Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at June 19, 2016

Most people have experienced an excruciating hangover that has left them in a fetal position and unable to cope with the day. A hangover occurs as the result of drinking too much alcohol, and it is the result of dehydration and the substances that are released when the liver breaks down alcohol. The only way to avoid a hangover is to avoid heavy drinking.


Definition & Facts 

A hangover is essentially the manifestation of several signs and symptoms that come about as the result of heavy drinking. A hangover is due to dehydration as well as the toxic chemicals that are released by the liver when breaking down alcohol. An individual who overindulges in spirits, wine, and beer will quickly become dehydrated, and his or her liver will become overwhelmed by more toxins than it can break down in a timely fashion.

Simply taking a pain reliever is not the right course of action because that can lead to additional toxins entering the body. In some cases, taking acetaminophen while recovering from a hangover can even lead to inflammation and permanent damage to the liver. This is because the liver is busy trying to process the alcohol put into the system, and it doesn't have the resources to also process the normally harmless compounds in the acetaminophen.

Symptoms & Complaints

There are a few common symptoms of a hangover. Typical symptoms can mimic a severe flu, including headaches, general sickness, dizziness, sleepiness, and dramatic thirst. More advanced hangovers may include body aches and pains, and severe dehydration that must be remedied.

An individual may also experience emotional symptoms like anxiety. They may express regret, embarrassment, shame and even depression. Several observable physical signs that a person is experiencing a hangover include an accelerated heart rate and bloodshot eyes. Bad breath is also typically present in someone who has a hangover.

In more moderate cases, an individual may have diarrhea, excessively salivating, flatulence, or vomiting. Several other signs and symptoms also may exist, including an increased sensitivity to light, concentration issues, sensitivity to loud sounds, and moodiness. An individual may also complain of a stomachache, trembling, and shakiness.

In severe cases, the individual may have alcohol poisoning which can be a medical emergency. This manifests itself in several ways, including irregular breathing, slowed breathing, and confusion. The patient may also experience hypothermia, seizures, loss of consciousness, pale skin, and vomiting that won't stop.


The cause of a hangover is pretty clear, and it involves drinking too much alcohol over a short period of time. There are multiple factors caused by alcohol that lead to a hangover. When people drink alcohol, it makes them urinate more frequently. This can cause dehydration, which can cause symptoms of lightheadedness.

Stomach acids are increased by the consumption of alcohol, which can stimulate the stomach's nerves into communicating to the brain that it is necessary to eliminate the stomach's content. This is one reason for the vomiting and nausea that is associated with a hangover. Drops in blood sugar can occur, and this can contribute to general malaise and seizures in extreme cases.

Alcohol also causes the blood vessels to dilate, which is a factor in causing headaches. Finally, a set of substances known as congeners are found in alcohol. Common congeners include aldehydes and esters, and these toxins can contribute to a hangover.

Since all of these factors can also affect an individual's ability to sleep, alcohol is also a cause of the tired and sleepy feeling that occurs the next day. 

Diagnosis & Tests

While most people won't need to see a doctor to determine if they have a hangover since the cause is generally readily apparent, there are some tests that are designed to confirm that person has a hangover. A blood test can determine if a person has a high enough blood alcohol content for a hangover. The more time that goes by from the beginning of drinking to the actual test, the less likely it is for a blood test to show a high concentration of alcohol. However, since alcohol can stay in the bloodstream for several hours, it's possible to get a test early on to determine the extent of alcohol intoxication.

Another quick method that can be used immediately after drinking is a breathalyzer. This device measures the amount of alcohol in an individual's breath. They don't measure the actual blood alcohol content, but it can be used to find out if a person has the potential to get a hangover. In most cases, a visit to the doctor after a night of heavy drinking will involve urine tests and blood testing. The doctor will also ask questions to determine the severity of the hangover. 

Treatment & Therapy

A hangover that occurs after a single night of drinking should not raise significant concern. Repeated hangovers and extended heavy drinking may require treatment for alcohol dependency. This could require an individual to meet with a psychologist or psychiatrist to receive medication and talk therapy (psychotherapy).

For isolated incidents, there is no cure for a hangover and there is no evidence that taking supplements or other medications before a night of heavy drinking will save an individual from a hangover. The best way to deal with a hangover is to drink plenty of water, eat bland foods and take a pain reliever that doesn't contain acetaminophen.

Good foods to eat include toast, crackers and bouillon soup. These foods can boost blood sugar and settle the stomach. They are also useful for restoring salt and potassium levels to a healthy state. If all else fails, individuals with hangovers should go back to bed and the hangover should pass. It is not advisable to drink more alcohol when hungover; it may provide temporary relief, but the situation will only get worse.

Prevention & Prophylaxis

There is only one guaranteed way to prevent a hangover, and that is to avoid drinking altogether. Drinking in moderation typically won't lead to a hangover, but even a single glass of wine can cause a hangover for an individual that never drinks or has a low alcohol tolerance.

Eating before drinking can help the alcohol get absorbed more quickly into the stomach. However, it's important to note that this won't result in a lower blood alcohol concentration. Enjoy one drink or less every hour, and choose drinks that have lower levels of congeners. Examples include light beers and wines. Heavy liquor like brandy, whiskey, dark beers and red wines have high levels of congeners.

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