How to ease The Day After (tips for the summer party season)

This article appeared in Healthy For Men earlier this year.

 How to ease the hangover if you can't avoid it all together. Picture by  MIslav Marohnic.

How to ease the hangover if you can't avoid it all together. Picture by MIslav Marohnic.

Hanging after a birthday bash? Dreading the day after after some bubbles in the park? Alcohol, tobacco and other recreational drugs and associated behaviour will throw a challenge for your body to mob, metabolise and transform toxins for safe excretion. On the firing line are your liver, gut and kidneys, all of which will appreciate little extra care before and after the onslaught.

Alcohol affects not only your "upper" brain, but it also affects our "second brain", our gut microbiota, or gut flora. Long-term exposure to alcohol has been found to increase the amount of gram-negative bacteria, which metabolises the ethanol to acetaldehyde (1). This toxic metabolite not only enhances your experience of hangover in itself, but punches microscopic holes in your gut wall, reducing the effectiveness of your initial detoxification phase, where foreign molecules are rejected at the level of gut lining.

Increased intestinal permeability opens the door to other molecules that normally are kept away from our circulation. In bloodstream, these molecules can initiate systemic inflammation by overloading livers’ functional capacity. Stress or lack of sleep compounds the situation and a nail in the coffin is the intake of painkillers the morning after (2). While painkillers are effective in stopping the sensation of pain, they further erode the gut lining, giving many a tender stomach over the following week.

Few things can help damage management. Starting from the gut, research has shown that Aloe Vera sooths excessive acidity of the stomach, helping to heal the mucosal damage while reducing inflammation (3,4). Flax seeds, soaked in water for quarter of an hour or more, forms similar protective gel, soothing the inflamed intestines. While probiotic foods like live yogurt and kefir may be useful (5), research on dairy is not conclusive and those with lactose intolerance should give this trick a miss. Dairy free probiotic drink Kombutcha or a good quality multi-strain probiotic supplement would provide relief and help balance an upset gut (6).

If the evening is likely to end up in a kebab shop or a chippie, you may want to learn from the Koreans. They found that oral intake of chlorella at 100gm/day reduced the absorption of the dietary carcinogenic agents present in fried, grilled or charred foods (7). Chlorella has also been found effective in generally supporting the liver load in healthy volunteers (8).

Be it alcohol, tobacco or other recreational drugs - what is absorbed from the gut is dealt by the liver. Powerhouse of our detoxification, liver is a nutrient hungry organ. A B-vitamin complex, branched chain amino acids and phytochemicals, such as those available from cruciferous vegetables, onions and garlic are essential. Antioxidants like vitamin C, E and A mop up the formed free radicals and cavalcade of amino acids are conjugated to the toxins to finally excrete them out of the body. Particularly taurine, methionine, cysteine and glycine are important and found in all complete protein (9). Herbal extract Milk Thistle is a extensively researched in relation to liver function (10), and its capacity to simultaneously support different liver pathways makes it a must add-on to any party animals daily armoury.

After the bacchanals, flush your system with plenty of clean filtered of water, preferably with a pinch of sea salt, rock salt or commercial Ph salts to restore your hydration and electrolyte balance. A Korean study found red ginseng extract effective in reducing hangover symptoms (11), while a Hungarian study found an amino acid complex containing 5-HTP useful in alleviating emotional symptoms (12). If the parties have been numerous, amino acids choline and betaine can provide support for the liver regeneration (13, 14).

While rest is important (especially if you’ve lost sleep) gentle exercise like a walking can replete serotonin, while increasing circulation and therefore aiding liver detoxification (15). Tryptophan rich food sources like poached eggs, cottage cheese or salmon provide building blocks for this mood lifting hormone; enjoy these with some complex carbohydrates like sweet potato to enhance the absorption. Supplementation with 5-HTP may also also help, but is contraindicated with anyone on antidepressants and should be taken after, not during excessive alcohol intake.

REFERENCES

1. Purohit, Vishnudutt, et al. "Alcohol, intestinal bacterial growth, intestinal permeability to endotoxin, and medical consequences: summary of a symposium." Alcohol 42.5 (2008): 349-361.

2. Bjarnason, I., et al. "Effect of non-steroidal anti-inflammatory drugs and prostaglandins on the permeability of the human small intestine." Gut 27.11 (1986): 1292-1297.

3. Yusuf, S. et al. “The effect of Aloe vera A. berger (Liliaceae) on gastric acid secretion and acute gastric mucosal injury in rats”. J. Ethnopharmacol. 2004, 93, 33-37. 

4. Mansour, Ghada, et al. "Clinical efficacy of new aloe vera‐and myrrh‐based oral mucoadhesive gels in the management of minor recurrent aphthous stomatitis: a randomized, double‐blind, vehicle‐controlled study." Journal of Oral Pathology & Medicine 43.6 (2014): 405-409.

5. Antoine, Jean Michel. "Probiotics: beneficial factors of the defence system." Proceedings of the Nutrition Society 69.03 (2010): 429-433. 

6. McFarland, Lynne V. "Use of probiotics to correct dysbiosis of normal microbiota following disease or disruptive events: a systematic review." BMJ open 4.8 (2014): e005047. 

7. Lee, Inyeong, et al. "Detoxification of chlorella supplement on heterocyclic amines in Korean young adults." Environmental toxicology and pharmacology 39.1 (2015): 441-446.

8. Aliashrafi, Soodabeh, et al. "The effect of microalgae chlorella vulgaris supplementation on inflammatory factors in non-alcoholic fatty liver disease: A double-blind randomized clinical trial." (2014): 113-121.

9. Liska, Lyon et al. “Detoxification and biotransformational imbalances”. In: Textbook of Functional Medicine. Institute for the Functional Medicine (2010): 275-326

10. Pradhan, S. C., and C. Girish. "Hepatoprotective herbal drug, silymarin from experimental pharmacology to clinical medicine." Indian Journal of Medical Research 124.5 (2006): 491.

11. Lee, Mi-Hyang, et al. "Red ginseng relieves the effects of alcohol consumption and hangover symptoms in healthy men: a randomized crossover study." Food & function 5.3 (2014): 528-534. 

12. Jukić, Tomislav, et al. "The use of a food supplementation with D-phenylalanine, L-glutamine and L-5-hydroxytriptophan in the alleviation of alcohol withdrawal symptoms." Collegium antropologicum 35.4 (2011): 1225-1230.

13. Jung, Young Suk, et al. "Alleviation of alcoholic liver injury by betaine involves an enhancement of antioxidant defense via regulation of sulfur amino acid metabolism." Food and Chemical Toxicology 62 (2013): 292-298.

14. Mehedint, Mihai G., and Steven H. Zeisel. "Choline’s role in maintaining liver function: new evidence for epigenetic mechanisms." Current opinion in clinical nutrition and metabolic care 16.3 (2013): 339

15. Young SN. How to increase serotonin in the human brain without drugs. Journal of Psychiatry & Neuroscience : JPN. 2007;32(6):394-399.