Wednesday, February 3, 2016

Another reason not to rely on medical advice from the Internet.

On New Year's Eve, The Daily Beast published an article with suggestions about how to avoid a hangover.

Some of the tips were reasonable such as limiting yourself to one alcoholic drink per hour and maybe avoiding certain beverages like wine, bourbon, and Scotch, which contain congeners and have been associated with worse hangovers.

However, some of the advice is wrong.

The article recommends this on the day you plan to party:

6 a.m.: Rise and hydrate! Drink early and drink often. One of the main causes of a hangover is dehydration. Women should be drinking 2.7 liters per day, and men should get 3.7 liters. That's 0.7 gallon and 0.97 gallon, respectively.

After you party, at 12 a.m.: Drink some water and get to bed. It’s your last chance of the day to hydrate, so seize it! Sip some water before your head hits the pillow, but avoid popping any anti-hangover pills.

The 6 a.m. recommendation has two important bits of misinformation. One, dehydration is probably not a major factor causing a hangover. A 2010 literature review explains that hangovers are much more complicated than most people think. From the abstract:

Markers of dehydration were not significantly related to hangover severity. Some studies report a significant correlation between blood acetaldehyde concentration and hangover severity, but most convincing is the significant relationship between immune factors and hangover severity. The latter is supported by studies showing that hangover severity may be reduced by inhibitors of prostaglandin synthesis. Several factors do not cause alcohol hangover but can aggravate its severity. These include sleep deprivation, smoking, congeners, health status, genetics and individual differences.

Two, the idea that you need to drink 8 glasses of water per day is a myth. The best plain English explanation of this appeared in the New York Times last summer.

The 12 a.m. suggestion may also be incorrect. Do you really need more water right before you try to sleep?

As the 2010 review pointed out, blocking prostaglandins by taking an anti-inflammatory drug like ibuprofen might be useful. However, a small risk of bleeding from gastric mucosal damage with the combination of alcohol and anti-inflammatory drugs is a concern.

Abstaining from alcohol or drinking it in moderation is the best way to avoid a hangover. Once you have a hangover, the best remedy is time.

A Washington Post article on the dangers of overhydration in marathon runners quotes an expert as follows: “Drink when you’re thirsty. It’s not something you have to tell your body to do.”

If you have normal kidneys and drink as much water as The Daily Beast recommends, you may avoid hangover because instead of getting drunk, you will be spending a lot of time in the bathroom peeing.


artiger said...

We're often told that food (to go along with the alcohol we consume) may help. Dilution effect in the stomach, or maybe because we get full and don't want to drink as much? I know that after eating a sit down meal, I usually don't want much more to drink, maybe just some port or a bit of brandy.

Skeptical Scalpel said...

Food slows the absorption of alcohol into the system. For example,

Salphd said...

I think the title of this article is misleading. No source of information is infallible. And the Internet provides medical information and advice from hundreds of thousands of different sources - from people with no medical background at all, to highly respected medical journals, hospitals, doctors, and universities. The reliability of the information will depend on the specific sources on the Internet that you are accessing. In the comments, you yourself cited information obtained from the Internet.

Skeptical Scalpel said...

If no source of information is infallible, why look anything up at all?

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