Updated on March 27, 2023
For most of us, rolling out of bed at the crack of noon after a night of drinking isn’t a common occurrence, but when it does happen, there’s a high chance of having a hangover. Nearly everyone has experienced waking up with a turbulent stomach and a pounding headache after a late night out—and many have sought relief from the malaise caused by consuming too much alcohol. However, although hangovers are an all-too-common consequence of both social and binge drinking, no definitive remedy exists.
Given the unaddressed needs of hangover patients everywhere, many enterprising scientists have attempted to formulate new hangover therapies, including specialized hangover pills. But do hangover pills work? Although such products claim to address the damage caused by alcohol consumption, questions remain about their efficacy. But now, patients who seek tools to assuage their hangover symptoms might find the solution they’re looking for if they’re willing to experiment with specialized hangover therapies like glutathione supplementation.*
Before you can evaluate whether a hangover therapy is worth a try, it’s necessary to understand the physiological basis of a hangover. Although a hangover is commonly thought of as simply the body’s reaction to excessive alcohol consumption, the medical basis of a hangover is more nuanced due to the multiple ways in which drinking affects the body. Because alcohol consumption is often paired with other broadly detrimental behaviors, like not drinking water, refraining from sleep, and smoking, the body’s defenses are weakened even before the negative effects of too much alcohol consumption kick in. These coincidental factors aggravate the subsequent hangover symptoms.
The symptoms of hangovers are diverse, and can include:
Importantly, the spectrum of hangover symptoms affects a number of different organ systems. Hangovers impact so many organ systems because they have more than one physiological cause; each physiological cause stems from alcohol consumption but can be treated in a piecemeal fashion. Hangovers have at least four separate pathologies:
Of these four pathologies, a 2010 review of hangover research concluded that alcohol’s effect on immune function was the largest contributor to hangover severity and incidence. However, that doesn’t mean treating immune function alone will be enough to minimize a hangover; each pathology produces a different subset of hangover symptoms, and there is no simple way to address all of them at once. For example, dehydration contributes to muscle cramping, thirst, and pain; whereas, disrupted sleep contributes to fatigue, headaches, and low mood. Treating one pathology can thus ameliorate one set of symptoms while leaving others raging, making the prospect of completely alleviating a hangover improbable.
The best way to prevent a hangover is to drink alcohol in moderation and ensure adequate other hydration when drinking. Drinking in moderation is an easy set of goalposts to miss, however; and, as people age, for example, their ability to process alcohol decreases, leading to an uptick in unexpected hangovers. This means that, despite popular expectation, there is a wide variety of individuals seeking hangover remedies.
Thanks to humanity’s long relationship with alcohol, putative hangover remedies have circulated since antiquity. Ranging from vinegar to raw eel, the hangover remedies of past centuries were typically revolting foodstuffs and, much like many modern hangover remedies, patients were forced to make do with the materials they had on hand. Of course, the view of modern medicine is that these historical hangover remedies were ineffective. Likewise, although many individuals today have a preferred technique for avoiding or abating a hangover, it’s no secret that these lay therapies are imperfect and these individuals often lose entire days to hangovers even with such therapies. Even if lay therapies like eating a raw egg or drinking another alcoholic beverage to stem a hangover can appear to work on occasion, the scientific consensus is that these approaches are bunk. However, with the advent of modern pharmaceuticals and nutritional science, there are a handful of sophisticated hangover therapies that are significantly more effective at treating hangover symptoms, although they are insufficient to be called cures.
