Hangover headache location
Hangover Headache | Johns Hopkins Medicine
While not a disease we treat at the Johns Hopkins Headache Center, delayed alcohol-induced headaches are extremely common, disabling and costly to society. This material is provided for general education purposes.
- How does alcohol affect the brain and the rest of the body?
- How little is enough to make an impact the next day?
- How long do the effects last?
- Are there any effective treatments?
How does alcohol affect the brain and the rest of the body?
Alcohol adversely affects the brain, the liver, the kidneys, the heart, blood vessels, the lining of the stomach, and various hormonal and regulatory systems. Even the word “intoxicated” indicates alcohol’s true nature: a toxic substance.
The first symptoms of ethanol intoxication on the brain are quite pleasurable for most people. You feel relaxed and happy, and with another drink or two you become boisterously enthusiastic — the life of the party. With increased alcohol consumption, your vision blurs, your reaction times slow, your perceptions are unreliable, and you become unsteady and uncoordinated. You start to lose your inhibitions, which can lead to another consequence of drinking: poor judgment. Speech begins to slur, and concentrating and “thinking straight” becomes impossible. At higher concentrations in the blood, hiccups, vertigo, confusion, lethargy, memory “blackouts,” vomiting, stupor, coma, slowed breathing and even death can result.
No one is exactly sure how ethanol causes its various effects, but once absorbed from the stomach into the bloodstream it can freely cross out of the blood and into nerve cells of the brain. Once in the brain it causes a chemical release that leads to pleasurable feelings, and it lessens inhibitions by depressing certain frontal lobe functions. Motor pathways become overactive, and blood sugar is processed less efficiently in the brain. As more and more ethanol molecules enter the membranes of the nerve cells, sedating effects develop. The effects of alcohol intoxication are relatively predictable based on measured blood alcohol content.
Some of these effects are caused by ethanol itself, and others are from an even more toxic byproduct of its metabolism called acetaldehyde. This chemical builds up in the blood as the liver breaks down the alcohol into a form that can be eliminated from the body.
The effects on other body systems are also important in the symptoms of alcohol intoxication. The kidneys increase urination substantially, leading to dehydration. Blood vessels in the skin dilate, causing flushing and increased cardiac output. The liver starts working overtime to detoxify the blood of ethanol and acetaldehyde, and cannot keep blood sugar adequately regulated.
Repeated drinking can lead to liver scarring, known as cirrhosis. Certain inflammatory chemicals increase in the blood and affect various natural hormonal pathways. The stomach lining may become irritated, increasing nausea and the chance of bleeding. The extra calories consumed often become converted into fat.
Many of these disturbances of the body’s natural physiology persist the next day, long after the alcohol is gone. Dehydration plays a significant role, as does acetaldehyde. Effects on hormones, blood chemistry, the sleep-wake cycle and inflammatory chemicals are also important in the thoroughly lousy feeling we have come to know as a hangover.
Most people are well aware of the presence of headache, malaise, diarrhea, loss of appetite, tiredness, nausea and sensitivity to light, sound and motion the day after binge drinking. What may be less well recognized is that manual dexterity, memory, reaction time, visual-spatial skills and attention are all adversely affected, even when your alcohol level has fallen back down to 0.
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How little is enough to make an impact the next day?
Like so many other answers to science questions, “it depends.” Body weight and gender are very important factors. While five to eight drinks for the average man, and three to five drinks for the average woman, are enough to cause some degree of hangover, specific effects will vary greatly between individuals. Certain ethnic groups (Japanese, for example) have a genetically reduced ability to break down acetaldehyde, the main byproduct of alcohol, as it is first processed in the liver. This results in more reddening of the skin ("“Asian flush”) and hangovers at lower amounts of alcohol.
People prone to migraines tend to have more problems with hangovers. People who drink alcohol regularly, or those who are taking certain specific medications that affect liver enzymes, may metabolize alcohol more quickly, having fewer problems with intoxication and hangover as a result. Conversely, there are many medications that interfere with the breakdown of alcohol and acetaldehyde, worsening the consequences of drinking. A thin, Japanese teetotaling woman taking prescription painkillers will clearly have more problems with a few drinks than a 250 pound linebacker who regularly drinks four beers a night.
How fast you drink is also important. Most of us can break down about one drink’s worth of alcohol each hour. What you drink is far less important than how much, but there’s some evidence that darker beverages — whiskey, brandy, red wine, tequila — cause more problems than clear drinks such as gin and vodka. They are thought to contain chemicals called congeners that add to ethanol’s harmful effects.
