You wake up. You're exhausted, but your attempts to fall back asleep are in vain. You’re wearing the same outfit you wore last night. Correction: You’re wearing the same shirt and socks you wore last night, but your pants are splayed across the floor, inside out.
Face it: You drank too much, and now you’ve got one helluva hangover.
Naturally you refer to your mental rolodex of hangover cures: Gatorade, greasy breakfast sandwich, Rupaul’s Drag Race marathon. Since the dawn of time humans have dedicated themselves to figuring out the best way to relieve a hangover—but what about the things you shouldn't do after drinking?
You've probably heard the big one—that you should avoid taking acetaminophen, better known as Tylenol. (In case you though this advice was an old wives' tale, like eating a deep-fried canary or burying yourself in wet river sand, it's not.) But are there other seemingly innocent remedies that, like Tylenol, do more harm than good?
Live-r let die
First, a quick recap on why taking Tylenol while drinking or hungover is bad for you. It all comes down to the liver, a super-important organ that's sometimes referred to as the body’s "washing machine.” Along with an estimated 500 different vital functions, the liver is responsible for removing harmful substances such as bacteria, drugs, and alcohol from the bloodstream.
When you consume alcohol, enzymes in the liver break down the substance, but the organ can only metabolize about one about drink per hour. If you drink more alcohol in a shorter period of time, your liver can’t keep up, and the alcohol enters your blood stream. This is when you get crunk.
With or without alcohol, Tylenol should be handled with care due to its effects on the liver. The organ can only metabolize a certain amount in a given period of time—there’s a reason the pill bottle tells you not to exceed 10 regular-strength pills in 24 hours. If you take took much, your liver will metabolize the rest in a process that produces a toxic byproduct that actually kills liver cells.
(Acetaminophen overdose is the number-one cause of acute liver failure in the U.S. and the U.K., so it’s probably a good call to follow the instructions before popping those pills.)
Now, when you mix Tylenol and alcohol, your liver is forced to work overtime—straining to metabolize both substances, explains Gary Murray, acting director of the National Institute on Alcohol Abuse and Alcoholism's division of metabolism and health effects.
Under normal circumstances, the liver can detox acetaminophen right away—but when under the influence, it’s too busy and toxic byproducts can accumulate. And even a little bit of byproduct can cause liver damage.
It’s official. You can blame it on the a-a-a-a-a-alcohol.
Got it. So what else should I avoid?
Sufficiently spooked, we set out to discover what other destruction we may have inadvertently wrought on our inner organs—or, in the spirit of helping you, dear reader, what other faux remedies one should avoid while hungover. But after interviewing experts from the National Institute on Alcohol Abuse and Alcoholism, it turns out acetaminophen is pretty much the main threat!
No other "cure" people commonly turn to to treat a hangover is as dangerous as Tylenol. I mean, don't go guzzling cough syrup or eating rat poison or anything—but avoid Tylenol, and you're okay.
Murray explains, "I don’t think [other hangover cures] are nearly as dangerous as that one. I think the other things that people do, like eating a greasy breakfast … or drinking fluids right before bed, those are probably okay. But the acetaminophen is what's downright dangerous."
And while some experts warn against drinking citrus beverages because the acidity may not sit well with the stomach, the nice folks at the NIAAA say orange juice isn’t going to do you any serious harm in the way acetaminophen can. It really depends on what makes you feel better.
So what can I do?
Hydrate and feed yourself. And sleep, I guess.
As Aaron White, a senior advisor to the director of the National Institute on Alcohol Abuse and Alcoholism, explains, “The best way to figure out how something works is to either prevent it or reverse it, and we haven’t found anything that works well for hangovers. Nothing really reverses it, so we’re still wondering what is really going on [in the body].”
Taking non steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin is commonly encouraged by doctors to alleviate that nasty morning-after headache—the effects of these drugs on the liver aren’t nearly as profound as with acetaminophen. But NSAIDs come with their own risks. When taken on an empty stomach, the drugs are known to cause gastrointestinal discomfort ranging from irritation of the stomach lining to bleeding ulcers, depending on the amount taken and the frequency. So make sure to eat that breakfast sandwich before downing these pills.
Will it help if I drink more?
Ah yes, the old hair-of-the-dog treatment. The short answer is no, but the long answer is a conditional no.
As White reminds us, a hangover can more accurately be described as "withdrawal." Alcohol calms the brain's stress axis, which includes the amygdala, hypothalamus, and pituitary gland. “But if you drink heavily and you suppress that stress system, it’s going to rebound," White said. Which is why folks tend to feel extra anxious the day after some intense drinking.
So, if you drink more alcohol when you're hungover, technically you can further suppress that anxious feeling—but of course, you'll still have to deal with the rebound of that drink, in the world's worst never-ending story since 1984's The NeverEnding Story. You're only prolonging the inevitable.
Any final tips for dealing with hangovers?
At the end of the day, everyone experiences hangovers differently. The damage has already been done. But White’s parting wisdom when it comes to hangover food?
“Whatever makes you feel better. For some people that’s going to be french fries, for some people, that’s going to be eggs and toast, it is very individual,” he says. “You’re not going to reverse the effects. You’re just trying to cope with the symptoms.”