Common therapies to reduce hangover symptoms include NSAID medications like Advil, which can address headaches and generalized pain. Over-the-counter NSAIDs are appealing to patients because they’re versatile, readily available, and useful; although NSAIDs do not address any root pathology, they are typically effective for analgesia. However, NSAIDs can also be problematic therapies in the context of hangovers. Ibuprofen NSAIDs, for example, can cause nausea, which means they might exacerbate some hangover symptoms even as they treat others. Additionally, many common NSAIDs and other analgesics, like Tylenol, are prepared in formulations that contain acetaminophen, which can be toxic to the liver, particularly if consumed contemporaneously with alcohol. This toxicity is important because some alcohol might still be present in a person who has a hangover. Nonetheless, NSAIDs and other over-the-counter analgesics remain popular hangover remedies.
Other hangover remedies include supplementation with nutrient and electrolyte mixtures. These products, such as Pedialyte, are designed for other purposes but are co-opted by patients with hangovers. By replacing the vitamins, minerals, and electrolytes lost during metabolic alcohol clearance, such products aim to reduce the impact of dehydration while providing the body with precursor chemicals needed to continue clearing toxic byproducts. Notably, these remedies have no identifiable side effects for healthy individuals, which makes the risk of experimenting with them very low. Likewise, these products are typically safe to combine with other hangover remedies, and they are generally tolerable for individuals with gastrointestinal symptoms.
Today, a growing number of pharmaceutical companies are manufacturing over-the-counter drugs marketed specifically as hangover pills, which often contain aspirin, caffeine, vitamins, minerals, and herbal extracts. Some hangover pills claim to prevent hangovers from occurring by fortifying the body’s defenses before alcohol consumption; whereas, others claim to lessen the severity of a hangover that has already developed. Because hangover pills vary so much in their composition, it’s difficult to generalize about their efficacy. Some individuals derive benefits from hangover pills that contain analgesics or stimulants; whereas, other individuals don’t. Like all other ostensible hangover remedies, the efficacy of hangover pills, in general, is dubious; a 2005 review of randomized controlled trials examining hangover remedies concluded there was no compelling evidence in favor of any specific remedy – pharmaceutical or otherwise. But hangover sufferers will be relieved to hear that the therapeutic landscape has changed since this 2005 publication.
As individuals continue to seek more effective ways to address hangovers, we are now witnessing the emergence of new products and services designed to provide relief. One of the most novel and successful innovations in recent years is the mobile hangover therapy van. Originating in Las Vegas, the mobile hangover van massively improves the care that hangover sufferers can access to address symptoms.
The premise of the hangover therapy van is simple: doctors and nurses make house calls to severely hungover individuals and provide them with supportive care, like intravenous rehydration and nutrient supplementation. Although most hangover therapy vans don’t boast any medical breakthroughs or advanced technology, they do introduce medical professionals to a pathology that rarely sees the inside of a clinic. Although the benefits of treating a hangover with the help of nurses and doctors are numerous, the primary appeal is access to supportive care tools that patients wouldn’t have otherwise. With the help of professionals, a hangover sufferer can receive not only over-the-counter medications but prescription therapies designed to treat pain or nausea, as well as intravenous rehydration to restore normal hydration while circumventing gastrointestinal disturbances. And although oral rehydration is effective, water taken orally needs a considerable amount of time to be absorbed as it makes its way through the gastrointestinal tract. Additionally, patients receive reassurance and emotional support at a time of acute distress.
A major downside of the hangover therapy van concept is its price. A recipient should expect to pay as much as $500 for a hangover house call. Furthermore, the hangover therapy van service is not available in most areas. For patients seeking a more accessible hangover remedy, there are other new options—used by the most advanced of the hangover vans—which rely on innovations in pharmaceutical science.
The most promising new hangover therapies seek to augment the body’s ability to compensate for cellular stress. Rather than simply providing pain relief or restoring lost nutrients, these therapies improve the ability of the immune system to function in the wake of overindulgence in alcohol. Bolstering immune system activity is critical because the inflammation common to hangovers is a result of immune dysregulation caused by oxidative stress.
