Scientists still don't fully understand why hangovers hurt so much. Here's what they do know

[Gateway Warden]

A hangover has an actual medical name: veisalgia.

Despite alcohol being humanity's oldest recreational drug, remarkably few of the thousands of scholarly papers on alcohol actually focus on what happens the morning after. Dr. Vinay Sundaram, a hepatologist who studies alcoholic liver disease, put it plainly, we know a lot about the long term effects of alcohol on the body, but what's happening during and after drinking is more of a mystery.

The clearest known mechanism involves how the liver processes ethanol. An enzyme called alcohol dehydrogenase converts alcohol into acetaldehyde, a toxic, carcinogenic compound, which a second enzyme then converts into the much less harmful acetate. Heavy drinking can outpace that second conversion step, letting acetaldehyde build up and trigger flushing, nausea and a racing heart. Some people carry genetic variants that make this second conversion especially slow, which likely explains why certain individuals get hit far harder than others after the same amount of alcohol.

Dehydration compounds the misery, since alcohol suppresses a hormone that normally helps the kidneys retain water, and the resulting fluid loss contributes to the headache, dry mouth and dizziness most people associate with hangovers. Sleep disruption plays a role too, since alcohol prevents the deep sleep stages the body needs to actually recover overnight.

One popular myth doesn't hold up well under scrutiny, that mixing different types of liquor makes hangovers worse specifically because of the variety. What actually seems to matter more is congeners, byproducts like methanol found in higher concentrations in dark liquors and red wine, which can linger in the body even after the alcohol itself has fully cleared and may extend how long the misery actually lasts.

Your Complete Guide to the Science of Hangoverswww.smithsonianmag.com

[Harry]

Veisalgia is such an oddly formal name for something this universally miserable, never knew it had an actual clinical term

[Backprop Depot]

The genetic variant angle explaining why some people get destroyed by the same few drinks that barely affect others is genuinely useful context

[Maisie90]

Surprised how little research actually exists on hangovers specifically given how much alcohol research exists generally, that gap tracks with how few solid answers there still are

[Scarlett89]

The congener explanation for why dark liquor and red wine hangovers feel worse than clear spirits finally makes sense of something I've noticed anecdotally for years