The Role of Alcohol Metabolism in the Pathology of Alcohol Hangover

Abstract

The limited number of available studies that examined the pathology of alcohol hangover focused on biomarkers of alcohol metabolism, oxidative stress and the inflammatory response to alcohol as potentially important determinants of hangover severity. The available literature on alcohol metabolism and oxidative stress is reviewed in this article. The current body of evidence suggests a direct relationship between blood ethanol concentration and hangover severity, whereas this association is not significant for acetaldehyde. The rate of alcohol metabolism seems to be an important determinant of hangover severity. That is, fast elimination of ethanol is associated with experiencing less severe hangovers. An explanation for this observation may be the fact that ethanol—in contrast to acetaldehyde—is capable of crossing the blood–brain barrier. With slower ethanol metabolism, more ethanol is able to reach the brain and elicit hangover symptoms. Hangover severity was also significantly associated with biomarkers of oxidative stress. More oxidative stress in the first hours after alcohol consumption was associated with less severe next-day hangovers (i.e., a significant negative correlation was found between hangover severity and malondialdehyde). On the contrary, more oxidative stress at a later stage after alcohol consumption was associated with having more severe next-day hangovers (i.e., a significant positive correlation was found between hangover severity and 8-isoprostane). In conclusion, assessment of biomarkers of alcohol metabolism suggests that fast elimination of ethanol is associated with experiencing less severe hangovers. More research is 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.

Immune Responses after Heavy Alcohol Consumption: Cytokine Concentrations in Hangover-Sensitive and Hangover-Resistant Drinkers

“…Despite these functional consequences, the pathology of the alcohol hangover has received relatively little research attention. The immune system has been proposed to play a role in the pathology of the alcohol hangover [ 9 , 10 ]. It is hypothesized that cytokines are released as a response to alcohol intake and subsequently interact with the central nervous system (CNS), contributing to the various next-day symptoms collectively called the hangover state.…”

N-acetylcysteine relieves neurologic signs of acute ethanol hangover in rats

“…Since the severity of ethanol hangover can be exacerbated and prolonged by the depletion of liver glutathione stores; NAC, which increases glutathione production, may be a promising and affordable treatment for hangover, which is consistent with several previous studies. At the same time, prophylactic administration of this drug may be promising (Green et al 2013, Mackus et al 2020.…”

“…Acetaldehyde is a product of alcohol metabolism and causes most of the symptoms of hangover. An increase in the concentration of acetaldehyde is observed as a result of a slowdown in its biodegradation under the action of acetaldehyde dehydrogenase, which is largely associated with the depletion of reduced glutathione in hepatocytes (Mackus et al 2020). Glutathione is the most important regulator of redox reactions in cells; the depletion of its reserves causes a slowdown in metabolism, including the processes associated with the conversion of acetaldehyde into less toxic acetic acid.…”

The Relationship between Pain Sensitivity, Pain Catastrophizing and Hangover Severity

“…The alcohol hangover has been defined as the combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero [ 1 , 2 ]. Although alcohol hangover is the most frequently experienced negative consequence of alcohol consumption [ 3 ], scientific knowledge on the pathology of the alcohol hangover is limited [ 4 , 5 ].…”