Nagging about diet and exercise is all well and good but I do sometimes feel we doctors could give a little more useful advice from time to time. At this time of year an obvious theme jumps out at me: how to avoid hangovers.I hear so many myths circulating on this subject and most are complete nonsense. So whilst I cannot possibly condone heavy drinking, even to celebrate so auspicious an event as the arrival of the baby Jesus, I can at least advise you on how to get through your Christmas parties with the minimal of damage and pain afterwards.The first mistakes people make occur before they have even left the house. Number one error is not eating before a night on the booze. Drinking on an empty stomach can lead to a rate of absorption of alcohol that is similar to being given it via an IV drip. This leads to disaster very quickly, and while the liver is in overdrive dealing with the booze it is not able to metabolise glucose very well. This causes blood sugar levels to drop, causing shakes and sweats. The heart pumps harder as well, causing blood pressure to rise, thought to be the reason why some drinkers suffer heart attacks the next morning. Wolfing down a dodgy kebab on your way home is too little too late, and will probably only make your hangover nausea worse. The reason some people get completely sloshed very quickly and others take much longer is partly to do with food, but it’s also partly due to genetics. The quantity of stomach enzymes that break alcohol down differs: women get drunk more quickly than men because they have more fat, less muscle and fewer enzymes. The good news for women is that as they get older women almost catch up with men. Brains shrink a little with age too, making them less prone to headaches the morning after.Whilst out, be aware of the need to avoid dehydration. The kidneys will produce more urine than normal, in response to the diuretic properties of alcohol, and this will dehydrate and deplete the blood's levels of sodium, potassium, calcium and magnesium. Although your brain may seem to tell you otherwise the next morning, alcohol doesn’t actually dehydrate the brain; it causes it to swell, creating pressures on the surrounding membranes and causing the infamous headache. Avoid this by alternating one alcoholic drink with one soft drink, to keep up your hydration levels, and the advice of drinking a pint of water before you go to bed is sound, provided you are not so pissed that you pee yourself in the night.
Despite what you have heard, all alcohol is the same, whether you are drinking the finest champagne or the roughest of alcopops. All drinks contain ethanol which your liver and brain deal with it in exactly the same way whatever the source. It's a myth that mixing your drinks makes a hangover worse. Beer before wine, or wine before beer, both will make you feel rough if you drink enough of them. What does make a big difference is what is mixed with the alcohol. Different drinks will affect you in different ways, and at different times, so choosing what you drink will help you the next day. Generally speaking the browner the drink, the worse the hangover it causes. Rum, whiskey, brandy and port can all be cruel. Vodka is least likely to give you a hangover as it is repeatedly filtered to remove as many impurities as possible. Beer is probably the least dangerous to drink but it's the most calorie rich - one pint contains between 170 and 200 calories.Lastly, I should warn you that knocking back painkillers can be dangerous. Aspirin is popular but can irritate the stomach, and even causing bleeding with alcohol. Paracetamol, too, is not ideal as it can promote further liver damage when combined with alcohol –this makes it a popular although slow acting suicide choice. Taking some before you go to sleep will not help –their effects will have worn off in about 4 hours and probably long before you wake up.And for our herbal and ‘complementary’ friends researchers have reviewed all the available studies on hangover pills, such as yeast and artichoke extract and concluded that there is no compelling evidence of any effective treatment. The only proven cure is time, and getting it right the night before.
Despite what you have heard, all alcohol is the same, whether you are drinking the finest champagne or the roughest of alcopops. All drinks contain ethanol which your liver and brain deal with it in exactly the same way whatever the source. It's a myth that mixing your drinks makes a hangover worse. Beer before wine, or wine before beer, both will make you feel rough if you drink enough of them. What does make a big difference is what is mixed with the alcohol. Different drinks will affect you in different ways, and at different times, so choosing what you drink will help you the next day. Generally speaking the browner the drink, the worse the hangover it causes. Rum, whiskey, brandy and port can all be cruel. Vodka is least likely to give you a hangover as it is repeatedly filtered to remove as many impurities as possible. Beer is probably the least dangerous to drink but it's the most calorie rich - one pint contains between 170 and 200 calories.Lastly, I should warn you that knocking back painkillers can be dangerous. Aspirin is popular but can irritate the stomach, and even causing bleeding with alcohol. Paracetamol, too, is not ideal as it can promote further liver damage when combined with alcohol –this makes it a popular although slow acting suicide choice. Taking some before you go to sleep will not help –their effects will have worn off in about 4 hours and probably long before you wake up.And for our herbal and ‘complementary’ friends researchers have reviewed all the available studies on hangover pills, such as yeast and artichoke extract and concluded that there is no compelling evidence of any effective treatment. The only proven cure is time, and getting it right the night before.
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