For most of us, rolling out of bed at the crack of noon after a night of drinking may not be a common occurrence, but when it does happen, there’s a high chance of having a hangover. Nearly everyone has experienced waking up with a turbulent stomach and pounding headache after a late night out—and many have sought immediate relief from the malaise caused by consuming too much alcohol. However, while hangovers are an all-too-common consequence of both social and binge drinking, no definitive remedy exists.
Given the unaddressed needs of hangover patients everywhere, many enterprising scientists have attempted to formulate new hangover treatments, including specialized hangover pills. But do hangover pills work? While such products claim alleviate the damage caused by alcohol consumption, questions remain about their efficacy. Now, patients who seek powerful tools to combat their hangovers might find the solution that they’re looking for if they’re willing to experiment with specialized hangover therapies like glutathione supplementation.
The Anatomy Of A Hangover
Before patients can evaluate whether hangover therapies worth a try, it’s necessary to understand the physiological basis of hangovers. While hangovers are commonly conceived as simply the body’s reaction to excessive alcohol consumption, the medical basis of hangovers is more nuanced due to the multiple ways in which drinking affects the body. Because alcohol consumption is often paired with other broadly detrimental behaviors like not drinking water, refraining from sleep, and smoking, the body’s defenses are weakened even before the negative effects of alcohol kick in. These coincidental factors aggravate the subsequent hangover symptoms.
The symptoms of hangovers are diverse, and can include:
- Low mood
- Muscle cramping
- Generalized pain
Importantly, the spectrum of hangover symptoms affects a number of different organ systems. Hangovers manage to impact so many organ systems because they have more than one physiological cause; each physiological cause stems from alcohol consumption but can be treated in a piecemeal fashion. Hangovers have at least four separate pathologies:
- Disruption of sleep
- Buildup of toxic metabolic byproducts like acetaldehyde
- Immune activation and suppression
Of these four pathologies, a 2010 review of hangover research concluded that alcohol’s effect on the immune system was the largest contributor to hangover severity and incidence. However, that doesn’t mean treating the immune system alone will be enough to stop a hangover; each pathology produces a different subset of hangover symptoms, and there is no simple way to address all of them at once. For example, dehydration contributes to muscle cramping, thirst, and pain, whereas disrupted sleep contributes to fatigue, headaches, and low mood. Treating one pathology can thus ameliorate one set of symptoms while leaving others raging, making the prospect of a complete hangover cure improbable.
Hangover Pills and Other Common Solutions To Hangovers
The best way to prevent hangovers is to drink alcohol in moderation and ensure adequate hydration when drinking. Drinking in moderation is an easy set of goalposts to miss, however; as people age, for example, their ability to process alcohol decreases, leading to an uptick in unexpected hangovers. This means that, despite popular expectation, there is a wide variety of patients seeking hangover cures.
Thanks to humanity’s long relationship with alcohol, putative hangover cures have circulated since antiquity. Ranging from vinegar to raw eel, the hangover cures of past centuries were typically revolting foodstuffs and, much like many modern hangover cures, patients were forced to make do with the materials they had on hand. Of course, the view of modern medicine is that these historical hangover cures were ineffective. Likewise, while many modern patients have preferred techniques for avoiding or abating a hangover, it’s no secret that these lay therapies are imperfect and patients often lose entire days to hangovers even with such therapies. Even if lay therapies like eating a raw egg or drinking another alcoholic beverage to stem a hangover may appear to work on occasion, the scientific consensus is that these approaches are bunk. However, with the advent of modern pharmaceuticals and nutritional science, there are a handful of most sophisticated hangover therapies which are significantly more effective at treating hangover symptoms, though they are insufficient to be called cures.
Common therapies to reduce hangover symptoms include NSAID medications like Advil, which can alleviate headaches and generalized pain. Over-the-counter NSAIDs are appealing to patients because they’re versatile, readily available, and useful; while NSAIDs do not address any root pathology, they are typically effective for analgesia. However, NSAIDs can also be problematic therapies in the context of hangovers. Ibuprofen NSAIDs, for example, can cause nausea, which means that they might exacerbate certain hangover symptoms even as they treat others. Additionally, many common NSAIDs and other analgesics, like Tylenol, are prepared in formulations which contain acetaminophen, which can be toxic for the liver, particularly if consumed alongside alcohol. This toxicity is important because some alcohol may still be present in people who have a hangover. Nonetheless, NSAIDs and other over-the-counter analgesics remain popularly sanctioned hangover recovery therapies.
