Too much to drink? Try one of these hangover remedies

It doesn't take a rocket scientist to figure out how to avoid a New Year's Day hangover: Don't drink.

Lucky are those among us who have figured out that they can be just as witty, clever and attractive — possibly even wear the requisite lampshade or other stylish gear — drinking nothing more than a glass of fizzy water and a twist of lime.

The rest of us, though, likely will succumb to the lure of alcohol on New Year's Eve, if only to relieve the boredom of waiting around for hours for the Big Moment. So you sip a few, and a few more, and before you know it, you've sipped too much. You know, or should, what's to come: a hangover. In the spirit of high spirits, we offer hangover cures from hither and yon, some serious, some not so. And to help tell which is which, a closer look at the hangover.

First, a bit of news: Researchers, after plying thousands of worms with booze, say they've found out what makes you drunk. Yes, we know you're now about to shout: IT'S THE ALCOHOL, STUPID!

But no! Science says it's a gene!

Scientists at the University of California, San Francisco, say alcohol acts on a gene whose normal job is to slow brain transmissions. A couple of double martinis later, train bransmissions, er, brain transmissions, are r-e-a-l-l-y, r-e-a-l-l-y s-l-o-wwwwwwwwwwww. But some worms stayed sober, which for worms was signaled by efficient peregrination. That means they formed a neat S shape for locomotion — the worm equivalent of walking a straight line.

Whazzis? the scientists asked. Turns out the sober worms had a mutation of a particular gene, disabling the brain-slow-down command, and keeping them "sober." Scientists, typically, warned that people are not worms. Well, actually, some people are worms. Especially when they drink. What researchers meant was that humans are more complicated than worms. Yes, they actually said that.

The point: Some people, just like some worms, are going to be more susceptible to hangovers than others. Just how much so likely depends both on genes and "environmental" circumstances.

Luckily, we have science trying to answer the question that's been burning since the first cave man left a bowl of berries sitting out in the sun, drank the fermented mess and suffered the consequences: What, exactly, is a hangover?

Here's what happens

There's a clue in the scientific word for hangover: veisalgia ("alcohol hangover"). It's from the Norwegian kveis, meaning "uneasiness following debauchery," and the Greek algia, the word for "pain."

A hangover, physiologically speaking, looks like this: You get dehydrated, your blood-sugar level plunges, you ache, your hormones go out of whack, your heart races and you get light-headed, flushed and sweaty.

The most common symptoms, most researchers have found, include headache, diarrhea, loss of appetite, nausea, tremulousness, fatigue and a general feeling that you have been run over by a truck. Other symptoms include trouble thinking, seeing and moving — "visual-spatial impairment." Because of its effects on blood sugar and the brain, alcohol can make you confused, stupid, irrational, clumsy, and it can shut down such semi-voluntary motions as salivating and blinking (leading to fuzzy mouth and red, puffy eyes).

Kevin Scheel, director of educational services for the Distance Learning Center for Addiction Studies and author of "Alcohol: Chemistry & Culture," says it's important to remember that alcohol is not only a toxin, but a depressant and an irritant. Take your stomach, for example. Because it's an irritant, alcohol has caused your stomach to produce more hydrochloric acid, which in small amounts can help digestion. But a large amount of alcohol has the opposite effect. In coping with an overload, says Scheel, your body simply "pulls the plug" on your gastrointestinal system.

In the morning, the body is confronted with a full or partially full stomach, he notes. "Instead of digesting it, the stomach performs a routine house-cleaning chore and expels the food."

Nice.

Alcohol also has interfered with your sleep, by messing with chemical messengers that influence sleeping patterns, robbing you of the important REM (rapid eye movement) stage of sleep. Because alcohol messes with your hormones, too, it affects many body functions. For example: Alcohol inhibits a hormone produced in the pituitary gland that regulates the action of your kidneys. When alcohol slows its action, you urinate more — often leading to dehydration, one of the hangover's prime symptoms. And although you now may be sober, you very likely still have what researcher Dr. Jeffrey Wiese calls "decreased occupational, cognitive or visual-spatial skill performance." Experiments have shown hangovers' detrimental effects on the performance of pilots, drivers, and skiers, as well as on those who need managerial or "task completion" skills.

According to Wiese, an associate professor of medicine at Tulane Health Sciences Center in New Orleans, hungover people show a number of physiological changes, including changes in brain waves, many hours after alcohol is no longer detectable in the blood.

