Monday, January 18, 2010

Hung Like a Horse

So you’ve woken up on the floor on Sunday afternoon…well, at least you think it’s Sunday afternoon…and you’re pretty sure it’s the floor…fully dressed and your mouth tastes like you’ve just sucked the fur off of Big Foot’s Scroto Baggins, and the queasiness in your stomach seems to back up that theory. On top of that it feels as though you’ve been held underwater for 12 hours and beaten mercilessly about the head and neck with a pillow case full of gravel and oranges, and, despite all of the windows being open in the middle of winter, your room smells like a combination of a primate house in need of maintenance, the men’s room at Wrigley Field during the seventh inning stretch of the second game of a double-header {shudder}, and the set of a porno after the filming of But Bongo Fiesta XXII {hork}. What the Hell happened? My guess is either you have a hangover, or you live a very, very interesting life and you’re lactose intolerant. We’ve all had a hangover at some point in our lives. If you haven’t then you need to get out of here right now…you seriously creep me out. The question at hand is why do we get hung over after an innocent night slugging down Jager bombs and 14 shots of Cuervo? Why, dear Odin, why does my body treat me so badly?

The medical term for the hangover is Veisalgia. It essentially means pain following debauchery. Aptly named. Symptoms of a hangover vary from person to person but generally include: headache, poor sense of overall well-being, diarrhea, inability to put up with your shit, anorexia, tremulousness (yes, it’s a word), fatigue, strong attraction to couches and nausea. Hangover symptoms reach maximum at about the time that blood alcohol levels reach zero. Research on hangovers varies and is pretty sparse considering the percentage of the population that experiences them and the number of lost workdays incurred due to overindulgence. However, most research agrees that an ethanol dose of 1.5 - 1.75 gms/kg body weight will almost always produce hangover symptoms in those susceptible individuals. Note the last four words in that sentence – “in those susceptible individuals.” Some people (or, as I like to call them – douchebags) are not genetically prone to having hangovers. Must be nice. According to those numbers, I would need to consume about ten beers to ensure that I get a hangover. I think it’s safe to assume that number is correct.

Before I get too far into discussing hangovers I think it makes sense to talk a bit about the properties of ethanol. Ethanol is a stimulant in small doses and a depressant in large doses. It is a diuretic and an excellent solvent for organic chemical reactions. Quick quiz: other than ethanol, name one other flammable liquid that you would gladly drink if I handed a glass to you. I’ll give you a minute. None? Hrmm… That should probably tell you something. Here is some other info taken directly from the MSDS for ethanol:

Potential Health Effects - Eye: Causes severe eye irritation. May cause painful sensitization to light. May cause chemical conjunctivitis and corneal damage. Skin: Causes moderate skin irritation. May cause cyanosis of the extremities. Ingestion: May cause gastrointestinal irritation with nausea, vomiting and diarrhea. May cause systemic toxicity with acidosis. May cause central nervous system depression, characterized by excitement, followed by headache, dizziness, drowsiness, and nausea. Advanced stages may cause collapse, unconsciousness, coma and possible death due to respiratory failure. Inhalation: Inhalation of high concentrations may cause central nervous system effects characterized by nausea, headache, dizziness, unconsciousness and coma. Causes respiratory tract irritation. May cause narcotic effects in high concentration. Vapors may cause dizziness or suffocation. Chronic: May cause reproductive and fetal effects. Laboratory experiments have resulted in mutagenic effects. Animal studies have reported the development of tumors. Prolonged exposure may cause liver, kidney, and heart damage.

The LD50 (the point at which half of the test subjects die from exposure) is 10.3 g/kg. That’s about 10 times more than the quantity it takes to ensure a hangover. I don’t know about you, but I don’t think I could even drink 100 beers in one sitting when I was in college…not that I’d remember it if I could.

Even though we know all of this we still gladly slug down drink after drink nightly. Why? Apparently it’s fun to slowly kill yourself…just ask Michael Hutchins. We truly are a stupid species. No other animal species on the planet (with the possible exception of one type of lemur) intentionally consumes large amounts of ethanol. Alas, such is our lot. Anyway, let’s say you’ve decided to rain Hell on yourself, and you pour a couple of mason jars of white lightening down your gullet at the office Christmas party. The next day you wake up in an alcohol-induced fog that you feel can only be relieved by self-trepanation and immediate death to your effing loud-arse roommates. What gives?

