Hoorah! It's getting to that time of year when opportunities to overindulge start to come thick and fast! Whilst Winchester GP is a medical practice, and we try to set a good example most of the time - we do also love a party. And, let's face it, 2022 has, for so many people, been a 'bit of a mixed bag'. So let us not judge too harshly if people want to let their hair down just a little. We at Winchester GP have instead turned our thoughts to how best to minimise and manage the after effects of a bit of a blow out! Specifically what are the best ways to avoid, minimise and fix a hangover. Read on for the fruits of decades of medical training, and countless nights of 'field work'.
What exactly is a hangover?
Firstly, let us profile our opponent. We can classify a hangover as a cacophany of undesirable symptoms, including headaches, nausea, dizziness and fatigue, caused directly or indirectly by excessive alcohol consumption. The precise mechanism of how things can deteriorate from 'Disco Inferno' at 2am to 'Death's Door' at 7am seems quite complex, but is believed to be a combination of factors including:
Poisoning - from the metabolic by products of alcohol, which are toxic to the body
Sleep disruption - alcohol interferes with brain activity, (you don't say?!) which, in addition to making your mouth run away with itself, can disrupt restorative sleep.
Hormone disruption - Alcohol interferes with the hormones that regulate our body clock - so can have an overall jet-lagging kind of effect
Dehydration - Alcohol is a diuretic (makes you pee more). Alcohol also makes you sweat, and could ultimately lead to diarrhoea or vomiting, all of which will dry you out even more, and this can be the root evil of many of the big hangover symptoms
Low blood sugar - Alcohol affects your blood sugar levels, depriving your brain of much needed fuel. This effect is compounded if you got so excited that you also forgot to eat
How can we prevent or fix a hangover?
Tip 1: hydrate Hydrate hydrate!
Dehydration is linked to many debilitating symptoms such as headache, nausea and dizziness. Yet it is super simple to address so make this your number one priority. Beware of complacency also; the lighter-than-usual urine that you may notice on a drinking night is not a sign that you are already super well hydrated - it is the alcohol making you pee more.
An evening spent sticking to long drinks that include plenty of water e.g. vodka lime and soda or wine spritzers is a good strategy.
Another method is to alternate alcoholic drinks with soft drinks - but our 'roving reporters' note that it is super easy to get knocked off your rhythm - around about the same time as your sensible head leaves the building, or someone thrusts another mulled wine in your hand.
If nothing else, as you go to bed, remember to knock back that very large glass of water or squash (for some extra sugar- see below) that you have wisely placed by your bed before going out. Your morning head will thank you for it.
Tip 2: Dealing with nausea
An upset tummy could be the result of low blood sugar, or dehydration, both of which will only get worse if you are struggling to keep any food or fluids down. If you don't think you can face starchy carbs like bread/toast, try testing the waters with cautious sips of a glucose drink, or just a teaspoon of honey. Even the smallest amounts of sugar can help to nudge your levels back to normal. Another option to relieve an upset tummy is to take an antacid to neutralize the stomach acid.
Tip 3: Beware the Dark Side
You've maybe heard 'on the grapevine' that dark red drinks such as red wine and brandy cause worse hangovers. The science suggests that there is an element of truth to this. Darker liquors contain compounds called congeners that, when metabolised by the body, create particularly nasty by-products. But that does not mean that you can pile in to the vodkas and gins - total alcohol consumed remains the key factor! (Sorry!)
Tip 3: Explore the No/Lo alcohol market
Not before time, the beverages industry has woken up to the need (and commercial opportunity) for interesting and 'grown up' no alcohol/low alcohol drinks. From alcohol free 'spirits' such as Seedlip to some really rather quaffable cork poppers (try Fizzero at M&S, or Nozecco at other major supermarkets) you can now enjoy a sophisticated and flavourful, yet low alcohol tipple. We've also noticed that it is becoming more socially acceptable to order these items, and even 'the norm' for them to be available, so great news on all fronts.
Tip 4: Understand and use your medicines wisely
Everyone will have their 'go to' hangover medicine remedy, but we hate to break it to you - there is no over the counter cure for a hangover - only a variety of ways to manage the symptoms whilst time and your own body's healing mechanisms take care of the rest. Paracetamol can help with headaches, but beware that if your liver is feeling hard done by already, paracetamol can add to this burden. Meanwhile the anti-inflammatory drugs such as ibuprofen and aspirin can help your pounding head but may irritate your stomach, so are not ideal if gastric symptoms are already an issue.
