How to Get Through a Hangover
The misery that is a hangover has no cure (aside from not drinking in the first place), but there are many at least marginally effective treatments. As far as we’re concerned, combining forces—advice from several different experts—makes the most sense. So here, we come at the problem of the hangover from several different angles to help you feel better, faster.
Functional medicine physician Robin Berzin, M.D., (who helms the holistic medicine practice Parsley Health, with locations in LA, SF, and NYC) shares the reasons we think hangovers occur in the first place, plus her tips for alleviating them; nutritionist Keri Glassman, M.S., R.D. gives us a morning-after eating plan; and osteopath Vicky Vlachonis created a DIY guide to acupressure points that can mitigate splitting headaches, nausea, and the like. Plus, we’re sharing some favorite preferred rehydration methods. See you at the (liquid IV) bar.
What Causes a Hangover
Scientists and doctors have tried to figure out what exactly causes a hangover—which is more complex than one might suspect. Alcohol’s impact on us appears at least in part to be inflammatory in nature and tied to the chemical effect it has on the brain. (*Fellow science nerds, see the footnote at the bottom of this piece.) Dr. Berzin explains three factors often behind the next-day side effects of a few too many martinis:
1. Dehydration: “Alcohol is a diuretic, which means it increases urine production,” says Berzin. “And if you’re drinking alcohol, that means you aren’t drinking water.”
2. Poor sleep: “Alcohol may initially help you fall asleep, but research shows it causes disruption and inability to reach deep sleep later in the night. We know that sleep is our bodies’ natural reboot. So if we are unable to sleep soundly and our bodies are busy trying to get rid of the alcohol and its byproducts, it can’t do its normal clean-up routine. This may be one reason we feel and look like garbage the next morning.”
3. Toxic build-up: “Your body had to metabolize all that booze. Alcohol is broken down in the liver by alcohol dehydrogenase to acetaldehyde. Acetaldehyde is further broken down by acetaldehyde dehydrogenase and glutathione. When drinking large quantities of alcohol, the liver can’t keep up. So the toxic acetaldehyde builds in the blood while the liver tries to make additional glutathione. Elevated levels of acetaldehyde, over time, may lead to oxidative stress, liver damage, and possibly cancer. Genetic variations within the detoxification process can determine how quickly and efficiently you are able to metabolize alcohol which can further cause issues for those who are slow metabolizers.”
Party Do’s & Dont’s
Of course, the surefire way to avoid a hangover altogether is…not drinking too much. (Berzin reminds us that organizations like The American Heart Association, American Cancer Society, and US Department of Health and Human Services recommend that men drink no more than two drinks a day, and that women have no more than one: “That one drink is defined as having about 14 grams of pure alcohol—1.5 oz of distilled spirits, 5 oz of wine, or 12 oz of beer,” she says.)
Besides limiting your drink count, here’s what else Berzin suggests pre-drinking and at the bar:
1. Hydrate: “Seems overly simple, but this is the best way to avoid a hangover. Alternating your alcoholic beverages with a glass of water not only keeps you hydrated, but also slows down your overall consumption.”
2. Eat: “Having a full meal—with good quality protein and healthy fats—before you start drinking helps slow the absorption of alcohol into the bloodstream.”
3. Pick your poison: “Stick with organic vodka or tequila mixed with soda water and lime. Clear spirits have fewer toxins than darker liquors; and make sure to avoid sugary mixers.”
Nutritionist Keri Glassman, M.S., R.D. of Nutritious Life (which offers loads of good food and wellness content, along with a course for health practitioners and professionals) has the kind of grounded-in-reality philosophy that’s easy to get behind. Meaning, you can count on Glassman for low-sugar smoothie hacks, simple veggie-focused dinner ideas, gluten-free takes on cookie dough, and a spicy margarita recipe—plus advice about what to eat when you’re…so f%*king hungover:
1. Eggs: “Your liver works in overdrive to neutralize the toxin acetaldehyde using an amino acid called l-cysteine,” says Glassman. “Give your liver a hand by having eggs for breakfast, which are a source of l-cysteine.”
2. Coconut water: “Alcohol, a diuretic, inhibits the pituitary gland from secreting vasopressin (anti-diuretic hormone), which then causes the kidneys to reabsorb less water, and instead excrete it out of the body. This loss of water can also cause an electrolyte imbalance. Dehydration, plus loss of electrolytes, can cause headache, shakiness, fatigue, dizziness, and muscle spasms. Combat dehydration with tons—I mean tons—of fluids. Coconut water supplies potassium, so it both rehydrates you and helps to replenish your electrolyte balance.”
3. Make your own sport drink: “Go homemade—mix water, fresh-squeezed juice, and a pinch of sea salt (honey optional!).”
4. Bananas: “These are high in the electrolyte potassium, and also a good idea if you’re suffering from an upset stomach. (Alcohol can have an inflammatory effect on your stomach lining and digestive system, which is a common cause of nausea and upset stomach.)”
