Hangover Remedies: What Works, What Doesn’t and Why
Everything you need to know about hangovers, including the science of hangovers, how to prevent them, and eight bar professionals-approved hangover remedies (one of them is “the closest thing there is to a real-deal, general-purpose hangover treatment.”)
A hangover is multiple things, which is the problem when it comes to treating it.
We all know what a hangover feels like, but to figure out how to get beyond that keen sense of suffering, it’s important to understand what a hangover is, which, unfortunately, is not easy to do. According to Brian D. Hoefling, author of Distilled Knowledge: The Science Behind Drinking’s Greatest Myths, Legends, and Unanswered Questions, “A hangover is multiple things, which is the problem when it comes to treating it.”
What is a hangover?
Basically, the headaches, nausea, the overwhelming sense of “just…can’t…” come down to the intersection of alcohol poisoning and alcohol withdrawal, which have different effects in different systems of the body, not only physical but psychological. In medical terminology, a hangover is a “multifactorial event.” (Which surely makes it sound more fun than it is.)
As a starting place, Hoefling explains acetaldehyde is much of the culprit behind your morning-after misery. “Basically, your body breaks down ethanol by turning it into acetaldehyde with one enzyme and then turning that into vinegar with a second enzyme. Acetaldehyde is poison. It's a chemical irritant, a carcinogen—nasty, nasty stuff,” he says, that “not one single tissue in your body likes to touch.” In order to move past your hangover, your body needs time for both of these metabolic processes to occur. The sooner acetaldehyde gets out of your system, the better you’ll feel.
How Do You Prevent a Hangover?
It perhaps goes without saying that the best way to prevent a hangover is to not get drunk in the first place. Getting drunk creates more acetaldehyde than your body can efficiently process, as it does so at a fixed rate. (This is the science behind pacing yourself.) But I’ll say it anyway: the difference between having a fun, hangover-free night out, and the kind of overindulgence that leaves you feeling awful the next day can be a fine line to walk, even for the best-intentioned. Responsible drinking is its own special discipline involving not only pace, but hydration, consumption of food, and most importantly, self-control, this last point often being the hardest one. Along with its desirable effects, drink number one starts to impair your ability to engage in all the good behaviors that differentiate careful drinking from calamitous drinking.
While there’s no actual “cure” for a hangover other than time—and be wary of anything that claims to be—there are things that can be done for damage control when you realize you’ve crossed the drunkenness threshold and those that can be done to help recalibrate yourself the morning after.
The Bar Professionals’ Take on Hangover Remedies
I consulted several bar professionals for their own takes on managing a hangover’s symptoms. Many people, including myself, have their own peculiar concoction of remedies they swear by. Mine? Water, ibuprofen, and a banana before bed. My favorite among those I queried: “Coca-cola, dark chocolate, and pho.” With additional insight from Hoefling, here’s an examination of how common remedies, and one yet uncommon one, do or do not work toward managing the malaise of a hangover.
Keeping your body in a hydrated state before, during, and after alcohol consumption helps your body more efficiently process alcohol out of your system.
Hydration
Alcohol is a diuretic, meaning that it dehydrates you. “The kidneys normally retain water, but alcohol inhibits the hormone that tells them to,” explains Hoefling.
Keeping your body in a hydrated state before, during, and after alcohol consumption helps your body more efficiently process alcohol out of your system. Popular remedies such as Pedialyte and Gatorade help via the restoration of electrolytes—electrically charged minerals—to help your body maintain hydration.
Miranda Garza, bartender at Carbone, in Miami recommends Liquid I.V., another electrolyte supplement: “These are awesome. I stay fully stocked and hand them out to my friends after a big night out. It’s best to take it before you go to bed, but if you wake up hungover it works within about three hours.”
Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, naproxen, and aspirin can provide relief from the effects of inflammation such as nausea and headaches.
Anti-Inflammatories
See “ibuprofen before bed” as above. Inflammation is your body’s way of responding to damage, and alcohol consumption does damage to your blood vessels and your gut. Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, naproxen, and aspirin can provide relief from the effects of inflammation such as nausea and headaches.
The Catch-22 of taking anti-inflammatory drugs, however, is that they can also irritate the stomach lining, which has already done some of the heavy lifting in processing the alcohol in the first place. Hoefling points out that this is the unfortunate case with many hangover remedies, and why they are so difficult to manage: “treating one symptom may worsen another,” he says.
Caffeine
You may get some relief by consuming a vasoconstrictor like caffeine.
Over-consumption of alcohol often goes hand in hand with lack of sleep, or poor sleep, so coffee or other forms of caffeine can simply make you feel somewhat better by making you feel more alert. Furthermore, caffeine can also specifically address your headache.
“The hangover headache is generally attributed to vasodilation,” says Hoefling, another effect of alcohol in the bloodstream. “As blood vessels expand, they put pressure on tissues inside the skull. You may get some relief by consuming a vasoconstrictor like caffeine.”
