Hangover's Explained

Drinking To Excess

Author Unknown

Many years ago I used to study alcohol metabolism.

Removal of alcohol takes several pathways. It is removed directly in the kidneys and in the lungs (blown off in the breath) and it is broken down in the liver.

Several people have pointed out that dehydration plays an important role in the hangover. That is true. You have probably had other headaches that feel much like hangovers when you have been sick or if you have exerted yourself on a hot day. Dehydration is a major part of this.

What no one has told you is *why* alcohol makes you dehydrated. Alcohol is a diuretic which is just another way of saying it makes you pee. Basically, removal of toxins from the blood stream is a water-intensive process. It is not exactly the chemical process of treating the alcohol that uses the water (as someone else said) but rather the fact that the toxins are carried accross the membranes in the kidneys disolved in lots of water. So it is the direct removal of ethanol that can lead to the dehydration. All the suggestions about drinking water or gatorade are good ideas. The water also carries off lots of electrolytes, so gatorade is a good idea.

There is another important component to the hangover besides dehydration and that is acetaldehyde. The breakdown of ethanol in the liver is a two-step oxydation carried out by two separate enzymes.

The first, alcohol dehydrogenase (ADH), converts ethanol to acetaldehyde. The second, aldehyde dehydrogenase (ALDH), converts acetaldehyde to acetate. Acetate is harmless, aldehydes are extremely toxic (you know what formaldehyde, which is not very different from acetaldehyde, can do to tissue). Now, one problem is that not all people have equally efficient enzymes. You may have heard that many Asians (and native Americans) cannot drink without getting very ill. That is because they carry a form of the gene for ALDH that makes a slower form of the enzyme.

To make matters worse, many also carry a fast form of ADH, so they really build up toxic levels of aldehyde. The particular combination of enzymes a person has, has alot to do with individual tolerances. You may also have heard of a drug called "antabuse," (disulfuram) which is given to alcoholics and makes them sick if they drink. The drug works by in-activating ALDH, leading to a toxic buildup of aldehyde. Also, treatment of severe alcohol poisoning usually involves the use of a drug that blocks ADH, that is, prevents the person from breaking down the alcohol at all. This way, they body will have time to clear some of the alcohol through the kidneys and lungs before the body gets flooded with aldehyde, which will kill the victim.

Dark and sweet drinks can create problems in addition to the alcohol. Alot of this has to do with other toxins in the product--the tannins in red wine for example. Considering your system is taxed enough by the alcohol alone, asking the liver and kidneys to clear lots of other things is insult to injury.

Everything said up until now has been fact. Here are some educated guesses pertaining to drinking to excess.

There are some guesses as to the relationship between sugar metabolism and ethanol metabolism. Both steps in alcohol metabolism convert NAD to NADH(H+) (the "dehydrogenases" remove hydrogen--I guess that is obvious--and the place your body puts hydrogens is on NAD or FAD or FMN to make NADH etc.). The full names of these molecules are Nicatinamide Adenine Dinucleotide, Flavin Adenine Dinucleotide and Flavin MonoNucleotide. You may recognize these names as similar to the "B" vitamins (Riboflavin, Nicatinamide). They are the B vitamins, which everyone will tell you are important in energy metabolism. In the metabolism of sugars, as I am sure you remember, you make ATP (riboAdenosine Triphosphate). You also store energy in something we call "reducing equivelents." This is nothing more than a source of Hydrogens which can be used to "reduce" (the opposite of "oxydize") the spent ADP and AMP back to ATP. OK? So reducing equivelents is another way to make ATP and is the end product of energy (Sugar) metabolism. Here's the payoff: The reducing equivelents are stored as NADH and FADH etc.--reduced B vitamins. So the guess is that having to metabolize lots of sugars along with the alcohol ties up all the B vitamins in the the reduced form. So there is not enough oxidized NAD available to participate in the metabolism of ethanol, or, more importantly, aldehyde.

This is what is behind the suggestion that you take B vitamins when you drink and also the suggestion that you not consume sugar and alcohol. I think the guess is a reasonable one. But it is not proven. Another thing people may have told you that fructose might help. This is because fructose throws something of a monkey wrench into sugar metabolism. It slows it down (I won't bother you with why). That may free up more of the oxidized B vitamins for aldehyde dehydrogenase. But, I am not convinced of this.

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Last Touched: 6/9/2005 11:35AM