I have read all sorts of articles on the science of hangovers and the preventions thereof. This is the best I have seen and it includes some key action points that are somewhat easily implemented and can be life-changing, or at least, morning-after changing.
Everyone with a bit of drinking experience knows about dehydration and electrolytes, but this is less widely known:
3. Acetaldehyde Build-Up
When alcohol reaches your liver, an enzyme called alcohol dehydrogenase breaks it down into acetaldehyde. Acetaldehyde is far more toxic than alcohol (by up to 30-fold!2).
So your body again attempts to break it down with the enzyme acetaldehyde dehydrogenase and glutathione, a powerful antioxidant that is crucial for liver detoxification (glutathione contains high levels of cysteine, which is why taking this in supplement form may help prevent hangovers… more on this below).
Together, this powerful detox duo can break down the acetaldehyde into harmless acetate (which is similar to vinegar).
However, when you drink too much alcohol, your stores of glutathione become depleted, which allows acetaldehyde to build up in your body, causing the toxic hangover effect.
It should be noted that women have less acetaldehyde dehydrogenase and glutathione than men, which is why women may have a more severe reaction to drinking the same amount of alcohol as a man of similar weight.
Test subjects injected with acetaldehyde very quickly get the nausea and shakes associated with too much drinking, so helping the liver to process it is mission critical. And here's how:
1. N-acetyl cysteine (NAC)
NAC is a form of the amino acid cysteine. It is known to help increase glutathione and reduce the acetaldehyde toxicity5 that causes many hangover symptoms. Try taking NAC (at least 200 milligrams) 30 minutes before you drink to help lessen the alcohol's toxic effects.
If you're wondering just how powerful NAC can be, consider that, like alcohol, one way that Tylenol causes damage to your liver is by depleting glutathione. If you keep your glutathione levels up, the damage from the acetaminophen may be largely preventable. This is why anyone who overdoses on Tylenol receives large doses of NAC in the emergency room -- to increase glutathione.
2. B Vitamins
NAC is thought to work even better when combined with thiamine, or vitamin B1.6 Vitamin B6 may also help to lessen hangover symptoms. Since alcohol depletes B vitamin in your body and they're required to help eliminate it from your body, a B-vitamin supplement taken beforehand, as well as the next day, may help.
3. Milk Thistle
Milk thistle contains silymarin and silybin, antioxidants that are known to help protect the liver from toxins, including the effects of alcohol. Not only has silymarin been found to increase glutathione, but it also may help to regenerate liver cells.7 A milk thistle supplement may be most useful when taken throughout the entire holiday season if you know you'll be having cocktails on more than one occasion.
4. Vitamin C
Alcohol may deplete your body of vitamin C, which is important for reducing alcohol-induced oxidative stress in your liver. Interestingly, one animal study showed that vitamin C was even more protective to the liver than silymarin (milk thistle) after exposure to alcohol.8 Just as with a dental anesthetic, vitamin C will also help detoxify alcohol, so make sure you're getting enough vitamin C, either via supplements or food, before indulging in alcoholic beverages.
You may not want to be at a party popping pills, so here is a simpler routine as a pre-game and again at the end of the evening:
NAC - at least 600 mg, but don't be shy. Oral NAC is administered in suspected Acetaminophen overdoses and the starting dose for a 110 pound person is 7 grams, with another 3.5 grams administered every four hours for three days. 600 mg is about 1/12 that amount, which is nowhere in sight of overdose territory. NAC probably won't be at your nearest CVS, sadly, but stores that specialize in supplements will stock it.
Emergen-C : great for the B vitamins, Vitamin C, other electrolytes, and water.
If you are a supplement nerd like me you won't pay up for the simplicity of Emergen-C but will just find the different components in your cupboard.
As to the milk thistle, I am sure it is a good idea and if you have it, great, but it does not seem to be critical to the efficacy of this protocol. (The sacrifices I make for science...).
Anyway - have a happy and responsible New Year. Prevention is still the best medicine, although often not the most exciting.