What causes a hangover? Excessive alcohol consumption causes a hangover. The amount of alcohol required depends on a person's body size and general health. Bodies break down alcohol into acetaldehyde, which is then metabolized into acetic acid, which produces the negative effects of intoxication such as slurred speech, dizziness, and nausea. Once the liver processes the acetaldehyde from the broken-down alcohol it turns it into water and carbon dioxide which are processed through urine or expelled through exhalation respectively. Alcohol withdrawal can produce some of the same symptoms as a hangover but with more intense sweating, shaking hands and an increased heart rate. Alcohol can be broken down through oxidation or through a non-oxidative process, and either way it produces acetaldehyde, which is turned into acetic acid by acetaldehyde dehydrogenase. Acetaldehyde dehydrogenase is capable of turning acetaldehyde into acetic acid and NAD (nicotinamide adenine dinucleotide) but it needs a cofactor called Pregnenolone to do this. If there is not enough Pregnenolone then the body experiences some of the symptoms of hangovers. Since Pregnenolone cannot be stocked in the same way that vitamins are, the only way to prevent a hangover at this point is to reduce or stop alcohol consumption entirely. The mechanism of the hangover effect is due to oxidative stress and damage to the mitochondria in the liver. This causes an increase in the activity of reactive oxygen species. Acetaldehyde also reacts with mitochondrial DNA or mtDNA, which usually takes place within liver cells called hepatocytes. When this process occurs the cell dies and this can happen to quite a large number of liver cells, which can then lead to a pattern of cirrhosis and failure in that organ. The other pattern that can be caused by alcohol consumption is hyperplasia and hypertrophy, meaning that instead of hepatocytes dying after alcohol consumption, there are more hepatocytes than normal present for a certain period after alcohol consumption. This can lead to an increase in the size of the liver but it is unable to function properly after that period. If alcohol is consumed quickly it can cause illness, vomiting, and make a person's blood-alcohol level (BAC) surge. If alcohol is consumed slowly over an extended period of time there are some hangover-like symptoms that may or may not be present. This includes dehydration, fatigue, impotence, weight gain, anxiety, depression and nausea. A study in 2015 found that only red wine was able to reduce hangovers when consumed before bedtime. It also found that not all alcoholic beverages led to heavy drinking when compared with non-alcoholic beverages. One drink of non-alcoholic wine was enough to make people drink more than one drink of non-alcoholic beer. Alcohol is a diuretic, meaning that it causes more urine to be produced, which can lead to dehydration. When alcohol is broken down by the liver, both water and electrolytes are pulled into the bloodstream. It is then excreted in urine while at the same time leading to an increase in urination. This can cause headaches, cramping, fatigue and nausea for people who are hung over. Some people may consume too much water while trying to counteract dehydration which inevitably can give them water intoxication or hyponatremia.
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