Now, if you know anything about biochemistry the reasons for expressing hangover symptoms are generally pretty straightforward. I’ll try to explain the processes as simply as possible just in case you’ve stumbled in here after a night of fierce imbibery. Drinking alcohol has a direct effect on the production and action of some of our body’s vital hormones, and the effects can literally range from grogginess to death. One of these process disruptions is immediately obvious to everyone. During normal operation the endocrine system produces a compound called anti-diuretic hormone (ADH) that makes the body retain water. Alcohol causes an immediate decrease in ADH production. So the body tries to void itself of as much water as possible sending our intrepid drinker on repeated trips to the bathroom. Once the body realizes that it’s losing too much water it starts over-producing ADH during the hangover causing us to be thirsty, bloated and bitchy.

Along with the purging of water, alcohol disrupts the production of several other hormones that regulate blood electrolyte levels and, consequently, blood pressure. Both aldosterone and cortisol production decrease while drinking which at first lowers blood pressure, but during the hangover phase the upswing in production of those hormones causes an increase in blood pressure and the muscle weakness, fatigue, vomiting, and loss of appetite that follow. The disruption in cortisol production also impairs the liver’s ability to make glucose and essentially starves the brain and body of that key sugar. This can result in fatigue, irritability, lack of attention and in conjunction with other hormonal imbalances may interfere with the body’s normal circadian rhythms which can throw off our internal clock by several hours. This is probably why you get that lovely I-just-stepped-off-of-the-slow-flight-from-New Zealand feeling the day after drinking heavily. Interestingly, cortisol also redistributes body fat from the arms and legs and uses it to create my beautifully sculpted beer gut for apparently no reason. Alcohol also causes an increase in production of two other compounds (rennin and thromboxane), both of which further exacerbate the increased blood pressure and result in an increased heart rate. This may be why there is an increase in mortality from heart attacks during a hangover. On top of blood pressure running all over the shop, alcohol increases the acidity of your blood by messing with your metabolism, and the higher your blood acidity the worse your hangover will be.

So, basically alcohol causes dehydration and disruption of critical endocrine functions that regulate some of your body’s key systems including blood pressure, heart rate, metabolism and elimination of toxins. Nice work. Hangovers are the body’s direct response to the disruption of those systems. You may notice that I didn’t mention whether or no you are more likely to get a hangover from certain types of alcoholic drinks. Some people swear that you are more likely to feel like cold poop in the morning if you drink whiskey or red wine instead of drinking vodka. The compounds that often get the (middle) finger pointed at them are called congeners, and they are the by-products of distillation. Dark drinks like whiskey and wine mentioned above have high concentrations, while light drinks like vodka and gin have less. Cheaper liquors have more congeners since more expensive brands can afford to filter out the suspect compounds. Having said that, there are two things that make me doubt the anecdotal evidence against congeners. The first is that the research is all over the place. One study will find a direct correlation while another finds no difference in hangover rate or severity between liquors. Also, (I’m sure I’m going to hear a bunch of gripes about this one, but) despite popular opinion, there is no research that shows mixing drinks makes you more drunk, or gives you a worse hangover. The second reason is that the majority of studies that deal with hangovers and drunkenness in general are done with pure ethanol. Some people may have allergies to specific congeners found in certain drinks which will tend to make their hangover worse, but it seems to me that the jury is still out on the poor, vilified congeners.

Now that you have a hangover what can you do to get rid of it as soon as possible? The short answer: nothing. Not exactly what you wanted to hear, I know. None of the cures that you’ve heard of will actually work, and many of them may actually exacerbate the problems. You just have to hold tight onto that chaise lounge so it doesn’t run away until your body can get its hormone levels back in check. How do you prevent yourself from getting a hangover? Easy - drink less. There are a bunch of things that contribute to the severity and likelihood of getting a hangover including: smoking, weight, age, mental health, allergies and rate at which you drink. So if you’re a skinny, old, mentally deranged smoker with hay fever that just decided to slam a bottle of Goldschlager through a funnel you’re in for some bad ones tomorrow. Suck it up. Besides, you really need to catch up on your daytime TV anyway.

Big thanks to the Hippy and Greg for suggestion.