Other hangover recovery therapies include supplementation with nutrient and electrolyte mixtures. These supplements, such as Pedialyte, are often designed for other purposes but are co-opted by patients with hangovers. By replacing the vitamins, minerals, and electrolytes lost during metabolic alcohol clearance, such supplements aim to reduce the impact of dehydration while providing the body with precursor chemicals needed to continue clearing out toxic byproducts. Notably, these supplement-based therapies have no identifiable side effects for healthy people, which makes the risk of experimenting with them very low. Likewise, supplements are typically safe to combine with other hangover therapies, and they are generally tolerable for patients with gastrointestinal symptoms.
Today, a growing number of pharmaceutical companies are manufacturing over-the-counter drugs marketed specifically as hangover pills, which may include aspirin, caffeine, vitamins, minerals, and herbal extracts. Some hangover pills claim to prevent hangovers from occurring by fortifying the body’s defenses before alcohol consumption whereas others attempt to lessen the severity of a hangover which has already developed. Because hangover pills vary so much in their composition, it’s difficult to generalize about their efficacy. Some patients may derive benefits from hangover pills which contain analgesics or stimulants whereas others may not. Like all other hangover cures, the efficacy of hangover pills in general is dubious; a 2005 review of randomized controlled trials examining hangover cures concluded that there was no compelling evidence in favor or any specific remedy, pharmaceutical or otherwise. But hangover sufferers will be relieved to hear that the therapeutic landscape has changed since the review’s publication.
New Paradigms of Hangover Therapy
As people continue to seek more effective ways to address hangovers, we are now witnessing the emergence of new products and services designed to provide relief for patients. One of the most exciting and successful innovations to crop up in recent years has been the mobile hangover therapy van. Originating in Las Vegas, the mobile hangover van massively improves the care that patients can access to alleviate symptoms.
The premise of the hangover therapy van is simple: doctors and nurses make house calls to severely hungover patients and provide them with supportive care like intravenous rehydration and nutrient supplementation. While most hangover therapy vans don’t boast any medical breakthroughs or advanced technology, they do introduce medical professionals to a pathology which very rarely sees the inside of a clinic. The benefits of treating hangovers with the help of nurses and doctors are numerous, but the primary appeal is access to supportive care tools which patients wouldn’t have otherwise. With the help of professionals, patients can receive not only over-the-counter medication, but prescription therapies designed to treat pain or nausea along with intravenous rehydration to restore normal hydration while circumventing gastrointestinal disturbances; while oral rehydration is effective, water taken via the oral route needs a considerable amount of time to be absorbed as it makes its way through the gastrointestinal system. Additionally, patients can receive reassurance and emotional support at what can be a time of acute distress.
The downside of the hangover therapy van concept is the price. Patients should expect to pay as much as $500 for a hangover house call. Furthermore, hangover therapy van service is not available in most areas. For patients seeking a more accessible hangover cure, there are other new options—used by the most advanced of the hangover vans —which rely on innovations in pharmaceutical science.
The Potential of Alleviating Hangovers by Treating Oxidative Stress
The most promising new hangover therapies seek to augment the body’s ability to compensate for cellular stress. Rather than simply providing pain relief or restoring lost nutrients, these therapies improve the ability of the immune system to function in the wake of overindulgence in alcohol. Bolstering immune system activity is critical because the inflammation common to hangovers is a result of immune dysregulation caused by oxidative stress.
Significantly, oxidative stress has recently been implicated as one of the primary mechanisms of the immunologic pathology of hangovers, in part because the flavor-enhancing additives in alcohol are often rich in toxic molecules which leave noxious byproducts when metabolized by the body, inducing oxidative stress. In general terms, oxidative stress is a process by which the metabolic byproducts known as free radicals bond to critical enzymes and cellular molecules, preventing them from being used for their intended purpose and causing damage. New therapies produced with this understanding of hangover pathology have the ability to prevent the stress from causing more damage, thereby reducing the severity of a hangover. The molecule known as glutathione is one such therapy option.
