Thursday, November 13, 2008

Your Brain on Alcohol: How Can You Make Hangover Go Away

Has last night's delight turned into this morning's demon? How can alcohol, a simple molecule composed of only a few natural elements, create the havoc of a hangover? Most important, how can you make it go away.

Alcohol's very simplicity (carbon, hydrogen, and oxygen) accounts for its unmatched affinity for the brain and its broad range of negative effects. A hangover is basically a milder version of the withdrawal symptoms suffered by alcoholics. It can persist for 24 hours or more.

You may just feel a bit irritable and overly sensitive, fatigued or muddled. Your muscles might ache or even tremor. You could have a mild or a killer headache. Your stomach could be upset or you could become nauseous. Worst case scenario: a person who passes out from nausea can die of asphyxiation.

One thing for sure, you will be dehydrated after drinking alcohol.

Water Works
The fundamental cure for a hangover is time and rest, plus plenty of pure water. Drinking alcohol upsets the body's fluid balance as far more water is lost than taken in. When the brain becomes dehydrated, its outer covering (dura matter) can temporarily shrink and cause the painful sensation of a headache. Alcoholics can have shrunken internal areas of the brain.

Marrku Linnoila, a researcher at the National Institute on Alcohol Abuse and Alcoholism, thinks the loss of electrolytes may contribute to hangover symptoms. He suggests replacing these electrolytes with a nightcap of one of the sports drinks that contain fresh supplies of sodium, potassium, calcium, and magnesium, as well as water.

Bull's Eye
There are some nutritional approaches that can intervene to prevent or diminish your hangover. If traditional folk remedies and modern hangover formulas work, it's because they support the body's natural alcohol detoxification process.

A classic remedy for hangover called the Bull's Eye is simply a glass of orange juice containing a raw egg. (Warning: raw eggs may contain salmonella, so use soft-boiled ones.) The juice supplies vitamin C and fructose; the egg is especially high in the sulfur-containing amino acids, cysteine and taurine.

Your liver needs cysteine to detoxify acetaldehyde, the first byproduct of its breakdown of alcohol. Acetaldehyde is approximately 30 times more toxic than alcohol. Used in the manufacture of adhesives and plastics, it is a close chemical cousin of formaldehyde. (Did somebody say embalming fluid?)

A powerful free radical generator, acetaldehyde is a potent neurotoxin that crosses your blood-brain barrier and is the primary culprit in a hangover. Acetaldehyde causes inflammation and depression, and interferes with energy production in the brain. It disrupts cellular function through its reactive tendency to cross-link molecules. (A good example of cross-linked tissue is the leathery skin of elderly alcoholics who spend a lot of time outdoors).

While the liver quickly converts the ethyl alcohol you drink into acetaldehyde, it is much slower at converting the acetaldehyde into acetic acid (which eventually is broken down into carbon dioxide and water). One of the biggest factors in a person's susceptibility to alcohol damage is their enzymatic ability to detoxify acetaldehyde. The longer acetaldehyde remains in the body, the worse the hangover. Furthermore, enzyme activity and liver function tend to diminish with age, disease, poor nutrition, and alcoholism.

Nutrients that Counteract Acetaldehyde
Important research on acetaldehyde was done in the 1970s at the National Cancer Institute by Herbert Sprince, M.D. When he pretreated rats with large doses of vitamin B1, vitamin C, and cysteine, they were able to survive a normally lethal dose of acetaldehyde.

Cysteine is available in supplement form, but to be effective it needs plenty of vitamin C. Steven Wm. Fowkes, editor of Smart Drug News, has found a combination that he says works remarkably well. "I use capsules (because they dissolve fast) containing 200 mg cysteine plus 600 mg of vitamin C (with or without extra B-1). I take one before I start drinking, one with each additional drink and one when IЖm finished." (Vitamin E and selenium also support cysteine's action.)

Your liver also needs cysteine (plus glutamic acid and glycine) to make glutathione, a crucial protective compound whose deficiency first affects the nervous system, causing hangover-like symptoms.

Taurine is another important amino acid that may help hangovers. Your liver makes taurine from cysteine, but because the cysteine is busy detoxing acetaldehyde, taurine may be in short supply. Taurine is an antioxidant and has a protective effect on the brain, particularly when the brain is dehydrated.

