The Problem: Drinking too Much, Getting Drunk

The Result - Hangover, Withdrawal

If you drink too much you are temporarily disabled and you may be sick for several days. The term "hangover" is used in a causal manner; some people boast of their hangover as if getting drunk was some kind of initiation ceremony or trial of endurance that brings merit. Hangover jokes are common and conceal the pain, suffering and risk attached to heavy drinking.

The hangover is said to begin the morning after heavy drinking. The severity of the hangover depends on how much was drunk, the food eaten and the duration of the intoxicated sleep. Vomiting aggravates dehydration and electrolyte loss, two of  the most acute problems that contribute to the hangover illness.

Alpha ENF is a nutrient formula that will correct the most common nutrient deficiencies associated with heavy drinking. Miner-electrolyte loss is most important in the 3 days following a drinking binge. Magnesium, calcium, sodium, potassium, phosphate and zinc all need replacement. The vitamins that are often deficient are Thiamine, B12, Folic Acid, Niacinamide, Pyridoxine, Riboflavin, Pantothenate.

Wise et al suggest: " In the United States, related absenteeism and poor job performance cost $148 billion annually (average annual cost per working adult, $2000). Although hangover is associated with alcoholism, most of its cost is incurred by light-to-moderate drinker. Patients with hangover may pose substantial risk to themselves and others despite having a normal blood alcohol level. Hangover may also be an independent risk factor for cardiac death. Symptoms of hangover seem to be caused by dehydration, hormonal alterations, dysregulated cytokine pathways, and toxic effects of alcohol."

Magnesium

Magnesium is a critical ion, regulating nerve and muscle cell function. It also is a co-factor for many enzymes of the energy extraction system, and protein synthesis pathways. The adult RDA is 300-350 mg/day. It is actively and passively absorbed. If active transport fails, dietary requirements rise sharply, analogous to calcium absorption problems. Magnesium is widely distributed in plant and animal foods, so that deficiency usually only occurs with impaired absorption, malnutrition, alcoholism, or diuretic use. Deficiency symptoms begin with nausea, loss of appetite, edema, fatigue, and progress to major neurological symptoms- tremors, disordered movement, convulsions, and coma. Magnesium and calcium deficiency may predispose to sudden death from cardiac arrhythmia, and ironically, is most likely to occur with diet and diuretic therapies for hypertension and heart disease.

Magnesium  deficiency  also occurs in alcoholism from Mg loss in the urine, exacerbated by low dietary intake, gastrointestinal losses with diarrhea or vomiting. Osteoporosis is prevalent in the alcoholic population. Hypomagnesemia in alcoholics may also contribute to increased cardiovascular disease by enhanced platelet  aggregation which can be corrected with Mg therapy.  Mg inhibits the synthesis of thromboxane A2 and 12-hydroxyeicosatetraenoic acid, eicosanoids thought to be involved in platelet aggregation. Mg also inhibits the thrombin-induced Ca2+ influx in platelets, as well as stimulates synthesis of prostaglandin I2, a potent antiaggregatory eicosanoid. Magnesium replacement is essential for alcoholics and increased doses are given during withdrawal from alcoholic beverage intake. Magnesium supplements in the range of 5 mg/kg/day or 300-500 mg/day for the average adult may be desirable.

The alcohol hangover.

PURPOSE: To review the cause, pathophysiologic characteristics, cost, and treatment of alcohol-induced hangover. DATA SOURCES: A MEDLINE search of English-language reports (1966 to 1999) and a manual search of bibliographies of relevant papers. STUDY SELECTION: Related experimental, clinical, and basic research studies. : Data in relevant articles were reviewed, and relevant clinical information was extracted.

The alcohol hangover is characterized by headache, tremulousness, nausea, diarrhea, and fatigue combined with decreased occupational, cognitive, or visual-spatial skill performance. In the United States, related absenteeism and poor job performance cost $148 billion annually (average annual cost per working adult, $2000). Although hangover is associated with alcoholism, most of its cost is incurred by the light-to-moderate drinker. Patients with hangover may pose substantial risk to themselves and others despite having a normal blood alcohol level. Hangover may also be an independent risk factor for cardiac death. Symptoms of hangover seem to be caused by dehydration, hormonal alterations, dysregulated cytokine pathways, and toxic effects of alcohol. Physiologic characteristics include increased cardiac work with normal peripheral resistance, diffuse slowing on electroencephalography, and increased levels of antidiuretic hormone. Effective interventions include rehydration, prostaglandin inhibitors, and vitamin B6. Screening for hangover severity and frequency may help early detection of alcohol dependency and substantially improve quality of life. Recommended interventions include discussion of potential therapies and reminders of the possibility for cognitive and visual-spatial impairment. No evidence suggests that alleviation of hangover symptoms leads to further alcohol consumption, and the discomfort caused by such symptoms may do so. Therefore, treatment seems warranted. CONCLUSIONS: Hangover, a common disorder, has substantial morbidity and societal cost. Appropriate management may relieve symptoms in many patients.

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