I went to a wedding on the weekend. Now, I’m aware that’s not really newsworthy, but while we’re still in the midst of this pandemic, any event that involves travelling from home and actually gathering with other people still seems like a BIG DEAL.

If you’ve been to a COVID wedding you’ll know that a lot of things are different – limited numbers of people, strict seating plans and more. But some things even COVID can’t change….people will still eat, drink and be merry….and, in my case at least, wake up the next day with the inevitable hangover.

After a big night, well after our organs have done the job of removing all the alcohol from our bodies we’re still left nauseous and dizzy, sweaty and shaky. It even has a name: veisalgia. But what causes it?

When I was growing up it seemed common knowledge that hangovers were caused by dehydration.

Kind of makes sense – alcohol is a diuretic (meaning it makes you pee), and when you’re drinking a lot you often forget the water. But studies have kind of debunked this idea.

Dehydration probably doesn’t help, and likely contributes to things like headaches, but it certainly doesn’t appear to be the only culprit.

A more robust theory is that our hangover symptoms are a result of toxic by-products from the breakdown of alcohol.

As we metabolise alcohol we produce a compound called acetaldehyde, which then gets converted to acetic acid. The acetaldehyde is pretty toxic (much worse than alcohol itself), and having it build up in our bodies is thought to explain a lot of the symptoms of our hangovers. Studies have linked it to nausea, vomiting and sweating.

Our immune system might also have something to answer for. While it’s fantastic at protecting us from infections, it seems excess alcohol might also trigger our inflammatory responses. This results in the release of signalling molecules called cytokines, which are thought to contribute to symptoms like nausea and headaches as well as feelings of fatigue.

While we now have some understanding of what causes a hangover, there’s still no cure.

Everyone seems to have their own favourite remedy, from the hair of the dog to taking vitamin B, but there’s not really evidence that any of these are effective.

The only sure-fire way to avoid a hangover is not drinking … although it’s too late for me…

Dr Mary McMillan is a senior lecturer at the School of Science and Technology, University of New England.

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