Going to a Party? Be Prepared!

Going to a Party?
Be Prepared!

Certain nutrients may help you “party-proof” yourself
so you’ll feel great the morning after
By Dr. Edward R. Rosick

Wine measurably drunk and in season bringeth
gladness of the heart, and cheerfulness of the mind.

— Sirach (Ecclesiasticus) 31:28

ith autumn half over, the holiday season, running from Thanksgiving through New Years, will soon be upon us. And with that, of course, come the holiday parties. Yes, it will again be that time of year when friends and families get together in homes, offices, and restaurants across the nation to catch up on what’s been happening, to laugh about the past, and, for many, perhaps, to consume a bit more alcohol than they normally would.

Human beings were making alcoholic beverages for thousands of years before the dawn of recorded history. And ever since writing began, the world’s great literature (including the Bible and the Talmud) has extolled the virtues and decried the vices associated with alcohol, especially wine. Among the virtues of alcohol consumed in moderation are many health benefits, which have been recognized since time immemorial, as have alcohol’s horrendously destructive effects when it’s consumed in excess.

Between the two extremes of abstinence and drunkenness, and constituting neither virtue nor vice, is an all too familiar phenomenon resulting from simple overindulgence: a hangover (called veisalgia in medical jargon—doctors have fancy words for everything).

Hangover Is No Laughing Matter

It has been estimated that three-quarters of the people who consume alcohol experience at least one hangover a year—and that’s one too many for most people. But what exactly is this ghastly condition that makes you wish your primordial ancestors had never discovered alcohol? Although there is no precise definition, most researchers agree that a hangover consists of multiple common symptoms, including headache, nausea, diarrhea, fatigue, cognitive impairment, and an overall poor sense of well-being (which, sometimes, is putting it mildly).

While being hung over may make you the butt of jokes at the office, the economic cost of hangovers is no laughing matter. Decreased productivity and poor job performance, along with worker absenteeism, have been estimated to cost American employers 148 billion dollars annually. Furthermore, alcohol-induced hangovers have been linked to increased cardiovascular morbidity (another fancy word, meaning a diseased state).1

What Causes Hangover?

So we know what hangovers are and how costly they are, but why do they cause such awful symptoms? To answer that, we need to know a little about what alcohol does when it enters the body (we’re talking, of course, about ethyl alcohol, or ethanol, as opposed to the countless other alcohols known to chemists). Alcohol inhibits the effects of many hormones, including antidiuretic hormone, also known as vasopressin. As its name implies, this hormone tends to suppress urination, so inhibiting its action has the opposite effect: it promotes urination. Alcohol, in fact, induces urination that’s out of proportion to the amount of fluid taken in. That tends to cause dehydration, which in turn can cause some of the symptoms of hangover, such as headache and nausea.


The researchers postulated that the
nutrients functioned synergistically,
stating, “Metabolically, ascorbic acid,
cysteine, and thiamine are known to
be interrelated in ways which
could enhance their individual
activity in the body.”


Another factor thought to be involved in hangovers is related to the proinflammatory effects of alcohol. People who are hung over have elevated levels of prostaglandins, hormonelike substances that are involved in inflammatory reactions.2 Furthermore, it has been observed that the most severe hangovers are generally associated with the consumption of ethyl alcohol containing high levels of congeners. These are closely related alcohols, natural byproducts of the fermentation or distillation processes by which alcoholic beverages are made. Some such congeners are believed to elicit an inflammatory response.

Acetaldehyde Is a Major Culprit

A nasty consequence of consuming ethyl alcohol (CH3CH2OH)—and probably a major factor in the symptoms of hangover—is the alcohol’s inevitable metabolism to the toxic compound acetaldehyde (CH3CHO); this reaction is catalyzed by the enzyme alcohol dehydrogenase. Fortunately, acetaldehyde is itself metabolized to the benign compound acetic acid (CH3COOH), which is often called acetate for short (acetate is actually the negative ion CH3COO); this reaction is catalyzed by the enzyme aldehyde dehydrogenase-2. These metabolic processes take time, however, so if you drink too much or too quickly, you will get drunk, and your body will accumulate more acetaldehyde than it can readily handle without discomfort. The result: a hangover.

Some Hangover Myths Debunked

Ask ten people how to avoid a hangover, and chances are you’ll get ten different answers, many of them misguided, because myths abound. Here are a few such myths:

  • Having something to eat before or during drinking will prevent a hangover. Sorry, but all that does is slow the alcohol’s absorption rate.
  • Drinking coffee will help sober you up and get rid of a hangover (a favorite trick in the movies). Listen up, Hollywood: all coffee does is make groggy drunks less groggy, and it does not ameliorate a hangover.
  • Having a drink in the morning (“hair of the dog”) will banish a hangover. While the fresh jolt of alcohol might make you feel better temporarily, it won’t cure the hangover, and it may make it worse.
  • Clear liquor, such as vodka or gin (or white wine), won’t give you a hangover, whereas colored liquor, such as whisky or bourbon (or red wine), will. Although any kind of alcoholic beverage can give you a wicked hangover if you overdo it, this “myth” may have some truth in it. Clear alcoholic beverages generally have lower levels of the congeners mentioned above, so if these congeners contribute to hangovers, then the clear beverages may be a safer bet for mitigating hangover than the colored ones.

A Nutrient Cocktail May Help

Myths aside, there are some simple things you can do (besides not drinking!) to minimize your chances of feeling rotten the morning after a big party. First, drink plenty of water or other nondiuretic fluids. Because alcohol is a diuretic, the more water you take in, the less chance you’ll have of becoming dehydrated. Second, dont smoke! Cigarettes produce significant amounts of acetaldehyde, among many other toxins, and that’s not something you want even more of. Last—but certainly not least—consider using supplements, such as the amino acid L-cysteine, along with vitamin B1 (thiamine), and vitamin C (ascorbic acid), which have been found to be helpful—especially in combination—in preventing hangover.

