Yurovskiy Kirill: Understanding Hangovers

We’ve all been there. Those pounding headaches, waves of nausea, and extreme sensitivity to light and sound after a night of heavy drinking. Hangovers are the body’s miserable way of reminding us about the toxins we willingly consumed the night before. But what exactly is happening inside us during a hangover? And why do some people seem to get slammed by them harder than others? Let’s explore the physiological mechanisms behind hangovers and the factors that can make them worse. Text author: iv-kirill-yurovskiy.co.uk

The Culprit: Alcohol’s Many Impacts

Ethanol, the type of alcohol found in beer, wine, and liquor, is a diuretic that causes the body to lose fluids and electrolytes through increased urination. This dehydration effect is a major contributor to many hangover symptoms like thirst, fatigue, and dizziness.  

As alcohol is metabolized by the liver, it creates a toxic byproduct called acetaldehyde as well as chemical culprits like congeners. Acetaldehyde has been linked to dilating blood vessels and contributing to headaches, while congeners are found in darker liquors like bourbon and red wine and can worsen hangover severity.

Alcohol is also an inflammatory substance, leading to immune system responses like release of cytokines that may trigger some of the aches, pains and fatigue experienced during a hangover. Alcohol can irritate the stomach lining as well, potentially causing digestive issues, nausea, and vomiting.

The Dreaded Dehydration

While the diuretic effects of alcohol are well known, the dehydration experienced during a hangover goes beyond just frequent bathroom trips. Alcohol actually suppresses vasopressin, an anti-diuretic hormone that regulates the body’s water retention. This double whammy means the body has a very hard time reabsorbing water and maintaining proper fluid levels.

Extreme dehydration during a hangover is a major cause of headaches, dizziness, dry mouth, and fatigue as the body’s organs aren’t able to function optimally without proper hydration. The alcohol-induced dehydration also depletes the body of important electrolytes like sodium, potassium, and magnesium, contributing to muscle aches, spasms, and weakness.

Blood Sugar Swings

For reasons still being researched, alcohol can cause a temporary spike in blood sugar levels during consumption before then causing a rapid drop in blood sugar in the morning. These swings in blood glucose appear to be another key factor in triggering hangover symptoms like moodiness, shakiness, fatigue, and headaches.

The Role of Sleep

Most people are able to fall asleep fairly easily when intoxicated, but alcohol actually disrupts and reduces sleep quality once the initial sedative effects wear off. The fragmented, poor quality sleep experienced after drinking can leave you feeling groggy, irritable, and fatigued – compounding the hangover misery.

Anxiety and Depression

There’s a reason we call it feeling “down in the dumps” the day after heavy drinking. Alcohol is a central nervous system depressant that impacts chemical messengers like serotonin and endorphins. The rebound effect from these chemical imbalances can contribute to feelings of anxiety, irritability, and even depression during a hangover.

Factors That Influence Hangover Severity

While hangovers are never fun, some people seem to get walloped by them harder than others. Here are some of the biggest risk factors that can worsen the morning-after misery:

Alcohol Quantity

It’s no surprise that drinking more alcohol generally leads to worse hangovers. Consuming a higher number of alcoholic beverages in a session exposes the body to more toxins and greater dehydration effects. Binge drinking is a surefire way to an epic hangover.

Alcohol Concentration

In addition to quantity, the concentration of alcohol matters as well. Having several glasses of wine may lead to a milder hangover compared to drinking the same amount of alcohol but in the form of shots or mixed drinks with hard liquor.

Congener Content

As mentioned earlier, congeners are toxic chemical byproducts formed during alcohol fermentation and act as a “hangover patriots.” Darker liquors like bourbon, rum, red wine, and tequila tend to be higher in congeners than lighter drinks like vodka or gin.

Biological Sex

Research shows that women tend to have a higher hangover susceptibility compared to men after drinking equivalent amounts of alcohol. The reasons are still being studied, but factors like differences in body water composition, alcohol metabolism, and hormonal influences may play a role.


While we may have put our hard-partying college days behind us, the hangovers seem to get worse as we get older. Declines in alcohol metabolism and increases in hangover symptom sensitivity appear to happen as we age.

Pre-Existing Health

Having underlying health issues like diabetes, migraines, anxiety, or persistent pain conditions can exacerbate the hangover experience. Alcohol’s effects on blood sugar, inflammation, and so on are multiplied in these cases.


Some people are just born with a hangover bullseye on their back due to genetics. Variations in the genes involved with alcohol metabolism as well as generally inherited alcohol intolerance can make some individuals more prone to brutal hangovers.

The Best “Cures”

With no true hangover “cure” beyond prevention, the best things you can do are to rehydrate and allow the alcohol to fully metabolize out of your system. Drinking water or electrolyte drinks, eating nutritious foods, getting some light exercise, using over-the-counter pain relievers, and resting can help ease the fatigue, headaches, nausea and other symptoms until the hangover passes.

The truth is, the only way to truly prevent a hangover is to avoid alcohol altogether or at least drink in moderation. But most adults will likely experience a hangover at some point. Understanding the physiological mechanisms behind them and your own personal risk factors can help you make smarter drinking choices to minimize the morning-after regrets.