyt-03-00004-g007.jpg). The liver converts alcohol (the kind we’re drinking is called Ethanol) into [acetaldehyde](https://pubs.niaaa.nih.gov/publications/aa72/images/metabolic.gif) (which is toxic, causes headaches, nausea, and feelings of ugh) and then into acetate where it’s then peed out. As alcohol is broken down into acetaldehyde, levels of acetaldehyde build up and cause problems. This takes time, and may extend into the next day.
4. **Starvation** – or more specifically a “chemical” kind of starvation. [Here’s another complicated diagram](https://images.squarespace-cdn.com/content/v1/5b8645f7266c07b084eb29c7/1550536489327-XL8AQ22OZ4IWFNSZOVXX/ethanol+metabolism.png?format=1000w), but the thing I want to point out is that “NAD” to “NADH”. Without getting into the weeds of it, you need this NAD thing to break down sugar into energy as well as a whole lot of other “staying alive” things. When you drink a lot of alcohol, the chemical engines in your cells go [“OH SHIT THAT’S POISON, GET RID OF IT”](https://images.ctfassets.net/vrrt8fsfwf0e/SzuykPsfRczLBEoxWwDqc/0344fa25b9cf21a5aa154d1de1bdaec4/Alcohol_and_ketone_bodies_Art_1.svg) and a bunch of that NAD becomes dedicated to breaking it down, meaning NAD is less available for other important things. Thankfully you have a backup system for this, but it’s *super* inefficient and results in waste products that get into your blood and make you feel like *crap*.

So eat a healthy meal before partying, snack while you drink, don’t drink too much (a good idea is 1 glass of water after every 1-2 alcoholic drinks), and eat a meal the next day with good sodium/protein/vitamins/minerals to get yourself back in fighting shape. You may still feel like crap, but it’ll feel *less* bad. As for why hair of the dog works? I can’t give you a scientific explanation, but I’d hypothesize that it’s not getting *rid* of the pain, it’s making your brain *not care* about the pain (drunk people don’t feel pain like sober people do).

I’ve been an alcoholic since the 90s. I haven’t had a hangover since the 90s. A few withdrawals but never a hangover. I do have to ensure I’ve got I’ve got enough water and one glass of vodka for the middle of the night. Also some salty foods and a bunch of thaimine.