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Health Protocols

Alcohol: Reducing the Risks

This protocol is not about reducing the detrimental effects of chronic, excessive alcohol consumption. No nutritional intervention can eliminate the health hazards associated with long-term alcohol overconsumption.

Rather, this protocol is intended to provide strategies that may minimize some of the ill effects (ie, hangover) arising from isolated instances of alcohol overindulgence.

Hangover symptoms typically result from binge drinking, the most common type of alcohol abuse in the United States. Symptoms include headache, nausea, fatigue, and increased sensitivity to light and noise.

The good news is that several integrative interventions, including clove bud extract, N-acetylcysteine, and glutathione may facilitate alcohol detox and help support systems disturbed by short-term alcohol consumption.

Alcohol Metabolism

  • Most alcohol (about 80%) passes into the small intestine and is absorbed rapidly into the blood.
  • Absorbed alcohol is mostly converted into acetaldehyde, primarily in the liver, by enzymes called alcohol dehydrogenases.
  • Acetaldehyde is a toxin and carcinogen that can cause nausea, vomiting, headache, and fatigue.
  • Most acetaldehyde produced from alcohol is converted by the enzyme aldehyde dehydrogenase into acetate, which can be used for energy production throughout the body.

How Alcohol Causes Hangover Symptoms

  • Hangover symptoms remain after the alcohol itself is no longer circulating in the body.
  • Residual effects like inflammation, altered immune function, and oxidative damage are likely to be key contributors to hangover.
  • Several individual factors can influence hangover severity, including:
    • Age. Adolescents and young adults experience more frequent and severe hangovers.
    • Genetics. Individual differences affect how alcohol is metabolized.
    • Smoking. Smoking is associated with increased hangover likelihood and severity.
    • Medications. Many medications can impact the risk of intoxication and hangover by influencing alcohol metabolism.

Note: Taking over-the-counter medication for hangovers can be problematic. Alcohol and non-steroidal anti-inflammatory drugs like aspirin and ibuprofen irritate the gastric lining and can cause gastrointestinal bleeding, and the risk of bleeding is exacerbated when used together. Because of its high potential for liver toxicity, acetaminophen is also not safe when combined with alcohol.

Minimizing Hangover Risk

  • Drink moderately and slowly. Limit intake to no more than three drinks on a given day for women or four drinks on a given day for men, AND no more than seven drinks per week for women or 14 per week for men.
  • Eat. Food in the stomach reduces the absorption of alcohol.
  • Drink tea. Black tea stimulates the enzyme that breaks down acetaldehyde, while green tea promotes the breakdown of alcohol.
  • Drink water. Drinking water may reduce the rate or how much alcohol is ingested, while carbonated water may encourage the breakdown of acetaldehyde.
  • Take into account the properties of various alcoholic beverages. Vodka has almost no congeners, molecules produced during fermentation and distillation, and may cause less severe hangover symptoms than the highest congener spirit, bourbon. Beer and wine may have fewer toxic effects than spirits.

Integrative Interventions

  • Nicotinamide riboside. Nicotinamide riboside is a precursor to NAD+, which is necessary for many metabolic processes. Depletion of NAD+ in alcohol metabolism, resulting in a lower NAD+/NADH ratio, has been suggested to be a contributing factor in alcohol toxicity.
  • Clove bud extract. A randomized, crossover trial found that a single dose of 250 mg of clove bud extract taken before drinking led to lower blood alcohol and acetaldehyde concentrations, less depletion of detoxification enzymes, and less severe hangover symptoms than a control group.
  • N-acetylcysteine (NAC). NAC directly binds acetaldehyde. In animal research, NAC has been found to reduce alcohol toxicity.
  • Glutathione. Glutathione is an important detoxification compound and antioxidant. In a rat study, two weeks of glutathione administration before alcohol exposure led to lower levels of alcohol and acetaldehyde.
  • Vitamin E and selenium. One animal study showed vitamin E prevented oxidative stress and glutathione depletion after acute alcohol exposure, and this effect was enhanced by treatment together with a form of selenium.