What really helps with hangovers?
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What to do about the hangovers. Eat something greasy. I'm talking fast food, pizza, a burrito, whatever it is, eat it. Vitamin B complex, magnesium and folic acid. Take a glass of water and add a little pinch of salt. You got to get on the road, go for a little jog in the morning, it's great. That's disgusting. People have been trying to deal with the inevitable pain of the morning after the night before for a long time.

Ancient Romans recommended raw owl's eggs. Ancient Assyrians swore by a mixture of bird's beaks ground up, mixed with myrrh. Modern Brits favoured the slightly more palatable, massive fry-up, washed down with a mug of tea. But could there be a way to avoid the headaches, lethargy, nausea and hangxiety before they kick in?

What if you could take a pill or a shot that could reduce your blood alcohol level and make you feel better in the morning? That's the promise of a range of wellness products aiming to be the next big hangover antidote. So today we're asking, what is the science behind a hangover? And is it avoidable? From The Guardian, I'm Madeleine Finlay, and this is Science Weekly.

So I stopped drinking three years ago and the effect on my mental health and my well-being and productivity has just been enormous. So yeah, the best hangover cure for me has been not drinking at all. That's Sally Adams, an Associate Professor of Psychology at the University of Birmingham and an alcohol researcher. Sally may have joined an increasing number of young people in avoiding hangovers by swearing off alcohol completely, but she's also been a part of a number of

But ditching drinks forever isn't going to be everyone's method of choice. So I asked her, what is a hangover, scientifically speaking? So that's a really good question and one that the alcohol research world has been baffling over for some time. But recently there was consensus that it is a combination of psychological and physiological symptoms that are experienced after an episode of drinking.

when the blood alcohol concentration is close to or has returned to zero, which means that there would be detectably no alcohol left in your system. So if you were asked to be breathalysed, that would say zero, but you are experiencing this collection of symptoms. And I'm sure I'll recognise a lot of them, but what exactly are some of the symptoms that you might have if you've undergone this episode of drinking?

It can be really wide ranging. So things from a terrible headache, upset stomach, feeling nausea, vomiting. But also more recently, research has been interested in things like low mood after drinking. So feeling anxious the next day, but also, you know, feeling that you can't make decisions or that your reaction times are affected.

So it really is a wide range of different symptoms that have kind of come to light in the research.

So there's this huge range of symptoms from a hangover, but what's behind them? What's actually happening in the body? One of the common misconceptions is that hangover is simply dehydration. And of course, that is part of it. But there are lots of things going on. Mainly, your body is trying to break down or get rid of the alcohol from your system. And

And in order to do this, one of the first things that happens is that your body has to convert alcohol into acetaldehyde, which is a chemical which is toxic. And this is thought to be really responsible for why we feel sick or why we might be sick. But at the same time, alcohol is often sugary, so it can lead to changes in our blood sugar. Alcohol also causes inflammation, so it inflames our stomach, our small intestine.

And on top of that, the way that alcohol works is that when we consume alcohol initially, it reduces our anxiety, it can give us euphoria. And this is because of the effects of alcohol on a neurotransmitter called GABA. It's the major inhibitory neurotransmitter and it works to dampen down parts of our brain. So it shushes all the noise and tells us to relax essentially. But

But overnight, our brain will try to put things right. So it will try to reset the levels of neurotransmitters, including GABA, also dopamine and serotonin. The reason why we might experience things like low mood and anxiety the next day is because these neurotransmitters haven't returned back to their normal levels yet.

we've kind of overshot and your brain is trying to put back everything into the right place. And when it's doing that, it can affect things like our sleep. So really alcohol is having a really big effect on our brain and our body. And it was interesting that you said that the scientific community had taken a long time deliberating even over the definition of what a hangover is.

Has there been much research into the science of hangovers? We're starting to see a lot more now. But if we were to compare, for example, the amount of research that's done on what happens when we're intoxicated, so the short time effects of alcohol or what happens to our bodies and our brains

if we consume alcohol for a long period of time. There's tens of thousands of peer-reviewed articles that have looked at those. But I would say we're more in the thousands if we're looking at hangover.