5. Ginger: “Slice fresh ginger root and add it to your water. Ginger can be effective for nausea and vomiting.”
6. Vitamin B: “B’s may be your BFF. One study showed that supplementing with B6 before, during, and after drinking could help reduce hangover symptoms.” (See below for a vitamin B-spiked electrolyte drink from Liquid I.V.)
Wondering if there’s any nutritional merit to the greasy spoon or hair-of-the-dog tradition? Alas, neither make Glassman’s list. If you wake up thinking of the drive-thru, Berzin says that what you’re really craving is salt and hydration: “Processed food can actually make you feel worse.” And while no one here is judging a Bloody Mary brunch, technically speaking, Berzin says that drinking to get over a hangover adds to the alcohol metabolism load she describes above: “You are delaying the inevitable hangover and doing more damage to your body.” On that note, Berzin also suggests avoiding painkillers: “Especially acetaminophen, which is also metabolized by the liver, and ibuprofen, which can damage an already fragile intestinal lining.” (As Berzin notes, the combination of alcohol and acetaminophen—the active ingredient in Tylenol—can be devastating to the liver; and accidentally taking too much acetaminophen can be deadly. To read/hear more, see ProPublica‘s in-depth reporting from 2013, done in conjunction with This American Life.)
Osteopath, pain expert, and author of The Body Doesn’t Lie, Vicky Vlachonis has a deep toolbox for curbing pain in many forms. When it comes to hangovers, Vlachonis says the toxic byproducts of drinking can “cause your body to take a beating.” She hones in on four acupressure points that she’s found to provide relief:
1. For your headache: Vlachonis explains that there is a pressure point on your hand, in the fleshy area between the pointer finger and thumb, known as LI 4 in acupuncture. “It’s the gate to the large intestine, and applying pressure to it can help with headaches, as well as with constipation, which sometimes accompanies a hangover.” To begin, rest your left hand on a table, making an L-shape with your pointer finger and thumb. With your opposite thumb, apply pressure and massage between the web of your thumb and pointer finger, in small circular motions. The trigger point, says Vlachonis, is up where you feel your pointer finger bone. Vlachonis recommends applying pressure for 10-20 seconds at a time, on each hand.
2. To stem nausea and overheating: Vlachonis calls this next acupressure move “opening the tap.” The idea, as Vlachonis explains, is to “move energy away from the mind and help open the stomach meridian, supporting oxygen and blood flow.” So, bend your right knee to ninety degrees, and with your right index finger, feel the outside bone by your knee (the fibula). Tracing below your kneecap, move your finger about an inch inward, and you’ll feel a dip (at the proximal tibiofibular joint). Press into this dip with your right index and middle fingers. Vlachonis says that you can sometimes feel your pulse at this spot. Again, she suggests applying pressure for 10-20 seconds at a time, and doing a few times on both knees.
3. Calming mind and body: The “gallbladder point,” explains Vlachonis, is between the fourth and fifth toes, a few fingers up from the fifth toe, at the tendon when you flex the pinky toe. “The gallbladder point is connected to decision-making. Sometimes, after a night of drinking, some self-doubt, negative self-talk, and/or paranoia can set in with a hangover—did I say the wrong thing last night?” To help ease the mind chatter, Vlachonis says to put pressure, and focus, on this spot (same time guidelines as above). “This point is also connected to your shoulder,” Vlachonis continues, “so applying pressure here can help with discomfort around the shoulder and neck as well.”
For more acupressure salves, see Vlachonis’s book, which has a step-by-step program for pain relief, including hangovers and headaches.
Vlachonis is a big fan of the comforting power of baths in general—over drinking your emotions: “Often when people are going through a difficult or stressful time, they turn to alcohol to numb the pain. I always remind my patients that this will only lead to double the pain, more anger, frustration, and sadness the next day. If you’re drinking to numb emotions, opt out for an anti-inflammatory bath, or a chat with a loved one instead. If you’re drinking to celebrate, enjoy in moderation.”
* Interesting research in this space comes from Jing Liang, M.D., Ph.D., an Adjunct Professor in USC’s Titus Family Department of Clinical Pharmacy and UCLA neuroscientist, Richard Olsen, Ph.D., who have studied receptors in the brain that the neurotransmitter GABA sticks to that are also sensitive to ethanol—i.e. alcohol. Liang identified a purified extract from the Chinese herb Hovenia, which goes by the chemical name dihydromyricetin, or DHM, that she explains acts on this same receptor, and which was shown to block the effects of ethanol in rats. Varied forms are being packaged into hangover-marketed supplements and some humans say it helps. Liang is now parlaying this work into Alzheimer’s research—exploring DMH as a possible AD medication.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.