A study published in 1975 examined the protective action of these and 15 other nutrients against acetaldehyde toxicity caused by heavy drinking or heavy smoking.3 The researchers administered the nutrients, individually or in various combinations, to 30 laboratory rats via oral intubation. Then, after waiting 30–45 minutes, they gave the rats, again via oral intubation, an LD90 of acetaldehyde (LD90 = lethal dose 90, the amount of an agent that would be expected to kill 90% of the animals, on average).

Individual nutrients or pairs of nutrients showed varying degrees of efficacy against acetaldehyde toxicity in the rats, and the best results were obtained with a combination of vitamin C, L-cysteine, and vitamin B1, which gave virtually complete protection for 72 hours against acetaldehyde lethality (but not complete protection against acetaldehyde toxicity). The researchers postulated that these three nutrients functioned synergistically, stating, “Metabolically, ascorbic acid, cysteine, and thiamine are known to be interrelated in ways which could enhance their individual activity in the body.”

Vitamin B6 May Also Help

Vitamin B6 may also be useful in warding off the irritating—often debilitating—symptoms of hangover. A study done in 1973 examined the effects of vitamin B6 in people who were drinking to intoxication (who says scientific studies are boring?).4 During an evening of heavy drinking, 17 men and women received 1200 mg of either vitamin B6 or placebo, in three equal doses of 400 mg each: the first at the beginning of alcohol consumption, the second 3 hours later, and the third at the end of the evening. Using a 20-symptom scale to assess hangover complaints, the researchers showed that the participants taking vitamin B6 had an approximately 50% reduction in their symptoms compared with those taking placebo. (For another alcohol-related benefit of vitamin B6, see the sidebar on this vitamin.)

Vitamin B6 May Help Prevent Alcohol-Induced Hypertension

Besides helping relieve hangover symptoms, vitamin B6 may also help in warding off one of the most deleterious consequences of chronic alcohol consumption: hypertension, which is among the leading causes of morbidity and mortality in the Western world. Although scientists are not sure why alcoholism causes hypertension, it has been suggested that—you guessed it—acetaldehyde may be the culprit.

Researchers in Newfoundland have tested this hypothesis in a study on the effects of vitamin B6 on ethanol-induced hypertension in rats.1 They divided a group of 18 young adult rats into three groups of six: Group 1, serving as the controls, received standard rat chow (containing a normal amount of vitamin B6) plus unlimited drinking water; Group 2 received the same diet but with 1% ethanol added to their water; and Group 3 also received 1% ethanol, plus a 20-fold increase in the amount of vitamin B6 in their chow.

After 14 weeks, the rats in Group 2 had a significant increase in their systolic blood pressure. The rats in Group 3, however, had no increase, indicating a protective effect of the vitamin B6.

Reference

  1. Vasdev S, Wadhawan S, Ford CA, et al. Dietary vitamin B6 supplementation prevents ethanol-induced hypertension in rats. Nutr Metab Cardiovasc Dis 1999;9:55-63.

Happy Holidays—And Party Wisely!

Combating acetaldehyde toxicity does not confer protection against alcohol intoxication (whether acute or chronic) or against the carcinogenic or other harmful effects of smoking. No pill will sober you up or prevent cigarettes from killing you. What some pills can do, however, is provide your body with healthful supplements, such as L-cysteine and vitamins B1, B6, and C, which may help you have a good time by preventing a hangover from ruining your holiday cheer.

References

  1. Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med 2000;132:897-902.
  2. Wiese JG, McPherson S, Odden MC, Shlipak MG. Effect of Opuntia ficus indica on symptoms of the alcohol hangover. Arch Intern Med 2004; 164:1334-40.
  3. Sprince H, Parker CM, Smith GG, Gonzales LJ. Protective action of ascorbic acid and sulfur compounds against acetaldehyde toxicity: implications in alcoholism and smoking. Agents Actions 1975;5(2):164-73.
  4. Khan MA, Jensen K, Krogh HJ. A double-blind comparison of pyritinol and placebo in preventing hangover symptoms. QJ Stud Alcohol 1973; 34:195-201.

Asian Flush (Not a Typo)

Ever heard of Asian flush? Well, if you’re not Asian, you might think it’s the latest card game out of Vegas—but you’d lose. Nor is Asian flush a typo for Asian flu, and it has nothing to do with bathrooms. It’s a hereditary condition affecting about 40% of people of Asian descent, in which alcohol consumption, even in small quantities, leads to facial flushing, headache, nausea, and rapid or irregular heartbeat.

The cause of this unfortunate condition is a mutation in the gene that codes for aldehyde dehydrogenase-2 (ALDH2), the enzyme that converts acetaldehyde to acetic acid. With an inactive form of this enzyme, the people affected suffer a rapid buildup of acetaldehyde to toxic levels—which is why the disorder is also called severe acetaldehydemia. Although it may seem that Asian flush is just a hangover, it’s really not, because the problem can be caused by very small amounts of alcohol.

Currently there is no realistic prospect for treating this genetic disorder except perhaps through gene therapy. One pharmaceutical company, however, has used the knowledge gained from Asian flush in a practical way by creating the drug disulfiram, more commonly known as Antabuse®. What Antabuse does is inhibit the action of ALDH2, thereby strongly “encouraging” alcoholics not to drink.


Edward R. Rosick, D.O., is an attending physician and clinical asst. prof. of medicine at Pennsylvania State University, where he specializes in preventive and alternative medicine. He also holds a master’s degree in healthcare administration.

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