Why hangovers are the worst

• Common symptoms of a hangover like headaches, nausea, and anxiety are caused by chemical changes in your body and brain that accompany drinking.
• Alcohol suppresses a hormone called vasopressin, which normally prevents you from urinating too much. Without it, you pee more and become dehydrated (cue morning headache).
• Other chemicals called proinflammatory cytokines are to blame for your flu-like symptoms, while changes in brain chemistry — not your choices last night — are responsible for so-called “hangxiety.”
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Hangovers and the horrible headaches that come with them are caused by chemical changes in your body that take effect as soon you down your first drink.

Following is a transcript of the video.

Ahhh. Your head hurts. You’re nauseated. You’re achy. And you’re certainly: Never. Drinking. Again. The only thought running through your foggy mind is: Why are hangovers the absolute worst?

Let’s go back to last night. As you down that cocktail, alcohol migrates through your GI tract to your liver, where enzymes break it down. But as you continue to drink, your liver can’t keep up. So the alcohol overflows into your bloodstream and travels to other organs, like your brain. There, it suppresses a hormone called vasopressin. Normally, vasopressin prevents you from urinating too much. So without it, you have to pee all of the time, dehydrating you in the process.

That helps explain your brutal headache the next morning. But there are other chemicals at work, such as proinflammatory cytokines. These are small proteins that stimulate inflammation, which causes symptoms like nausea, jitters, and headaches. And people who are hungover have tons of them in their blood.

In fact, when researchers injected proinflammatory cytokines into people who were stone-cold sober, they actually felt hungover, without any of the fun beforehand. Now, scientists aren’t exactly sure why binging triggers this kind of inflammatory response. But there’s some evidence that it’s more severe when you drink darker alcohols. In one study, participants who drank bourbon instead of vodka reported that their hangover symptoms were 36% worse the next morning.

Then there’s that awful morning anxiety…sometimes called hangxiety. And no, it’s not that guilt you feel from any bad decisions you may have made the night before. It’s actually biological. Hangxiety starts to develop when you finally put down that last empty cocktail glass. You see, up until that point, your brain has been ramping up the activity of receptors called GABA. They’re what give you that calming buzz. And at the same time, it’s been blocking glutamate — a stimulant that’s linked to anxiety.

But when you stop drinking, it flips. Your brain empties of those calming GABA receptors and floods with the stimulating glutamate, which can make you feel abnormally anxious by the time morning comes around. It can also disrupt your sleep, so you wake up still tired.

But enough of the bad news. How can you make that nasty hangover go away? Sorry to say, a greasy breakfast isn’t the cure-all you might think. Your body is running low on water — not fat. So your best bet is to hydrate and take an anti-inflammatory. Chances are, the hangover will vanish within 24 hours. Or at least in time for next weekend.

EDITOR’S NOTE: This video was originally published in April 2019.