[Paleopsych] NYT: Raw Eggs? Hair of the Dog? New Options for the Besotted

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Raw Eggs? Hair of the Dog? New Options for the Besotted
NYT December 7, 2004
By JONATHAN D. GLATER

[Did the Sage ever deal with this important issue? Did he himself ever 
need such a remedy?]

On the third day of a seemingly endless bachelor party in
Cabo San Lucas last year, Hal Walker, 33, woke up with a
set of classic symptoms. His head ached. Loud noises made
him wince. Bright lights hurt his eyes.

Mr. Walker's flight home from Mexico to Colorado, where he
is now a co-owner of the Island Grill in Fort Collins, left
at 8 a.m., and it was all he could do to get to the
airport.

"If you can find a remedy for hangovers, that would be
great," he said, voicing a sentiment familiar to anyone who
has imbibed just a little too much and was sorry about it
the next day.

In fact, recent studies suggest that help for at least some
aftereffects of intoxication may not be too much to ask
for.

Last summer, a group of doctors reported in The Archives of
Internal Medicine that an extract from the fruit of the
prickly pear cactus, taken in capsule form, was effective
in staving off hangover symptoms like dry mouth and nausea.


Perfect Equation of Vista, Calif., financed the research
and has patented the extract, which it says is derived from
the skin of the prickly pear, Opuntia ficus.

Another company, Living Essentials of Walled Lake, Mich.,
markets Chaser, a pill containing activated calcium
carbonate and activated charcoal. The company has financed
a study of the dietary supplement, completed in 2002, its
marketing director, Carl Sperber, said. The findings have
not been published.

Experts say that despite such products, a true hangover
cure remains elusive. And the hangover itself is
imperfectly understood, perhaps because scientists have
largely devoted their efforts to understanding alcohol
dependence and the health effects of drinking.

Dr. Linda C. Degutis, an associate professor of emergency
medicine and public health at Yale, said hangovers were
"incredibly understudied."

Most popular remedies, including those sold over the
counter, have no peer-reviewed research to back up their
assertions. Some experts argue that even conducting such
research raises ethical issues.

The development of a foolproof hangover cure, for example,
might encourage people to drink more, knowing they could
take a pill to avoid suffering the next day.

And the prospect of bus drivers' or airplane pilots'
popping hangover pills and going to work is enough to give
anyone pause.

Some researchers argue that hangovers impose such large
costs on society that they have to be studied. No one has
precise figures, but one study cited in the prickly pear
article estimated the cost of alcohol-related problems,
including hangovers, at nearly $150 billion a year in the
United States.

Such studies - focusing on whether remedies for hangover
symptoms would also prevent the effects of a hangover on
judgment, concentration, motor skills and other critical
functions - "are absolutely the next step," said Dr.
Michael G. Shlipak, associate professor of medicine at the
University of California, San Francisco, and an author of
the prickly pear report.

One obstacle, however, may be that there is no consensus
among scientists on how to define a hangover, Dr. Degutis
said.

Headache, thirst, nausea and muscle aches are probably the
most familiar symptoms. Dr. Shlipak's study identified
additional symptoms, including soreness, tremulousness and
dizziness.

The effects of alcohol on the body are well known. When
people drink, alcohol is quickly absorbed through the
stomach lining. Most of it directly enters the bloodstream.


In the body, alcohol dilates blood vessels, creating a warm
flush. It also depresses the central nervous system,
resulting first in euphoria and then, as the alcohol wears
off, anxiety, insomnia and depression.

Carried in the blood to the liver, alcohol breaks down into
acetaldehyde and other byproducts that leave the body
through the urine and the lungs.

On average, the body can process about one drink an hour,
and sticking to that pace for a limited period should
reduce the likelihood of a hangover, Dr. Degutis said. One
drink is defined as one 12-ounce can of beer, 1.5 ounces of
80 proof whiskey or 5 ounces of wine.

But every person's body is different, she cautioned.

What
happens when a drinker consumes enough alcohol to result in
a hangover is a little less clear.

Dr. Shlipak and his colleagues have focused on the
possibility that the immune system may react to toxic
byproducts of fermentation in alcoholic beverages called
congeners.

Congeners "are poisons, and the body recognizes them as
such," said Dr. Jeffrey G. Wiese, an associate professor of
medicine at Tulane and also an author of the prickly pear
study. As a general rule, Dr. Wiese said, the darker the
alcoholic beverage is, the more congeners it has.

So according to studies, vodka generally causes less severe
hangovers than, say, bourbon.

The researchers theorize that congeners may set off the
release of cytokines, molecules that white blood cells
release in fighting off viruses or other invaders.
Cytokines signal inflammation in the body and cause the
achy, tired feelings that people get when they have the
flu.