Taurine is used to counteract anxiety, hyperactivity, and even to treat seizures. It helps calm overexcited brain cells that are withdrawing from the effects of excess alcohol. Studies show that taurine levels naturally increase in the brain in response to both acute and chronic exposure to ethanol.


Do B Do B Do
Acetaldehyde rapidly destroys vitamin B1, thiamine. Originally known as the nerve vitamin, thiamine is crucial to brain function. Poor nutrition combined with a chronic B1 deficiency induced by excessive consumption of alcohol can lead to a condition known as Korsakoff's psychosis, which involves memory loss similar to Alzheimer's disease.

Durk Pearson at Life Enhancement tells how, when vitamin B1 became available in an injectable form earlier this century, interns discovered they could treat a hangover by injecting large doses of it.

Pantothenic acid (vitamin B5) aids the body in alcohol detoxification. Known as the anti-stress vitamin, B5 can become depleted in the detoxification of acetaldehyde. A deficiency of pantothenic acid may contribute to the hangover symptoms of headache, nausea, and fatigue.

All the B vitamins need regular replenishing — more so after drinking alcohol. Try taking a B-complex before, during, and as soon after a drinking session as possible. The same goes with vitamin C, which is perhaps why tomatoes are a common ingredient in many hangover remedies. Tomatoes are high in B vitamins and in vitamin C, the body's primary antioxidant nutrient.

An Oxidant Waiting to Happen
After alcohol turns to acetaldehyde, the production of free radicals increases. These highly reactive forms of oxygen damage the structural fats that give your brain cell membranes their strength and fluidity. Brain function is compromised depending on how much alcohol is consumed as well as for how long one has been a drinker.

To combat the destructive action of free radical oxidants, your brain must have an ample supply of antioxidants. Basically, antioxidants are chemicals that oxygen finds more attractive than the structural components of your cells. Antioxidants sacrifice themselves to preserve your body parts.

In addition to their vitamin C content, orange juice and tomato juice also contain a good dose of potassium, a mineral that is lost during urination when drinking. Low levels of potassium can contribute to feelings of weakness and shakiness. This may be the basis of a Chinese folk remedy for hangovers that says to boil a couple of banana peels in water and drink the liquid.

Folk Remedies Fight Free Radicals
Perhaps vitamin C has something to do with the Ayurvedic remedy of drinking fresh orange with a teaspoon of lime juice and a pinch of cumin stirred in . . . or the Puerto Rican folk remedy for hangovers that recommends rubbing a quarter lemon into each armpit. Chinese remedies include drinking fresh mandarin orange or tangerine juice.

Another Chinese folk cure is to eat 8 to 10 fresh strawberries, all at once. In addition to vitamin C and minerals, strawberries contain significant amounts of another antioxidant, lycopene.

Tomatoes are also very high in lycopene, the protective plant compound that gives them their distinctive red color. A French study found that alcoholic men had significantly lower concentrations of lycopene and other carotenoids in their blood than men who consumed low or moderate amounts of alcohol.


Alcohol and Brain Fats
Alcohol decreases levels of DHA in the brain, a specialized fatty acid essential to healthy brain cell membranes, which are rich in DHA. According to research by Dr. R.J. Pawlosky at the National Institutes of Health, alcohol not only appears to dissolve the DHA already in the brain's membranes, it also blocks the enzyme that manufactures DHA from dietary fats. This is not good, because lower concentrations of DHA in the nervous system are associated with a loss of nervous system function.

This same enzyme (D6D) blocked by alcohol is also responsible for manufacturing gamma linolenic acid (GLA) which in turn makes the crucial anti-inflammatory PGE1 prostaglandins. When PGE1 levels are low, the inflammatory prostaglandin PGE2 dominates — which is often the norm today and why so many people need to take over-the-counter nonsteroidal anti-inflammatory drugs. (D6D is also inhibited by stress, aging, trans fatty acids, viruses, and common medications.)

Prostaglandin Pressures and Pleasures
Supplements of preformed GLA may help increase levels of PGE1, which can alleviate hangover symptoms associated with inflammation and swelling, such as headache and aching muscles — even depression. In a Scottish study, GLA supplements dramatically reversed depression in certain alcoholics (Celtic, Scandinavian, Scottish, Welsh, American Indian). Again, it's genetic racial factors that affect enzyme activity and account for the inability of some people to withstand alcohol while others seem impervious to it.

