The Physiology of a Hangover

Dog looking hungover

Veisalgia is my new favorite word. They didn’t teach us that one in medical school. My last name is Norwegian so I’m drawn to the viking roots of the word “kveis” meaning the “uneasiness after debauchery.”

Let’s get rid of some hangover stigma

Hangover evokes images of alcoholism, but research shows that hangover is more often associated with the light to moderate drinker.  Research also shows that the loss of productivity and missed work due to hangover costs the US alone $148 billion.

There is no research that shows that alleviation of hangover symptoms leads to increased alcohol use.  Actually, relief of the hangover leads to less likely use of alcohol, whereas feeling hungover can lead people to drink alcohol as a cure, aka “the hair of the dog.”

Let’s face it, when you are on vacation and hanging out with friends and family you don’t see often it’s easy to wind up having an extra drink or two.  I don’t know about you, but since I turned 30 all it takes to give me a hangover is 3 glasses of wine.

Despite feeling quite awful, most people don’t think to go to the hospital when they have a hangover.  You know what it is and you know that it will get better with time.  Actually, not treating your hangover symptoms is in a sense comparable to not taking Ibuprofen after spraining your knee. Now, with our help you have the means to treat your hangover symptoms more quickly.

Get the most out of your vacation

Not feeling your best and getting the most of your vacation is a waste of your resources.  You probably paid a lot of money to come to Tahoe to enjoy all our outdoor activities—don’t waste your time feeling miserable in your hotel or condo.  If you wouldn’t hesitate to seek treatment if you threw out your back or had a sore throat,  why not get treatment for a condition that makes you feel much worse than that?

Hangover patients are sick. The physiology of a hangover includes abnormal glucose metabolism, oxidative stress, endocrine and sleep cycle abnormalities.

Let’s talk about the nerdy stuff

Ethanol is absorbed in the stomach and small intestine, then metabolized by the liver. In the first step it is oxidized to acetaldehyde which is then oxidized again to acetic acid, which is then converted in the citric acid cycle to carbon dioxide and water. The liver needs NAD+ and alcohol dehydrogenase (ADH) to convert ethanol to acetaldehyde. Acetaldehyde is toxic and so it must get quickly metabolized on to the next step by acetaldehyde dehydrogenase (ALDH1 in the liver and ALDH2 in the mitochondria) and more NAD+ as the oxidizing agent.  Acetic acid is the product of that reaction, which is harmless.

Metabolism of alcohol uses up NAD+ which lowers cells oxidation capabilities which leads to impaired glucose synthesis (gluconeogenesis), accumulation of lactic acid, increased lipid production, and decreased fat and protein degradation. This can cause hypoglycemia and acidosis.

The buildup of acetaldehyde is thought to be the cause of hangover type symptoms.  Disulfiram is a drug that inhibits aldehyde dehydrogenase. Therefore drinking alcohol after taking that medication only causes buildup of acetaldehyde which essentially causes immediate headache, flushing, nausea, vomiting, and dizziness.
Most everyone knows that alcohol inhibits antidiuretic hormone.  Approximately 3 shots will cause you to lose 1.5-2 pints in the following hours. Also, low alcohol content drinks stimulate stomach acid, while hard alcohol drinks irritate the stomach lining – leading to gastritis (inflammation of the stomach).

No need for self-punishment because you had an extra drink the night before.

Let us make you feel better with an IV hydration so you can move on and get your vacation back!


  1. J. G. Wiese et al., Ann. Int. Med. 2000
  2. Chemistry of a Hangover — Alcohol and its Consequences

Photo credit: TAZphotos on flicker