Two of the problems here are it's quite difficult to capture hangover or to measure it. So when we do research on how intoxicated people are, we can say they have this amount of alcohol reliably in their bloodstream when we're asking them to perform a task or to tell us how they're feeling. But we rely on people having no alcohol left in their system when we do hangover research.

So it's quite difficult research to undertake. Also, as you can imagine, people are very reluctant to come into a laboratory and do a series of experiments when they're really hungover.

Also, hangover is often thought of as quite trivial and, you know, the start to a good story. So I really don't think that it's kind of received the attention that it should. And I was wondering about the sort of ethical boundaries of asking people to get drunk, you know, when you know that it's going to do them some level of damage and then come into the lab. Yeah, that's a really valid question. And

What we do when we select people for research, any alcohol research really, is that we're not asking people to engage in any behaviour that they wouldn't do themselves. So we wouldn't ask someone to come in and take part in a hangover study if they weren't someone who already regularly consumed the amount of alcohol that we would be looking at. And it's definitely easier to recruit people for an intoxication study versus alcohol.

Saying that, I think we've only ever had one vomit incident in the whole time we've been doing the research. That's pretty good going. So this isn't always the easiest research to undertake. And so our understanding of hangovers is still developing. But there are now products that say they can help with a hangover or prevent one.

First off, there's Miracle, which is marketed as a pre-drinking pill. And that says it contains Bacillus coagulans, what you might call a quote unquote good bacteria. And there's also Bacillus subtilis. This is a bacteria known to naturally break down alcohol into water and carbon dioxide. And then there's also L-cysteine, an amino acid, and vitamin B12.

There's also a product called SureShot, which sells itself as the first clinically proven rapid alcohol reducer. So how are they supposed to work? So both of these products are probiotics and they contain a mixture of minerals, vitamins and botanicals.

And they are proposed to work by reducing the absorption of alcohol. So this is the idea that it breaks down the amount of alcohol that is absorbed into your bloodstream before it's had a chance to have its effect.

Which, as you can imagine, not only has an impact on how hungover you might be, but also potentially impacts how intoxicated you become. So this is preventing a hangover by making you less intoxicated in the first place? Yes.

I mean, there is a question there of why bother drinking? Or, you know, you could just have some non-alcoholic drinks instead if you like the taste and you want the drink, but you don't want to suffer the hangover. This was my first thought when I read these papers. I was thinking, well, people are drinking alcohol to feel the effects of alcohol predominantly because the claims that some of these make are that it reduces, say, for example, miracle alcohol.

proposes that it breaks down 70% of the alcohol within 60 minutes of consumption. So yeah, I would be interested in whether that does actually affect the pleasure that people get from drinking the drink in the first place. Interesting. And SureShot says it's also doing something else, right? Yes.

It also claims to support the metabolism of alcohol. So you'll remember that I mentioned about bodies have to work hard to metabolize alcohol into products we can get rid of. So it claims to be able to do that. It also additionally suggests that it can replenish electrolytes, which is something that is lost when we drink alcohol.

And it also claims to improve cognition and physical and mental well-being. So this product is claiming to do a lot. And as you say, it suggests that it's clinically proven. But I found it really hard to find the peer-reviewed evidence. From what I looked at, it was one study that was conducted. Same as Miracle, really well-designed research. So something we call double-blind placebo-controlled research.

So this is where the person receiving doesn't know if they're getting the sure shot or a placebo and neither does the researcher. So everybody is blinded and it's the best way of conducting research. And they claim that after 30 minutes, they saw a reduction in the amount of alcohol in participants' bloods and also that participants reported feeling better after they'd taken this. But I'm

But I haven't been able to actually get my hands on the research itself to be able to look into this. And these aren't the only products on the market. There's also Zebartix, a pre-alcohol drink. How does that purport to work? So this is also a probiotic, but works in a different way. So it's proposed to work by actually breaking down acetaldehyde, which is the toxic probiotic.