It's interesting to note that the reason why a first drink may feel good is because alcohol has the ability to briefly activate the tiny levels of PGE1 that exist within the brain. This provides a welcome temporary relief from depression, but soon leads to a crash when the PGE1 reserve is depleted.

GLA is available in capsules of evening primrose oil. DHA is available in capsules of oil derived from fish or microalgae.


Honey, Please Pass the Blood Sugar
In an informative 1998 report, Jim Roberts describes an 18th century hangover recipe which instructs "the afflicted to suck on a sugar cube containing drops of clove oil, then chew on a sprig of parsley, followed by a cup of chamomile tea (sweetened with honey), followed by teaspoons of honey every half-hour for two to three hours. Clove was considered a painkiller back then, and parsley and chamomile were thought to soothe the stomach muscles." Parsley is also a good source of vitamin C.

Honey and fruit juices are common ingredients in hangover remedies, probably because they raise low blood sugar (glucose) levels and relieve hypoglycemia. Alcohol depletes the glucose reserves in the liver (stored as glycogen), so the brain is deprived of glucose and hence the energy it needs for normal functioning.

Low blood sugar may account for hangover symptoms of lethargy. Also when alcohol breaks down, acidic byproducts can build up in the blood and cause muscular weakness. Ian Calder, an anaesthetist at London's National Hospital for Neurology and Neurosurgery, says that both problems can be remedied by consuming extra sugar.


Magnesium Calms the Jitters
Acetaldehyde causes magnesium to be flushed out through the kidneys. Low levels of magnesium can cause nerves to fire too easily — even from minor stimuli. This can result in jangled nerves and a hypersensitive brain where even mild noises sound excessively loud, lights seem too bright, and emotional reactions are exaggerated.

An extreme case of alcohol-induced magnesium deficiency is delirium tremens, a life-threatening effect of withdrawal that is a medical emergency. It is characterized by sweating, shaking, confusion, hallucinations, seizures, agitation, and disturbances of memory. Emergency room treatment for the d.t.'s includes injections of magnesium sulfate.


Fifty Ways to Love Your Liver
Because your liver is the organ responsible for detoxifying alcohol, its health is paramount. Basically, it needs all known vitamins, minerals, and amino acids, including special nutrients such as lipoic acid, coenzyme Q10, and N-acetyl cysteine (NAC).

In addition, certain phytonutrients found in plants seem to promote or even repair liver function. These include milk thistle (silymarin), dandelion root, and turmeric (curcumin). Siberian ginseng supports the liver and is associated with people remaining alcohol-free after going through rehabilitation. For next day hangover relief, some swear by a shot of liquid ginseng chased by a tumbler of water.

Other Hangover Remedies
Some people use aromatherapy to clear their head or inhale apple-scented oxygen at one of the new "oxygen bars" that are cropping up in major cities. Others consume a few charcoal tablets as a remedy for hangovers, which is similar to a 19th century practice by chimney sweeps who drank warm milk with a teaspoon of soot. Nux vomica is the classic homeopathic remedy for people who feel woozy or nauseous after drinking too much alcohol.

A Promising Plant is Knocking at Our Door
Kudzu is a plant that's best known in the United States because it has been spreading unchecked throughout the South. But in China, an extract from this edible vine has long been used to treat headaches and hangovers. The Japanese make a hangover remedy tea with equal parts of kudzu root, umeboshi plum, and fresh ginger root.

A 1993 Harvard study found that alcohol-craving hamsters treated with kudzu extracts rapidly lost their appetite for alcohol and voluntarily cut their consumption by 50%. Animal studies done in 1996 at the Indiana University School of Medicine showed that daidzin, an isoflavonoid extracted from kudzu (Pueraria lobata), lowering blood alcohol levels. Daidzin and two other compounds from the plant also were effective in suppressing voluntary alcohol consumption by the rats.

Modern Formulations Put It All Together
A well-nutrified body is a good start, but taking extra nutrients before, during, and after a drinking session is usually necessary if you want to prevent or minimize a hangover. To sum it up, some key nutrients include: vitamin C, B-complex (with extra B1 and B5), magnesium, cysteine, taurine, lycopene, GLA, DHA, and kudzu.

Other nutrients include Siberian ginseng, MSM (a good source of bioavailable sulfur), and NAC (a stable form of cysteine and precursor to glutathione). GABA is an amino acid that acts as an inhibitory neurotransmitter and keeps nerve cells from over firing. It may also be of value to help calm the hypersensitivity associated with a hangover.

