The more ethanol you consume, the longer your body takes to deal with it. Result? You start to accumulate nastily toxic by-products from your body’s ethanol processing. Seriously scary, poisonous by-products begin to form inside you. Keep your ethanol levels low and your body can handle these toxins. Go one too many or – worse – too many too many and you’re gonna be in trouble on the Morning After.

Veisalgia. That’s doctor-speak for hangover

Until June 2000, there wasn’t even a medical term for the “condition” we know as a hangover. That’s when Dr Jeffrey G. Wiese, Dr Michael G. Shlipak and Dr Warren S. Browner coined the term “veisalgia”. It appeared in an article called The Alcohol Hangover published in the Annals of Internal Medicine, a journal of the American College of Physicians.

The authors said that veisalgia combines the Norweigian word “kveis” – meaning “uneasiness following debauchery” – with the Greek word “algia”, meaning “pain”.

Okay… when I first read this years ago, I thought it was possibly an April Fool’s joke. Apparently not. Since that happy June, it’s no longer an indecent hangover. It’s a recognised, respectable medical condition called veisalgia.

And while the symptoms are all too apparent and have been known since the gods were boys, the precise causes of veisalgia are not fully understood. Sure, veislagia is clearly a result of too much booze. But exactly how the booze does what it does to you on the morning after is still a bit hazy.

Which is probably why nobody has come up with a sure-fire cure. What is boringly certain is this: prevention is far better than cure. Drink less (ho, ho) and perhaps be a bit more wary of the booze you choose. Here’s what seems to be why.

Beware Mr Hyde – in triplicate

The first Mr Hyde is acetaldehyde. As hard on your head as it to pronounce. It’s the initial by-product created primarily by your liver as it processes booze’s main alcohol (ethanol) through your system. Unfortunately, we can pour booze into ourselves faster than our bodies can detox the acetaldehyde by eventually turning it into acetic acid, carbon dioxide and water.

Drink too much – or too quickly – and you can end up awash with more acetaldehyde than you can handle. And because this Mr Hyde is much more toxic than ethanol, an excess will certainly contribute to a hot flush, higher heart rate, a dry mouth, nausea and a headache.

Beware the second Mr Hyde: dehydration. De-Hyde-Ration. See? A hiding Hyde

Ethanol is a diuretic. It makes you wanna go. And it makes you wanna go a lot more than if you were just drinking similar quantities of water. It causes your kidneys to step-up a couple of gears and produce more water than usual. It may cause you to lose maybe four times as much liquid as you drink.

First bad result from dehydration? Ethanol reduces saliva production, it dries your mouth out and you wake up feeling rather thirsty. How can this be? Surely you drank enough the Night Before?

“His mouth had been used as a latrine by some small creature of the night, and then as its mausoleum. During the night, too, he’d somehow been on a cross-country run and then been expertly beaten up by secret police. He felt bad.”

Kingsley Amis, Lucky Jim

Second bad result? Brain pain. As your dehydrating body scavenges itself for H²0, your once water-rich brain starts to constrict inside your skull. This pulls on the membranes (the dura) that hold it in place. It’s kinda like an inside-out version of putting your head in a crushing vice. Apparently, although your brains have no pain sensation, the skull-connecting dura are pain-sensitive and their unnatural stretching revs-up your headache.  

Third bad result: low blood sugar. This one’s a real double-whammy. Because your liver is so busy tackling acetaldehyde, it doesn’t release normal levels of sugars into your blood. Symptoms of low blood sugar? Headache, dizziness, blurred vision and, potentially, coma. Coma. Such a pretty, little word… Oh, and something abnormal happens in your pancreas to do with insulin production but I dozed-off reading the bio-chemical stuff about that.

Beware methanol and the third Mr Hyde: formaldehyde

Only once your body has finished coping with the ethanol can it turn its attention to the other principal alcohol in booze, methanol. In other words, the processing of methanol only begins in earnest once the amount of ethanol in you has been knocked back.