Prickly pear extract, Dr. Shlipak and his colleagues
suggest, helps by reducing the immune response to
congeners. In their study, the researchers found that when
graduate student testers drank five hours after taking the
pill, they experienced less severe hangover symptoms.

Living Essentials says Chaser works by capturing certain
congener molecules, preventing the body from absorbing
them.

"The secret is the activation of the calcium carbonate,"
said Mr. Sperber, the marketing director. "You can't just
take Tums and burnt toast and get the same effect."

Dr. Shlipak said that he had not seen any studies on the
effectiveness of Chaser but that charcoal, which does not
bind to alcohol, could in theory block the absorption of
the congeners in alcoholic beverages. That would mean that
people who had consumed charcoal before drinking would
still absorb all the alcohol, but might experience less
severe hangover symptoms.

"It's possible," Dr. Shlipak said. "Without commenting on
how their product works or if it works, I think the concept
is intriguing."

Other researchers pointed out that anyone who can remember
to pop any type of hangover pill through a night of
drinking should be able to remember to drink water or even
take the radical step of drinking a little less.

Dehydration also plays an important role in hangovers. The
body tends to lose water as more alcohol is consumed
because alcohol is a diuretic, causing people to urinate
more frequently regardless of how much water they are
drinking.

That is why interspersing water or some other beverage with
alcoholic drinks is a good idea, said Dr. Erik DeLue, a
doctor of internal medicine at St. Margaret Mercy Hospital
in Hammond, Ind., outside Chicago. Not only does the water
rehydrate the body, Dr. DeLue said, but it also reduces the
desire to consume more alcohol to slake thirst.

"It's doubly effective," he said.

There is some evidence
that the withdrawal of alcohol contributes to some hangover
symptoms. The body essentially becomes more excited to
counter alcohol's depressant effects, and after the alcohol
is removed, the body is left in that somewhat hyper state.
That explains why some people with hangovers may experience
an accelerated heart rate and become twitchy and sweaty.

In serious cases, alcohol withdrawal can lead to "holiday
heart," called that because it may occur after a few days
of binge drinking.

The heart may beat too quickly or, worse, its muscles may
beat out of sequence, in extreme instances causing heart
failure or, indirectly, a stroke.

After drinking too much, people tend not to sleep very
deeply, Dr. Wiese said, because the brain also becomes more
alert as the depressant effects wear off. While that means
that alcohol-fueled dreams may be very lively, it also
means that in addition to being dried out and suffering
various aches, pains and twitches, hangover victims are
quite likely to wake up tired, thirsty and very, very
sleepy.

Mark Harris, a former dot-com worker who lives in San
Francisco, recalled a painful day suffering several
symptoms after a company outing in Palo Alto, Calif., about
10 years ago.

"There were some bigwigs, and they were all trying to
outdrink each other," Mr. Harris said. "We put down a lot
of Guinness. There was a lab meeting in the morning, and it
was not optional, and all of us knew it.

"So the next day, we all dragged ourselves in. I tried the
Odwalla blackberry shake to mitigate the circumstances. I
thought maybe the fresh fruits and the vitamins would help
me out."

He paused and added, "That was just horrific."

Several people interviewed about their hangovers said they
had stumbled across possible cures by chance and every once
in a while found a solution that they liked.

Sheila Turner, a publicity agent in Washington, said she
used vitamin C. Other people swear by tomato juice, raw
eggs, carbonated beverages, hot coffee or big greasy
breakfasts.

Doctors say there is little evidence to support most
popular hangover remedies.

Tomato juice makes some sense, Dr. Degutis said, because it
contains salt, which helps the body retain fluids.

But raw eggs make no sense at all, Dr. Wiese said, "unless
it's that the pain of eating the raw egg takes your mind
off" the hangover.

Many doctors recommend drinking orange juice, Gatorade or
similar sports drinks that replenish electrolytes and
taking pain relievers like aspirin or ibuprofen. Tylenol
may not be a good idea, some experts said, because, like
alcohol, it is metabolized by the already-overworked liver.


One thing that no one advises is more alcohol, the
traditional cure known as "hair of the dog that bit you."

While drinking to help a hangover may alleviate the problem
of alcohol withdrawal, it can also impair mental
functioning, contribute to alcohol addiction and a worse
hangover down the road, Dr. Degutis said.

Many experts agreed that the best cure for a hangover was
to avoid drinking too much in the first place.

"Ideally, you're not supposed to drink more than three if
you're a man, two if you're a woman," Dr. Karin Rhodes, an
emergency attending physician for the University of Chicago
Hospitals, said. "And you should never drive within four
hours of drinking two or more drinks."

http://www.nytimes.com/2004/12/07/health/07hang.html