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How long do the effects last?
Hangovers can last up to 72 hours after drinking, but most are shorter in duration. Again it depends on how much was consumed, how dehydrated you became, nutritional status, ethnicity, gender, the state of your liver, medications, etc.
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Are there any effective treatments?
If you’ve consumed too much alcohol and have to work the next day, what do you do? In short, you suffer, and so does your job performance. Thinking about calling in sick? You’ll be in good company. Estimates of lost revenues due to reduced job productivity and absenteeism from alcohol run as high as $148 billion a year in the U. S. alone. Much of this expense is related to hangovers in light to moderate drinkers.
A quick Google search for "hangover cure OR treatment OR remedy OR prevention” pulls up over 2 million webpages. There are countless commercial products (Cheerz, Chaser) and homemade recipes with wildly unsubstantiated and pseudoscientific claims of benefits. It is important to note that a recent study from the British Medical Journal concluded that there was essentially no substantial scientific evidence that any substance has proven effectiveness in preventing or treating a hangover. That being said, the authors themselves admit that very few well-designed scientific studies have ever been conducted on the subject, so it is more than possible that some of these unproven treatments might work.
There is some evidence that vitamin B6 taken before drinking can be mildly helpful. An anti-inflammatory drug called tolfenamic acid has been shown to be somewhat helpful when taken during alcohol consumption. While this drug is not available in the U.S., other related medications, including ibuprofen, naproxen, and prescription nonsteroidal anti-inflammatory drugs (NSAIDs) may be similarly helpful. However, when combined with alcohol they might increase the risk of stomach bleeding. Staying well-hydrated with plenty of water is helpful. Gatorade or other fitness drinks may be better than water alone, but there is no scientific proof. A chemical called N-acetyl-cysteine may be useful in detoxifying the body from acetaldehyde buildup, but this too is an unproven treatment. Light exercise may be helpful, provided you stay well-hydrated.
Here’s some advice on what to do after an evening of “overdoing it”:
- Avoid more alcohol (“hair of the dog”) — this will only increase your misery.
- Avoid further dehydration by drinking liquids (other than alcohol!) — water, chicken soup, Gatorade, whatever works for you.
- Avoid acetaminophen (Tylenol) at all costs — it can overtax your already hard-working liver, leading to dangerous swelling or even liver failure.
- Avoid unpalatable “recipes” that combine such ingredients as eggs, raw fish, Tabasco and sausage. You wouldn’t eat like that when you are at your best, so what makes you think you’ll stomach it when you’re hungover?
The very best prevention of a hangover? Don’t drink. The best cure? Time.
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Where's your headache at? | Health & wellbeing
We all know what it's like to have a headache. They can turn the best of occasions into a form of torture. Four out of five people get tension headaches. One in seven experience migraines. Headaches cost the economy around £1.5bn a year through lost work days. Trouble is, while some causes of headaches are obvious – such as when you've had too many glasses of wine the night before – others are more tricky to call. And how can you tell what's serious and what isn't? A good starting point is knowing what type of headache you have.Tension headache
Tension headaches tend to feel like a pressure or tightness around the head. They can last for only half an hour or up to a week. This is the most common type of headache and most people will have had one. Tension headaches can be stress-related or due to problems with the muscles in the neck and face, but there is often no obvious cause. Most people who get tension headaches don't get them very often but around 3% of the population get them regularly, on average every other day. Ibuprofen or paracetamol are usually effective, and exercise helps too. For regular headaches preventative treatment with amitriptyline is available. Although better known as an antidepressant, amitriptyline doesn't prevent headaches by making you happier, although why exactly it does work is still not known.Migraine
Migraine causes recurrent headaches on one side of the head that last for more than four hours. It is common to feel sick and sitting in a dark room often helps. A quarter to a third of migraine sufferers get an "aura" before the headache begins. This is not a supernatural glow around the body, but unusual sensations such as pins and needles, seeing bright lights, or feeling distant from people around you.