Glutathione is a molecule produced by the body which is responsible for protecting cells from oxidative stress by bonding to free radicals with great efficiency, preventing damage to the cellular machinery. A 2017 paper written by researchers from the University of Buenos Aires lends credence to the idea that glutathione could be an effective therapy for hangovers by shedding light on the extent of oxidative stress caused by excessive consumption of alcohol. When mice were artificially induced to have the conditions of a hangover, the researchers found that there were 17.5% more free radicals present in their blood than in healthy controls, indicating high levels of oxidative stress. In contrast, glutathione concentrations were found to be 43% lower than in controls and activity of certain critical enzymes was 40% lower. As oxidative stress increased with the severity of the hangover, the glutathione of the mice became further depleted. As glutathione levels decreased, the free radicals could easily damage enzymes, reducing their activity and causing harm to the mice. This harm included a 57% increase in the incidence of enzymes responsible for recycling neurotransmitters, suggesting broadly detrimental and wide-ranging mood disturbances. The results of the study imply that glutathione shortages are a large part of the problem when it comes to the molecular basis of hangovers.
If patients use a glutathione supplement when suffering from a hangover, they could improve their body’s ability to cope with oxidative stress at a minimum. Reducing the oxidative stress caused by hangovers could also very well correspond to reduced inflammation and thereby improved comfort. This could also potentially allay some of the gastrointestinal distress involved in a hangover by allowing intestinal cells to perform more normally while simultaneously improving mood. A glutathione supplement might also treat the major pathologies unaddressed by the current standard of hangover care and act as a safe, effective, and easily accessible alternative to traditional hangover pills.
For the most acute patients, the hangover vans will likely increasingly administer glutathione via I.V. to help address inflammation as quickly as possible. These patients can subsequently advised to take specialized oral glutathione supplements to conclude their course of treatment. Historically, oral glutathione supplements suffered from poor bioavailability, limiting their therapeutic value. Recently, oral glutathione supplements have been developed in sophisticated formulations which address the metabolic obstacles which are present. These formulations enhance the bioavailability of glutathione, allowing it to affect the patient’s physiology and reduce hangover symptoms. As a result, patients can continue their glutathione therapy even after the hangover van has moved on. Patients might also use an oral glutathione supplement to forgo hangover vans altogether if they don’t have a hangover that is severe enough to warrant a visit.
Though there are currently no clinical trials documenting the beneficial effects of glutathione in the context of hangover therapy, researchers based out of South Korea have identified its promise. In a study published in Current Drug Abuse Reviews, the research cohort documents the impact of various minerals and physiological molecules like glutathione on generalized hangover symptoms. While the authors caution that their optimistic outlook on glutathione’s use in hangover treatment is speculation based on the synthesis of prior research, they conclude by reporting that the future is bright for its use as a hangover therapy. For patients who are willing to push beyond the limits of conventional hangover remedies, glutathione might well be the best chance they have at curing their hangovers.
Hangover Heaven. https://www.hangoverheaven.com/
Karadayian AG, Malanga G, Czerniczyniec A, Lombardi P, Bustamante J. 2017. Free radical production and antioxidant status in brain cortex non-synaptic mitochondria and synaptosomes at alcohol hangover onset. Free Radical Biology and Medicine. 108:692–703. https://www.sciencedirect.com/science/article/pii/S0891584917305476
Min J-A, Lee K, Kim D-J. 2010. The application of minerals in managing alcohol hangover: a preliminary review. Current Drug Abuse Reviewse. 3:110–115. http://www.ingentaconnect.com/content/ben/cdar/2010/00000003/00000002/art00008
Penning R, van Nuland M, AL F, Berend O, C Verster J. 2010. The pathology of alcohol hangover. Current Drug Abuse Reviews. 3:68–75. http://www.ingentaconnect.com/content/ben/cdar/2010/00000003/00000002/art00002
Pittler MH, Verster JC, Ernst E. 2005. Interventions for preventing or treating alcohol hangover: systematic review of randomised controlled trials. BMJ 331:1515–1518. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1322250/