Wiese, lead author of "The Alcohol Hangover" in the Annals of Internal Medicine of June 2000, says for the average person, a hangover equals tossing down two drinks in the past hour in its effect on reaction time and cognitive abilities.

Why it happens

Exactly what produces a hangover is still under debate.

Most experts believe a prime culprit is acetaldehyde, produced when alcohol is metabolized. Since alcohol is a toxin to your body, your liver breaks it down, first to acetaldehyde, then to acetic acid, which can be burned by all your organs, with your liver taking the lead.

Wiese thinks inflammation also plays a big part, and key in that process is the action of "cogeners," chemicals formed during processing and maturation. Research shows drinks high in cogeners — brandy, wine, tequila, whiskey and other dark liquors — are more likely to cause a hangover than clear liquors — white rum, vodka or gin, for example.

Researchers tested bourbon (high in cogeners) versus vodka (low) in the same doses on subjects: 33 percent of the bourbon drinkers got severe hangovers, while only 3 percent of vodka drinkers felt like a chewed dog bone in the morning.

Wiese says there's truth to the old saw that cheap liquor is more likely to cause a headache. The reasoning: More expensive liquors undergo more rigorous filtration. In one study, researchers measured the effect of liquor impurities, giving a dose to one group of subjects and placebo impurities to the other.

No alcohol was involved. The subjects who got impurities got hangovers — without alcohol, Wiese noted.

Hangovers, researchers agree, aren't strictly related to how much and what you drink, but are influenced by a number of other factors, including body weight, food consumption, amount of sleep, physical activity while intoxicated, dehydration and general health.

What ads claim will help

That makes it harder to figure out how to "cure" a hangover.

The good news is there are lots of "hangover remedies." The bad: There aren't many proven to work.

Two "natural" products, RU-21 and Liv.52, have been studied only by their manufacturers.

RU-21, being advertised heavily this holiday season, scantily clad females and all, has a "biochemical rationale," says Dr. Boris Tabakoff, chairman of pharmacology for the University of Colorado School of Medicine, who has studied RU-21's composition and company-produced data. "The problem is, it hasn't been rigorously tested, or tested at all."

If the drug, as claimed, slows the formation of acetaldehyde, it may well also slow the conversion of the acetaldehyde to acetic acid, which would defeat the purpose, Tabakoff says.

Scheel, too, says he has difficulty with the claims. "If something changes the liver's function to remove alcohol, causing the irritating effect to stay longer, it can have more serious problems, both short term and long term."

Tabakoff has ethical qualms about the idea of a "hangover remedy," he concedes. "What are you going to be saying: 'Go ahead and drink more and we'll protect you'? If people think by taking this drug and drinking in excess, they will not become dependent, they're crazy."

Wiese, who studied 108 research reports on hangovers for the Annals report, sees hangovers from a different angle: Hangovers have a huge societal cost.

They're suffered mostly by light-to-moderate drinkers, the largest portion of the work force. Surveys show such drinkers average about eight to 12 hangovers per year, making hangovers more prevalent than the common cold.

Studies done in other countries show huge costs in lost wages and decreased occupational productivity; one study estimated yearly U.S. costs at $148 billion.

What might actually help

Wiese says there's no evidence hangovers deter drinking. So he doesn't have mixed feelings about the search for a remedy. So far, though, only a few show any proof of effectiveness. Among them:

• Rehydrate. Buckets and buckets of water before you go to bed.

• Take Vitamin B6 before you drink. In one study, hangover symptoms were reduced 50 percent among those who took three 400-mg doses of B6 (one when the party began, one three hours into it, and another at party's end).

• Drink fruit juice or other beverages with lots of glucose or fructose while you drink alcohol. One small study showed those who got such a dose showed 50 percent reduction in mistakes on a test of cognitive ability. However, research subjects were a bit less coordinated, and overall hangover symptoms were the same.

• Tolfenamic acid, an anti-inflammatory drug available in Europe, was associated with a small improvement in symptoms when taken immediately following drinking. Other non-steroidal anti-inflammatory drugs may work, too, Wiese notes, but haven't been studied.

That may be it from science, but there is nothing like a hangover to inspire people, apparently. We've culled some "cures" — serious and not so — including some in the popular "hair of the dog that bit you" category (see sidebars). While grounded in some truth — if you keep drinking, you may postpone some effects — such "cures" also add to the total amount of alcohol inflicted upon your system, which adds to the total hangover effect. Its real attraction, it seems, is to distract you from your symptoms.

But never fear: Science, and legions of drinkers, will keep searching for that elusive remedy.

Happy New Year.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com