San Diego-based educator and consultant Steven D. Hirschauer concurs and alludes to other remedies with his multi-dimensional hangover approach: “As someone that isn't recommended to use NSAIDS, I find coffee and Coca Cola help, and then pho. The caffeine works almost like an Excedrin, and the phosphorus in the cola helps settle the stomach. The pho rehydrates and brings protein and minerals, and a bit of steam to sweat it out as well.”
Alcohol depletes your body of vital nutrients.
Vitamin Supplements
Alcohol depletes your body of vital nutrients, and several of the industry pros I queried mentioned taking vitamin supplements or DHM —dihydromyricetin—which purports to help “detox” the body from a hangover. One USC study does show that DHM can help protect the liver, but this is more insurance for your liver against long-term alcoholism than a remedy for a single, heavy night out. Nonetheless, you can chalk it up to “can’t hurt.”
In an article for ted.com, Dr. David Nutt, author of “Drink?: The New Science of Alcohol and Your Health,” says, “Most of these have no evidence, although it might be worth your taking a B vitamin complex. Some companies are developing combination treatments to speed up alcohol metabolism—they seem promising but expensive.”
“Hair of the dog” comes from the complete adage “hair of the dog that bit you.”
Hair of the Dog
“Hair of the dog,” from the complete adage “hair of the dog that bit you,”—originally a remedy for rabies—refers to the practice of drinking alcohol as a means of recovering from drinking alcohol. Naturally, this is a controversial approach.
On one hand, famed bartender Salvatore Calabrese wrote a recipe book on the topic: “Hair of the Dog: 80 Hangover Cocktails and Cures,” which does include plenty of non-alcoholic selections alongside his hangover cocktails. Several other bartenders, I queried mentioned drinks such as Bloody Marys (and find out why a bartender’s Bloody Mary is better than yours ) or uncomplicated beers as ways to limit time spent in hungover anguish.
On the other, if this approach seems like a bad idea, it’s probably because it is. “Keep in mind that you’re treating withdrawal by taking more of the same drug,” says Hoefling. “Your body built up a temporary tolerance to the side effects of alcohol last night, and some of the steps it took to compensate will linger,” he explains, delirium tremens being an example of a symptom of withdrawal in the nervous system. “Drinking the next morning restores that balance and eliminates the symptom,” thereby releasing you from withdrawal. In this case, you’re just delaying the hangover.
Eating is especially helpful before drinking, but during or after can also be beneficial.
Feed the Beast
Having a meal before starting drinking can help you stay sober longer by processing some of the ethanol in alcoholic beverages in the stomach before it makes it to the small intestine, where the thin walls allow alcohol to be more easily absorbed into the bloodstream. (If you’re feeling sciency, look into “gastric emptying rate,” which is a topic for a much longer essay.)
Eating is especially helpful before drinking, but during or after can also be beneficial. Beyond the go-to “greasy foods,” that have long-since been associated with managing a hangover, the bar pros I queried mentioned all manner of morning-after meals to help ease the pain: beyond pho, (still my favorite,) were Irish Breakfast, pizza, breakfast burritos, and simply, “carbs.”
Following heavy drinking your body is literally running on fumes, your stomach lining is irritated, you are nutratively depleted, and your blood sugar is low. Just about any meal will help with some or all of these issues, and it’s best to give your own body whatever comfort meal you know will improve things.
Languishing in bed may be all you feel like doing, but getting moving, and especially exercising, can help.
Sweat it Out
One thing I noticed when I started working in the hospitality industry, was that while the social opportunity for hangovers increased, time spent hungover definitely decreased, as having an active job got me out of bed and moving around the next day much more quickly.
Languishing in bed may be all you feel like doing, but getting moving, and especially exercising, can help. While you may feel like your sweat glands are actually releasing alcoholic fumes, in reality what you’re getting from exercise is an endorphin boost, as well as a metabolic rate increase.
The closest thing there is to a real-deal, general-purpose hangover treatment.
Broccoli Before Bed
Say what now? Having previously said that there is no cure for a hangover, Hoefling nonetheless offers “the closest thing there is to a real-deal, general-purpose hangover treatment.” And that treatment is cruciferous vegetables: broccoli, cauliflower, kale, etc.
According to a research paper published in 2013, “They contain a chemical—sulforaphane —that speeds up the body's ability to metabolize acetaldehyde,” Hoefling explains. “Best to have some before you go to bed, to minimize the time you spend with that nasty irritant floating around in your veins, but in my experience, it's still helpful if you do it the morning after.”
A hangover is still something that the only way out of is through, but Hoefling’s recent research shows that this chemical can at least help move you into the hangover-free express lane. Admittedly, my hangover comfort meals tend not to include such vegetable superfoods, but as something that’s good for you in more than one way, that’s hangover medicine I’m willing to try.