The best way to prevent a hangover is to drink less, not to take supplements. Although they are often over marketed, there is a time and a place for dietary supplements. If you’re going Vegan, vitamin B12 is a must. Similarly, many of us benefit from some extra Vitamin D from time to time. During pregnancy, folate supplements are always recommended. However, there isn’t a pill you can take to undo the damage done by excessive drinking. There isn’t a supplement regimen out there that is going to protect you from a hangover if you abuse alcohol, period. I have certainly had my fair share of cocktails over the years, so no judgment, but drinking to excess is going to give you a hangover, almost without exception. There are many “problem drinking” definitions across the internet, but suffice to say that regularly waking up with a hangover is a sign you are drinking too much and should slow down, or consult an addiction specialist.
What causes hangovers?
For starters, drinking too much alcohol. When our bodies metabolize alcohol, a substance known as acetaldehyde is produced as a byproduct. Acetaldehyde is toxic, even more so than alcohol, and our bodies have to use large amounts of glutathione (our most powerful natural antioxidant) to clear the stuff. Consuming multiple drinks in one night has the potential to overload the liver with the toxic acetaldehyde, and deplete glutathione levels as a result. The bottom line for this article is that regularly drinking alcohol puts a toxic load on the body. Acetaldehyde weakens the immune system and is a known carcinogen. Drinking alcohol loads up the liver with toxins it has to work hard to clear, and in so doing draws down on our stores of “endogenous” antioxidants, leaving us more susceptible to the free radicals produced by all that booze.
N-acetyl-cysteine and hangover marketing
The FDA issued warnings to some hangover supplement manufacturers for making overly aggressive marketing claims. As a result, Amazon has banned NAC supplements from its massive online platform. N-acetyl-cysteine, or “NAC,” is a common ingredient in hangover prevention supplements. In fact, it was research on NAC that largely started the supplement hangover marketing craze. When we drink alcohol, glutathione levels in the liver fall as the body deals with alcohol’s toxic burden. NAC is a glutathione precursor, meaning it helps the body make our “master antioxidant” which is responsible for clearing toxins from our system. Taking NAC can increase the levels of glutathione in our livers. However, NAC is only effective for glutathione restoration, not maintenance. NAC is one of a handful of supplements that also functions as a pharmaceutical. When patients come to the hospital with acetaminophen overdose, the standard of care in hospitals is to administer intravenous NAC. In other words, NAC can be an effective supplement to take if you’ve run your glutathione levels down, as you will have after an acetaminophen overdose, but you won’t get the same benefit if your glutathione levels are already in the normal range. Supplement manufacturers latched on to the research about NAC restoring glutathione levels after depletion and boot strapped the argument to claim that NAC was a hangover “cure.” This is why the FDA got involved and why Amazon banned these products – they were making bold health claims unsubstantiated by science. The research on NAC and alcohol is actually quite weak. This study in mice showed that NAC had protective effects on the liver when taken before drinking, but accelerated liver damage when taken after drinking. Now, it’s important to keep in mimd that this was a study in mice where the mice were given mega doses of straight ethanol, not the mouse equivalent of social drinks, so we can’t say for sure that there is any application for humans.
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The bottom line for the world of hangover prevention supplements is they don’t work. A few small mouse studies on NAC and alcohol metabolism in mice, as well as NAC’s clinical use as a tool for restoring hepatic glutathione in cases of acetaminophen overdose, led supplement manufacturers to make unsubstantiated claims about various nutrients that together could prevent a hangover. These claims aren’t rooted in science, they are pure marketing, which is why they have been flagged by FDA. The best way to prevent a hangover is to limit the number of drinks you have, or not to drink alcohol at all.
Dr. Aaron Gardner, BSc, MRes, PhD
Dr. Aaron Gardner, BSc, MRes, PhD is a life-scientist with a strong background in genetics and medical research, and the developing fields of personalized medicine and nutrition. Read his full bio here.
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