A recent survey found that a third of people who work with a migraine sufferer are suspicious that migraine is used as an excuse for days off work. Perhaps we should be more sympathetic: the World Health Organisation has ranked a day with severe migraine as disabling as a day with quadriplegia, psychosis or dementia. It is not a psychological illness: "Migraine is very clearly a brain disorder," says Dr Paul Shanahan, consultant neurologist at the Headache Group, National Hospital for Neurology and Neurosurgery in London. "There are changes in activity of certain brain regions which occur during an acute migraine attack that give rise not just to pain, but a wide variety of symptoms. It's not 'just a headache', and it's certainly not psychological."
The mechanism underlying a migraine has been the subject of much debate over the years. Researchers used to think that the aura was caused by blood vessels in the brain narrowing. Then the vessels widen, which was thought to cause the headache. However, more recent research shows that blood flow changes may be a consequence of unusual brain activity rather than the initial cause of the migraine. During an aura, a wave of electrical activity travels slowly (at only a few millimetres per minute) across the surface of the brain. This can trigger a variety of symptoms including visual disturbance, pins and needles, speech difficulties and limb weakness. The way the brain processes sensations becomes disordered so that movement, lights, sounds and even smells become harder to tolerate.
Avoiding triggers can be useful so keeping a headache diary can help. However, only 20% of migraine sufferers have a dietary trigger. The British Association for the Study of Headache (Bash) guidelines warn that "too much effort in seeking triggers causes introspection and may be counter-productive. " If migraine can't be relieved by over-the-counter painkillers such as ibuprofen, triptans can help. Triptans can abort migraine attacks by mimicking the effect of the neurotransmitter serotonin at nerve receptors.Cluster headache
Cluster headaches cause severe throbbing pain on one side of the face around the eye. Each headache lasts for up to four hours and is often accompanied by a red eye, tears and a runny nose.
The pain can be unbearable. "Cluster headaches have been described as the most severe form of pain a human can experience," says Shanahan. "Occasionally patients can be driven to suicide by the severity and relentlessness of the pain, hence their description as 'suicide headaches'."
The name derives from their tendency to occur in clusters, often occurring at the same times every day. "These cycles can run for weeks, months or even years, and point to the brain's 'body clock' as having a role in the condition," says Shanahan.
Oxygen therapy (breathing pure oxygen through a mask for 20 minutes or more) is one of the best treatments for cluster headache and is available on prescription. However, not enough people are getting this, or other effective treatments such as sumatriptan injections, according to Shanahan. "These treatments for cluster headache are under-utilised, and, frustratingly, we see patients who are undertreated while having excruciating daily pain."Hangover
The exact cause of a hangover headache isn't known but there are plenty of likely culprits: alcohol causes blood vessels in the brain to widen and can alter the effects of serotonin on nerve endings – both of which occur in migraine. Alcohol also causes dehydration, a common trigger of migraine attacks. Fortunately the pain usually goes after some paracetamol and a good night's sleep but some may have migraine without realising it, according to Shanahan. "People who get headaches when thirsty may well have migraine, as do many people who get bad hangovers after fairly modest amounts of alcohol. Alcohol is often a very potent trigger for cluster headache, as well."Medication overuse headache
Paradoxically, all painkillers can cause a headache if taken regularly over a long period of time. Medication overuse headache is difficult to tell apart from the original headache so it can be very difficult to diagnose. Anyone who takes codeine or triptan-based drugs for more than 10 days a month or other over-the-counter remedies such as paracetamol or ibuprofen for 15 days a month is at risk.
The only treatment is to stop taking the painkillers. The headache often gets worse initially, and improvement may only be seen between a week and a month later.Brain tumour
Fewer than 4% of brain tumours present with a headache. Tumours cause the pressure within the skull to rise, which causes a morning headache and vomiting that gradually gets worse. Brain scans are only necessary when these or other features of a tumour such as weight loss, seizures or personality change are present.Subarachnoid haemorrhage
A sudden severe headache, usually at the back of the head, may be caused by a bleed inside the brain called a subarachnoid haemorrhage. Many people with this say it's like being hit with a baseball bat. It is commonly caused by the rupture of an aneurysm at the base of the brain and needs urgent investigation and treatment.Temporal arteritis
Headaches in people over 50 can be due to temporal arteritis. It often feels different to previous headaches and can be accompanied by a tender scalp or pain when chewing.
Temporal arteritis is caused by inflammation of the artery in the temple (hence "temporal") and can be treated with steroids. It is important to diagnose early as it can lead to blindness if untreated.Meningitis
A headache with a high temperature, neck stiffness and/or a new rash may be due to meningitis. This needs hospital treatment as soon as possible.