by-product of alcohol that we think is responsible for a lot of the hangover symptoms that we see. So Sally, what is the available evidence for these products? In the papers that you were able to track down,

Did you find research that would suggest these products are doing what they claim? Being a researcher, I always want to go back and read the actual peer-reviewed paper. It's quite difficult to pin them down. But when you do seem to get to the evidence, they seem to be a single study that is either based in some cases on only animal models, so research that's been conducted on rats,

In some cases, there are human studies, but the number of people that they've looked at in these studies is very small, sometimes only male. And they tend to purely focus on whether there is a change in

in the amount of alcohol being absorbed. What they don't necessarily ask people is how they feel or whether it's actually had an impact on anything observable. So is there a change in reaction times, things that we would be able to measure? So on the whole, it doesn't look very convincing.

The take home for me would be that if it was a medication that was being brought onto the markets, let's say to treat depression or anxiety, it would have to go through clinical trials over and over to show that it was safe, to show that it was effective, to show that it was better than what was already currently available on the market.

But because these cures are pitched as nutritional or probiotic supplements, they don't have to go through the same rigorous testing before they can be put on the market. Sally, I wonder about some of the other hangover prevention techniques that you hear about. You know, everyone has their own and some are definitely more legit than others. Someone that I used to know would swear by starting their night with what they termed a Barodka, which was a vodka with a Barocca vitamin tablet in it.

But what about some of the more classic methods like the pint of water before bed, maybe with a rehydration sachet in it or taking an ibuprofen? Are there any that we should take seriously or even that you would swear by? So I think what you can do is treat different components of a hangover. Rehydrating and drinking water either before going to bed or the next day is certainly going to help.

address the idea that you become dehydrated from alcohol, you lose a lot of water due to urinating a lot, but also if you're sick, obviously you become more dehydrated. Electrolyte imbalance we know is definitely a component of a hangover. So if you can take those rehydration salts before or after drinking regularly,

If you can stomach to eat food before going out, fat slows down the absorption of alcohol. So, you know, that idea of lining your stomach, there's some evidence behind that. I think there has been some research on B vitamins and how they might help a hangover.

If we think that hangover is just dehydration or just electrolyte imbalance or just rebalancing blood sugar, then yes, some of these probiotics or minerals or botanicals could be helpful. But the idea that you could take something to prevent or something after drinking that's going to be a miracle cure that's going to target people

the dehydration, the inflammation that you might see in your stomach, the anxiety that it's termed now, the next day fear that you get. I think the idea that something's going to target all of those things, if you could pop a pill and not experience a hangover the next day and go out and drink as much as you would like, I think the person who discovers that would be a billionaire.

So pasta, water and rehydration salts at the ready. Sally, thank you so much. Thank you.

When we reached out, Zbiotics told us that it's well established within the scientific literature that acetaldehyde is highly toxic and that it's formed in the gut and absorbed into the bloodstream. It's therefore a reasonable hypothesis that targeting your known exposure from consuming alcohol with a novel probiotic engineered to specifically break down acetaldehyde

would be beneficial to how you feel the next day. They told us, We see about a 90% customer satisfaction rate on over 6 million bottles sold since we launched the product five years ago, which is consistent with that hypothesis. SureShot did not reply to our request for comment, but their website states, SureShot is the world's only complete product to be clinically tested and validated on humans. The double-blind, randomised, placebo-controlled clinical trial showed across all subjects...

a rapid and significant reduction in blood alcohol, as well as a significant reduction in toxins and the ill feelings associated with alcohol consumption. The study examined various indicators of mental alertness, acuity and wellbeing. It was conducted by an outside contracted research organisation and further substantiated by medical professionals and audited by a third party to ensure accuracy and adherence to protocols.

Miracle previously told The Guardian that a double-blind study with 24 male and female participants, funded by parent company Defer, concluded that using the pills for a week resulted in a substantially lower uptake of alcohol into the blood.

And that's it for today. This episode was produced by me, Madeline Finlay and Josh Unchana. It was sound designed by Joel Cox and the executive producer is Ellie Burey. We'll be back on Thursday. See you then. This is The Guardian.

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