Alcohol, hangovers

Photo by christopher lemercier on Unsplash
  1. Alcohol itself does not cause the hangover directly, rather the metabolite acetaldehyde which becomes manifest a few hours after the ingestion of whatever alcoholic beverage you are consuming. Acetaldehyde is a direct cellular poison which not only causes the acute symptoms of the hangover which can lead to a variety of toxic effects within the body as well as on a chronic basis, cellular damage also, in particular, the liver, brain and the heart.
  2. Alcohol is a diuretic, thus leading to dehydration. It is felt that part of the reason for the throbbing headache and dry mouth is dehydration but no doubt the vasodilating effects of acetaldehyde also contribute.
  3. Sleep apnoea — alcohol and acetaldehyde have potent effects on disrupting sleep markedly increasing the severity of sleep apnoea which is present, to some degree, in all males and postmenopausal females. After a bad episode of sleep apnoea, your blood pressure is driven up, you feel unbelievably tired and unwell.
  4. But, it also appears that there are other aspects to drinking and certain types of alcohol are more prone to causing a more intense hangover. There are certain chemicals present in the variety of forms of alcohol known as congeners which are separate to alcohol and acetaldehyde. These congeners include sulphites, amines, amides, acetone, histamine and methanol. Certain types of alcohol have higher concentrations of congeners, typically the more coloured forms such as the darker liquors such as whiskey and cognac and of course the increasingly popular red wine. Interestingly, for the more moderate drinkers who will keep the wine for a few days, after the wine is opened and exposed to the air, the longer time increases the concentration of congeners. I’m not suggesting this as an excuse to ensure that every time you open a bottle of wine you finish it in one hit, but I am suggesting that you obtain the suction devices to take as much air out of the partly consumed bottle as possible and also leave the wine in the fridge, which will reduce the concentration of congeners. It appears that the colourless spirits, such as vodka and gin, have much less congeners and appear to cause less hangover. The key point is that the more you drink, regardless of the drink, the greater your risk for a hangover and on a chronic basis, significant health issues.

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