Significantly, oxidative stress has recently been implicated as one of the primary mechanisms of the immunologic pathology of hangovers, in part because the flavor-enhancing additives in alcohol are often rich in toxic molecules which leave noxious byproducts when metabolized by the body, inducing oxidative stress. In general terms, oxidative stress is a process by which the metabolic byproducts known as free radicals bond to critical enzymes and cellular molecules, preventing them from being used for their intended purpose and causing damage. New therapies produced with this understanding of hangover pathology have the ability to prevent stress from causing more damage, thereby reducing the severity of a hangover. The molecule known as glutathione is one such therapy option.
Glutathione is a molecule produced by the body that is responsible for protecting cells from oxidative stress by bonding to free radicals with great efficiency, preventing damage to the cellular machinery. A 2017 paper written by researchers from the University of Buenos Aires lends credence to the idea that glutathione could be an effective therapy for hangovers by shedding light on the extent of oxidative stress caused by excessive consumption of alcohol. When mice were artificially induced to have the conditions of a hangover, the researchers found that there were 17.5 percent more free radicals present in their blood than in healthy controls, indicating high levels of oxidative stress. In contrast, glutathione concentrations were found to be 43 percent lower than in controls and the activity of certain critical enzymes was 40 percent lower. As oxidative stress increased with the severity of the hangover, the glutathione of the mice became further depleted. As glutathione levels decreased, the free radicals could easily damage enzymes, reducing their activity and causing harm to the mice. This harm included a 57 percent increase in the incidence of enzymes responsible for recycling neurotransmitters, suggesting broadly detrimental and wide-ranging mood disturbances. The results of the study imply that glutathione shortages are a large part of the problem when it comes to the molecular basis of hangovers.
If patients use a glutathione supplement when suffering from a hangover, they could improve their body’s ability to cope with oxidative stress at a minimum. Reducing the oxidative stress caused by hangovers could also very well correspond to reduced inflammation and thereby improve comfort. This could also potentially allay some of the gastrointestinal distress involved in a hangover by allowing intestinal cells to perform more normally while simultaneously improving mood. A glutathione supplement might also treat the major pathologies unaddressed by the current standard of hangover care and act as a safe, effective, and easily accessible alternative to traditional hangover pills.
For the most acute patients, the hangover vans will likely increasingly administer glutathione via I.V. to help address inflammation as quickly as possible. These patients can subsequently be advised to take specialized oral glutathione supplements. Historically, oral glutathione supplements suffered from poor bioavailability, limiting their therapeutic value. Recently, oral glutathione supplements have been developed in sophisticated formulations which address the metabolic obstacles which are present. These formulations enhance the bioavailability of glutathione, allowing it to affect the patient’s physiology and reduce hangover symptoms. As a result, patients can continue their glutathione therapy even after the hangover van has moved on. Patients might also use an oral glutathione supplement to forgo hangover vans altogether if they don’t have a hangover that is severe enough to warrant a visit.
Though there are currently no clinical trials documenting the beneficial effects of glutathione in the context of hangover therapy, researchers based out of South Korea have identified its promise. In a study published in Current Drug Abuse Reviews, the research cohort documents the impact of various minerals and physiological molecules like glutathione on generalized hangover symptoms. Although the authors caution that their optimistic outlook on glutathione’s use for hangover symptoms is speculation based on the synthesis of prior research, they conclude by reporting that the future is bright for its use as a hangover therapy. For patients who are willing to push beyond the limits of conventional hangover remedies, glutathione might well be the best chance they have at curing their hangovers.
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Karadayian AG, Malanga G, Czerniczyniec A, Lombardi P, Bustamante J. 2017. Free Radical Biology and Medicine. 108:692–703.
Min J-A, Lee K, Kim D-J. 2010. Current Drug Abuse Reviewse. 3:110–115.
Penning R, van Nuland M, AL F, Berend O, C Verster J. 2010. Current Drug Abuse Reviews. 3:68–75.
Pittler MH, Verster JC, Ernst E. 2005. BMJ 331:1515–1518.