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The role of alcohol metabolism in the pathology of alcohol hangover
A limited number of available studies which examine the pathology of alcohol hangover focus on biomarkers of alcohol metabolism, oxidative stress and the inflammatory response to alcohol as potentially important determinants of hangover severity. An open access paper in the Journal of Clinical Medicine reviews the available literature on alcohol metabolism and oxidative stress.
The review authors say that the current body of evidence suggests that the ethanol elimination rate is a critical determinant of hangover severity for a number of reasons. First, significant correlations have been found between ethanol concentration (but not acetaldehyde) and hangover severity. Second, nutrients, microbiota, and hangover treatments that speed up the conversion of ethanol into acetaldehyde are associated with less severe hangovers. Taken together, the data suggest that a more rapid conversion of ethanol to acetaldehyde and other aldehydes is associated with less severe hangovers. The association between blood ethanol content and hangover severity is physiologically plausible, because unlike acetaldehyde, ethanol can freely pass the blood brain barrier (BBB). Compared to fast metabolisers of alcohol, slow metabolisers will have relatively large amounts of circulating ethanol that can cross the BBB over a longer time period, increasing the relative probability of a more severe hangover.
The review suggests that high levels of oxidative stress in the first hours after drinking are associated with less severe hangovers, whereas high levels of oxidative stress during hangover are associated with more severe hangovers. The authors note, however, that currently limited data are available on the role of oxidative stress and antioxidants in the pathogenesis of alcohol hangover, and this observation was based on only one study. More research is therefore needed to further examine the complex interrelationship between alcohol metabolism, the role of acetaldehyde and oxidative stress and antioxidants, and the pathology of the alcohol hangover.
Notwithstanding the limited amount of research, it is evident that alcohol metabolism and ethanol elimination rate play a critical role in the presence and severity of the alcohol hangover.
Source: Mackus M, Loo AJV, Garssen J, Kraneveld AD, Scholey A, Verster JC. The Role of Alco-hol Metabolism in the Pathology of Alcohol Hangover. J Clin Med. 2020 Oct 25;9(11):E3421.
The review authors say that the current body of evidence suggests that the ethanol elimination rate is a critical determinant of hangover severity for a number of reasons. First, significant correlations have been found between ethanol concentration (but not acetaldehyde) and hangover severity. Second, nutrients, microbiota, and hangover treatments that speed up the conversion of ethanol into acetaldehyde are associated with less severe hangovers. Taken together, the data suggest that a more rapid conversion of ethanol to acetaldehyde and other aldehydes is associated with less severe hangovers. The association between blood ethanol content and hangover severity is physiologically plausible, because unlike acetaldehyde, ethanol can freely pass the blood brain barrier (BBB). Compared to fast metabolisers of alcohol, slow metabolisers will have relatively large amounts of circulating ethanol that can cross the BBB over a longer time period, increasing the relative probability of a more severe hangover.
The review suggests that high levels of oxidative stress in the first hours after drinking are associated with less severe hangovers, whereas high levels of oxidative stress during hangover are associated with more severe hangovers. The authors note, however, that currently limited data are available on the role of oxidative stress and antioxidants in the pathogenesis of alcohol hangover, and this observation was based on only one study. More research is therefore needed to further examine the complex interrelationship between alcohol metabolism, the role of acetaldehyde and oxidative stress and antioxidants, and the pathology of the alcohol hangover.
Notwithstanding the limited amount of research, it is evident that alcohol metabolism and ethanol elimination rate play a critical role in the presence and severity of the alcohol hangover.
Source: Mackus M, Loo AJV, Garssen J, Kraneveld AD, Scholey A, Verster JC. The Role of Alco-hol Metabolism in the Pathology of Alcohol Hangover. J Clin Med. 2020 Oct 25;9(11):E3421.
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