Migraine Action: migraine.org.uk
Ouch (the Organisation for the Understanding of Cluster Headaches): ouchuk.org
Why does the head hurt after alcohol
Even a small portion of alcohol can cause a headache in 80% of people. Why and how to escape from this headache, our neurologist Daria Zakharovna Korobkova told.
📎 What kind of headache is this?
This is pain that develops within 3 hours after drinking alcohol and disappears within 72 hours after you stop drinking alcohol. It has at least one of the characteristics:
- aggravated by physical activity;
- or may be pressing in nature and localized in the frontal region.
A headache that develops immediately after a person drinks alcohol is less common than a hangover headache (which begins when the blood alcohol level drops).
The intensity of pain depends on the quantity and quality of the drink, as well as on the individual characteristics of the person.
Alcohol also often triggers a migraine or cluster headache attack if the person suffers from these conditions. At the same time, only certain drinks can cause seizures. For example, red wine can provoke, and cognac - no. This moment is purely individual: therefore, try to identify your alcohol provocateur with the help of a diary and refuse it.
📎 What causes this headache. A bit of science.
Its mechanism, oddly enough, is not fully understood. But several factors probably work:
▪️ Alcohol affects the central nervous system and cerebral vessels
It is believed that alcohol can dilate the vessels of the meninges, which can manifest itself as a headache. In addition, it is believed that it also acts on the pain system of the brain. It is known that alcohol has a short-term analgesic property, however, after its withdrawal (especially when a significant amount is consumed), the so-called hyperalgesia occurs - an increased sensitivity of the body to pain stimuli.
Alcohol has diuretic properties: along with urine, liquid is removed from the body, the amount of blood decreases and the blood flow slows down, the removal of carbon dioxide is difficult. Vomiting and diarrhea associated with alcohol intoxication also lead to dehydration.
Acetaldehyde is a breakdown product of ethanol that occurs in the human body. When there is a lot of it, it has a toxic effect on brain cells, disrupting the work of neurotransmitters and changing the electrical activity of neurons.
▪️ Sleep is disturbed
Alcohol negatively affects the phase of REM sleep, in which the brain processes and remembers the information received and synthesizes various proteins involved in important brain processes.
What else: dark alcoholic beverages (whiskey, cognac, brandy) contain significantly more congeners - of other toxic chemical compounds other than ethanol (these are acetone, tannins, fusel oils, methanol), which are fermentation by-products. Therefore, it is believed that the risk of a hangover headache from dark drinks is higher.
📎 What to do with a hangover headache?
The classic headache after drinking alcohol usually goes away on its own within 72 hours. What else can help:
✅ sleep in a cool room or walk in the fresh air;
✅ compensation for dehydration: give preference to water without gas, and then drink tea or coffee. Better yet, drink two glasses (but no more) of sodium-magnesium mineral water - it makes up for the electrolyte deficiency after drinking alcohol;
✅ light snack (toast and a glass of juice, honey). Alcohol helps lower blood glucose levels, and a light snack will help replenish it;
✅ analgesics: aspirin, ibuprofen and other non-steroidal anti-inflammatory drugs. But not paracetamol - if alcohol and its metabolites have not yet been eliminated from the body, taking paracetamol can increase their toxic effects on the liver.
📎 What not to do
❌ Relieve a hangover with another portion of alcohol.
❌ Taking hot showers/baths and engaging in sports or physical labor if alcohol and its metabolites have not yet been eliminated, there is a risk of stress on the heart.
☝️ If the pain is very severe and does not subside for more than three days, even though taking analgesics, you need to see a doctor.
Image by Peggy and Marco Lachmann-Anke
Migraine plus dizziness. What is it and how to treat Chronic migraine in the elderly. Clinical features and treatment. Part 2. Chronic migraine: why it is difficult to recognize and treat. 1 part
How to get rid of a hangover headache
Headache is the most common hangover symptom that occurs as a result of intoxication of the body with alcoholic beverages. The condition is quite dangerous, because it not only negatively affects well-being, but can also cause irreparable damage to health. There are several ways to get rid of a headache on your own, but sometimes you need the help of a specialist.
Causes of a hangover
Frequent use of alcoholic beverages in unlimited quantities leads to disturbances in the body. The condition, which is commonly called a hangover syndrome, is caused by an increase in the concentration of toxic components. The state of intoxication provokes the development of some unpleasant symptoms:
- nausea and vomiting;
- dry mouth;
- dizziness and headache;
- tremor of limbs;
- pain and discomfort in the stomach and intestines;
- feeling of anxiety.