The first by-product of this later, methanol-processing is formaldehyde. Yep, the stuff that’s used to preserve dead, once-living things. Like Damien Hirst’s immensely “bottled” Tiger shark.

It gets worse. In the next step, this Hyde gets turned into formic acid which is then processed into excretable carbon dioxide (mainly exhaled) and water, which is mainly peed.

Formaldehyde and formic acid are neurotoxins. Brain poisons. Formic acid is processed more slowly than formaldehyde and it’s certainly bad for your eyes. It’s probably got a lot to do with that bleary-eyed aversion to opening the curtains on the Morning After.

Methanol can only be dealt with once the ethanol has been processed. And that only happens when you stop drinking. Which is exactly where, veisalgiacally speaking, it all starts going horribly wrong – when you stop drinking and go to bed – or at least to sleep…

Beware the demon sleep

You have a grand night out and as you toddle off to bed, the world is just as dandy as dandy can be. You’re happier than early-morning birdsong. And yet you wake up feeling a little lousy – to say the least. What has occurred? Simple. You’ve been undone by sleep.

It’s a cardinal rule. If you want to avoid a hangover, avoid the debilitating demon of slumber. But please don’t take my word for it:

“When metabolised, elimination of methanol from the body coincides with the onset of a hangover.”

Alcohol Hangover: Mechanisms and Mediators. Robert Swift MD, PhD and Dena Davidson PhD

To me – in a twisted, foolish way – this scientifically suggests that sleep causes hangovers. It works like this. Because you can’t drink and sleep at the same time, your ethanol intake ends. And that’s when Mr Hyde goes to work on you with acetaldehyde. Once that’s finished, he hands over the task of seriously damaging you with methanol-producing formaldehyde and formic acid.

Beware the dark

Scary enough as the “real” Mr Hyde may have been, in the booze world he has two alchemical siblings that lurk alongside him in the dark. Congeners. Fusel Oils.

Congeners can be spotted in the colour of your booze. In simple terms, the darker the brew, the worse for you. They might sound like a group of congenial drinking mates – “I’m meeting a coupla congeners later. Wanna come?’”Don’t be fooled.

They’re produced during booze-making. The word comes from Latin and means “born together”. These amiable-sounding fellas make a big contribution to your favourite tipple’s lovely colours and its appealing flavour.

But congeners ain’t your mates. Amongst other chemicals, congeners contain alcohols that fall into a grouping called “fusel oils” and the most abundant of these is methanol. High methanol content – like in fruit brandies and port – produces high formaldehyde content and that Mr Hyde produces the mother of all hangovers.

Although you could possibly get a veislagia just trying to get your head around all this stuff, what does it all mean? Right. Red wines and whiskies, ports, brandies, bourbons and other darkly-coloured booze routinely contain much higher levels of congeners than white wines, vodkas, gins and white rums. Beware the dark. Ever had a port-induced hangover? Memorable, hey?

Wanna cure? It has to be a hair of the dog that bit you

“My clay with long oblivion is gone dry. But fill me with the old familiar juice, Methinks I might recover by and by.”

From the Rubyiat of Omar Khayam

I’m certainly not suggesting that you fill yourself with the old familiar juice, but a couple of stiff ones will certainly buffer veisalgia. That fact is endorsed by America’s National Center for Biotechnology Information which advances science and health by providing access to biomedical and genomic information:

The fact that ethanol re-administration fends off hangover effects may be further evidence of methanol’s contribution to the hangover condition, given ethanol’s ability to block methanol metabolism and thereby slow the production of formaldehyde and formic acid.

The “Ethanol re-administration”. You gotta love it! Gimme some ERA…

That’s exactly why reviving brunch drinks like the Bloody Mary are so, so popular. They work. It’s my bar-none favourite cocktail partly because of its arresting flavours but more so because of the immense gratitude it fosters in me on the Morning After. There’s a grand TGIFood article about it here and a happy little piece here on what to eat with it – Eggs Benedict.

I’ll end with these sound words of advice from W.C. Fields:

“I always keep a supply of stimulant handy in case I see a snake – which I also keep handy.” DM