There are lots of compound treatments out there, such as Alka Seltzer XS - but the fancy marketing does not make them magic- check the ingredients list and you’ll find the usual suspects: paracetamol, ibuprofen and caffeine. That means that their main benefit, in our view, is convenience. If you are taking several remedies throughout the day, do keep a close eye on the total amount of each component you have taken, to avoid unintentionally overdosing.
Tip 5: Use caffeine with discretion
Unfortunately caffeine has not been shown to have any special 'sobering up' or anti-hangover powers, but if you are sleep deprived and groggy, it might just give you the short term lift that keeps you on your feet until home time. Go easy though- because the Holy Grail you really seek is a decent night's sleep. You don't want to be wide eyed and wired come bedtime! Caffeine is also a diuretic (makes you lose water) so accompany your flat white with (another) glass of water.
Tip 6: What about Vitamins? Zinc? We'll try anything!
The theory on antioxidants, such as Zinc, seems sensible, if you consider that drinking alcohol causes oxidative stress, leading the body to produce free radicals. Antioxidants could therefore help by mopping said free radicals up. However, large scale clinical studies to prove that they genuinely help at the time of need, over and above a placebo effect, is thin on the ground. An overall healthy diet rich in antioxidants is always a good thing - (read more about this in our Lifestyle Medicine explainer, written by Dr Nirusa Kumaran) but when it comes to spending extra money on vitamin and mineral preparations specifically marketed as a hangover cure, we will need a bit more persuading.
Tip 7: Ride out the Hangxiety!
At 2am you could quite possibly have been the secret love child of John Travolta and Beyonce. Yet this morning's memory of proceedings is telling you something altogether different? And the psychological challenges of the morning after don't stop at disturbing flash backs. Some people really get down on themselves, and life in general when they have a hangover. And yes, in the cold light of day one might argue that a hangover is one of the sillier ways we can injure ourselves, like walking in to a lamp post. But if it's once in a very infrequent while, we'd like to encourage an approach of self love. As long as no bones were broken, crimes committed or valued friendships ruined, we suggest you chalk it up to experience and move on. If possible, plan some recovery time after that one event that you think will be particularly raucous- some pre-booked time off will feel so much better than a shameful call in to work with 'food poisoning'. However, if the gloom feels more serious it might be worth compassionately but honestly examining your relationship with alcohol, and general mental health more closely. If your low mood outlives your other hangover symptoms, or you are tempted to alleviate them by drinking again, or indeed you suspect that excessive alcohol has become your way of coping, please do seek help. A full list of support services is listed at the foot of this blog post, and our friendly and empathetic GPs are on hand to consult and support you.
Tip 8: Beware the Hair of the Dog
Has anyone not tried this at some point? Christmas is an ideal opportunity after all - a Christmas morning bucks fizz to take the sting out of the effects of Christmas eve revelries? Our 'on the ground' experience is that in very moderate amounts it can indeed make you feel a little better. Why this would be the case is up for debate. Getting 'a little bit' drunk again might just make you less acutely aware of your symptoms. Another more scientific explanation is that some hangover symptoms could be attributed to the brain experiencing alcohol withdrawal - so a little bit more would then make for a softer landing. But medically speaking, hair of the dog is not something that we can recommend - at best, while you remain drunk your body is not really recovering, and really you are just 'kicking the can down the road'. What is more if this regime is repeated, it risks becoming a far less healthy downwards spiral- approach with caution!
Tip 9: Take a back seat
Regardless of whether you have managed the symptoms well, your cognitive and motor functions will be impaired by a big night out, so please exercise huge caution around driving and operating machinery. The body metabolises alcohol at approximately one unit per hour, so it is absolutely possible to wake up from a night out, and still be over the legal driving limit. Further more, it is now widely accepted that lack of sleep can impact your driving skills in the same ways as being drunk, so please think twice before getting behind the wheel.
The (possibly disappointing) bottom line
You've read this far, and we would love nothing more than to reward your persistence with THE ANSWER- a magical cure that allows you to indulge unfettered, yet spring out of bed bright eyed and bushy tailed the next morning. Alas, we can confirm that this is as much of a myth as Father Christmas himself (Wait, what??) But we do hope that our suggestions can give you some comfort, help you avoid any major alcohol induced maladies, and mean that when you do party, you enjoy it all the more! And remember, our doctors are only a phone call or online booking away if you would like to consult further.
May we wish you and all you love a most enjoyable Christmas, and a happy and healthy 2023 xx
Useful links:
Online booking for Winchester GP appointments (telephone and video consultations may be booked on line- face to face bookings may be made by calling 01962 776010)
www.drinkaware.co.uk
www.turning-point.co.uk
www.samaritans.org.uk