Perhaps the two most comprehensive anti-hangover formulas available today are Source Naturals Hangover Formula™ and Life Enhancement's Party Pill II™. They combine many of the above nutrients plus a broad range of supporting ones.

Some Basic Preventative Measures
If you take some preventive measures before and during your drinking episodes, you have the best chance of minimizing the symptoms of a hangover.

  • Don't drink on an empty stomach. Fatty protein foods such as cheese or cold cuts absorb alcohol the best and will slow down the rate at which it enters your bloodstream.
  • Drink slowly. At best, your liver can only break down about one ounce of alcohol per hour.
  • Be aware that champagne and carbonated mixed drinks will accelerate the absorption of alcohol into your bloodstream.
  • Know your limit and the effects of different kinds of alcohol. Darker drinks such as red wine, brandy, and port are higher in "congeners," ingredients that tend to worsen hangovers.
  • To ward off dehydration, drink plenty of pure water during and after alcohol use, including during the night when you wake. (Coffee is not advised because it contributes to dehydration.)
  • Don't try to cure your hangover with more alcohol ("hair of the dog").


WARNING — Before and While You Drink:
Never take Tylenol (acetaminophen). Combined with alcohol, it can cause severe liver damage. Also, don't take aspirin, because it will make you drunker.

Regarding the use of over-the-counter pain medication, the Mayo Clinic advised in their Dec. 1997 Health Letter: "Acetaminophen [Tylenol] or nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin and ibuprofen, may help relieve your headache. However, they're not risk-free. NSAIDS, when combined with alcohol, may irritate your stomach. And excessive doses of acetaminophen can be toxic to your liver, particularly when combined with alcohol."

Final Notes
Alcohol temporarily deactivates the protective capabilities of your blood-brain barrier, making your brain more vulnerable to toxic substances, most of which cause free radical damage which can kill brain cells. What's more, several studies conducted since the 1980s suggest that ethanol accentuates the damage caused by lead and aluminum in the brain.

Alcohol triggers the release of stress hormones from the adrenal glands. Current research is shedding light on the real dangers these hormones do to memory and longevity. Click here for more information about the effects of stress on brain health and fitness. (And, click here to learn about ways to activate your relaxation response.)


References
Sprince, H., et al., "Protectants against acetaldehyde toxicity: Sulfhydryl compounds and ascorbic acid." Fed Proc 33(3) (Part 1): March 1974. Sprince, H., et al., Agents and Actions 5(2): 164-73, 1975. Sprince, H., et al., Intl J Vit Nutr Res 47 (Supplement 1G): 185-212, 1977.
De Witte, P., et al., "Acute and chronic alcohol injections increase taurine in the nucleus accumbens." Alcohol Alcohol Suppl 1994;2:229-33.
Dahchour, A., et al., "Taurine increases in the nucleus accumbens microdialysate after acute ethanol administration to naive and chronically alcoholised rats." Brain Res 1996 Sep 30;735(1):9-19
Montoliu, C., et al, "Ethanol-induced oxygen radical formation and lipid peroxidation in rat brain: effect of chronic alcohol consumption." J Neurochem, 63(5):1855-62 1994 Nov
Lecomte, E,. et al., "The relation of alcohol consumption to serum carotenoid and retinol levels. Effects of withdrawal." Int J Vitam Nutr Res 1994;64(3):170-5
Pawlosky, R.J., et al., "Ethanol exposure causes a decrease in docosahexaenoic acid and an increase in docosapentaenoic acid in feline brains and retinas." Am J Clin Nutr 1995;61:1284-89
Lin, R.C., et al., "Isoflavonoid compounds extracted from Pueraria lobata suppress alcohol preference in a pharmacogenetic rat model of alcoholism." Alcohol Clin Exp Res, 20(4):659-63 1996 Jun
Mathews-Larson, Joan, "An End to the Revolving Door." Addiction & Recovery, June 1990
"Drunk as a Skunk," New Scientist, Dec. 20, 1997
Durk Pearson & Sandy Shaw, "Why Not Party-Proof Yourself This Summer?" Life Enhancement, June 1998
Fowkes, S.W., "Living with Alcohol," Smart Drug News, Dec. 13, 1996

No comments: