As a dietary staple in cultures around the world, alcohol has been consumed widely for thousands of years. The ancient Egyptians worshiped a beer god who they believed invented the sacred beverage. Unfortunately, no god existed to protect them from the adverse effects of alcohol, collectively named a hangover.

Despite the amount of research into alcoholism and alcohol dependency, very little research has been conducted on hangovers and the causes of its associated symptoms. Perhaps the lack of attention is attributable to the moral hazard incurred by any discoveries or formulations found to prevent or treat hangovers. Many clinicians believe the hangover to be a deterrent to consuming large amounts of alcohol--some would rather a cure remain elusive. Although this belief has merit, the market for such a discovery, supported by double-blind clinical research, would be enormous. However, executing necessary research poses problems in of itself as procedures for such studies would be difficult to adhere to. It is no surprise that few clinical studies have been conducted to explore the effectiveness of existing remedies and formulations.

There are a few distinct theories behind the causes of hangover symptoms, although a combination of them all is the likely case. Two identifiable contributors to hangover symptoms are dehydration and acetaldehyde.

Alcohol is a diuretic, causing water loss within the body. When alcohol is consumed, it inhibits the release of the antidiuretic hormone (ADH) from the pituitary gland. This hormone regulates the body's re-absorption rate of water within the kidneys. As alcohol interrupts the hormone levels, water re-absorption slows and more water is excreted from the body. This explains the numerous "bathroom breaks" one takes while consuming large amounts of alcohol. Although water is obtained from the alcoholic beverages themselves, a majority is ultimately expelled due to hormone disruption of ADH levels. In beverages with higher alcohol content the impact is even more pronounced. For example, after consuming a glass of wine (12.5% alcohol by volume), well over 100% the amount in water will be released from the body.

Mild to moderate cases dehydration can result from an intake of alcohol. Symptoms of dehydration are similar to those experienced during a hangover: dry or sticky mouth, lightheadedness, headache, lethargy, and confusion. The cure for dehydration is an obvious one--water. To help prevent dehydration while drinking alcohol, glasses of water should be consumed intermittently. Extra care should be taken when drinking beverages with higher concentrations of alcohol as these intensify dehydration. Electrolyte balance can also be disrupted due to water loss (alongside water-soluble B and C vitamins). Electrolytes can be replenished through sport beverages such as Gatorade and Vitamin Water. Taking B-complex and vitamin C can help restore these levels within the body.

Acetaldehyde is identified as the major culprit contributing to hangovers. Acetaldehyde is a chemical compound produced during the metabolism of alcohol within the body. It is a toxic substance (much more than that of alcohol itself) that can produce a plethora of the symptoms experienced during a hangover. Its effects include flushing of the skin, throbbing headache, nausea and vomiting.

When alcohol is consumed, it is initially broken down by the enzyme alcohol dehydrogenase, converting the alcohol into acetaldehyde. Acetaldehyde is then converted to acetic acid (vinegar) by the enzyme acetaldehyde dehydrogenase. This second stage requires sulfur-containing antioxidants in order to complete the conversion. If antioxidant supplies are depleted during alcohol consumption, a buildup of acetaldehyde can result and escape into the bloodstream. A build-up of acetaldehyde can wreak havoc on biological functions, inhibiting mitochondria reactions and ultimately causing hangover symptoms. This is seen in alcoholic patients undergoing treatment with the drug Disulfiram. Disulfiram prevents the conversion of acetaldehyde into acetic acid by blocking necessary enzyme function. Alcohol consumption while taking Disulfiram will result in amplified hangover symptoms--throbbing headache, nausea and vomiting, mental confusion and possibly circulatory failure--strong deterrents to alcohol consumption.

A potential cure for this buildup of acetaldehyde is supplementation with sulfur-containing antioxidants such as N-Acetyl-L-Cysteine (NAC). NAC is readily absorbed into the body and binds with acetaldehyde in its conversion process to acetic acid. This helps prevent antioxidant depletion and the toxic effects of acetaldehyde. NAC's antioxidant properties may also help protect against liver damage such as fatty liver disease. NAC can be readily purchased at most health-food stores and vitamin outlets. Commercial formulations containing NAC and specifically designed for hangovers also exist.

Other theories explaining hangovers include congeners and alcohol withdrawal. Congeners are compounds found in certain types of alcohol and created during the fermentation process. Some evidence exists that these compounds can contribute to a hangover. More congeners are found in dark alcohols and red wines, explaining why people commonly target these beverages as hangover-conducing.

Costing billions of dollars in losses to businesses each year, hangovers inflict their damage both physically and financially. The hangover remains an elusive beast, lacking both adequate clinical study and significant research. Alcohol abstinence is always a choice, but one doubted to find many followers.