Hangover occurs due to the destructive effect of alcohol on the cells of the body. A large amount of alcohol destroys cell membranes, negatively affects the nucleus, disrupts the function of organelles.
Why does the head hurt
Most often a person is tormented by a headache after excessive drinking. Doctors point to several main causes that lead to headaches:
- mixing of several types of drinks;
The body accumulates acetaldehyde, which is a breakdown product of ethanol. The substance is very toxic, therefore it negatively affects the entire body as a whole, as soon as it enters the bloodstream. The brain suffers the most.
Dehydration or dehydration is a pathological condition that occurs when drinking alcohol. It is expressed not only in a decrease in the amount of moisture in the body, but also in violation of metabolic processes. Only 200 g of drunk alcohol can remove more than 800 g of water from the body. Together with it, many microelements are removed, which cannot be replenished immediately. The body tries to take fluid from the brain, which leads to severe pain.
Intoxication of the body is much stronger if you mix several types of alcohol during a feast. When drinking strong alcoholic beverages, the enzyme that breaks down ethanol is not synthesized. Alcohol with a high sugar content increases its concentration. For this reason, mixing drinks leads to the formation of toxins and disrupts the liver.
Age also causes headaches after drinking alcohol. The older a person is, the more difficult it is for his body to cope with the consequences of poisoning. First of all, this is due to a decrease in enzymatic activity. The rate of production of enzymes that eliminate ethanol is decreasing, which means that alcohol stays in the body longer. Accordingly, the signs of intoxication become more pronounced.
First aid for a hangover at home
First of all, you need to measure your blood pressure and count your pulse. Folk remedies and medicines for headaches will be ineffective if the indicators are too high. There are home methods by which you can quickly get rid of an unpleasant condition without a specialist. However, it is worth noting that they are suitable for those who are not dependent on alcohol and the use of alcoholic beverages was one-time.
How to replenish fluid in the body
Since alcoholic beverages lead to dehydration and wash out useful components from the body, it is important to replenish fluids in a timely manner. After drinking alcohol, it is recommended to drink fruit drinks, compotes, and a decoction of ginger is also useful. It thins the blood, has a calming effect, is able to quickly normalize the work of blood vessels, so the headache, as the drink is taken, gradually disappears. The decoction is not safe for those who have pathologies of the digestive tract.
Many people prefer to quench their thirst with brine. Within a few minutes after consumption, a surge of vigor, spasm relief and improvement in overall well-being are noted. It is advisable to drink cabbage brine, because it contains succinic acid. It stimulates liver function, promotes the rapid elimination of ethanol and prevents the development of hypoxia. However, for people with high acidity, the brine is not recommended for use.
In addition, recommended for use:
- green tea;
- bread kvass;
- natural juices, including tomato;
- mineral water without gas;
- fermented milk products (tan, curdled milk, kefir).
Drink in small portions, but often. It is forbidden to drink strong black tea and coffee, as well as drinks with a high sugar content. Separately, it is worth noting one of the most popular ways to deal with a hangover - a new portion of alcohol. Under no circumstances should this method be used. After a while, the relief is replaced by a more intense headache. Again, you need a serving of alcohol. This is how alcohol addiction develops. A person goes into a binge and then it is impossible to do without the help of a specialist.
Water treatments will help you get back to normal quickly. A visit to the bathhouse, sauna, and a hot bath is recommended. This will help relieve puffiness and eliminate toxins. Such procedures are allowed for people who do not have pathologies of the cardiovascular system.
The best solution is to take a warm bath. The water temperature should correspond to room temperature. This procedure will help to relax and bring the blood vessels back to normal. If there is no predisposition to allergies, you can add medicinal herbs to the bath, for example, chamomile, mint, motherwort, lemon balm.
Thus, folk methods of dealing with headaches are not as harmless and effective as it might seem at first glance. Sometimes they aggravate the condition and lead to serious complications. It is advisable to contact a narcologist who will give recommendations and help eliminate unpleasant consequences.
Medication therapy is the only way to deal with hangovers and headaches. It is allowed to drink a sorbent, antispasmodic or analgesic.
Sorbens are considered first aid for hangovers. They provide a quick removal of toxins from the body in case of poisoning. They can be of natural or synthetic origin. Adsorbent substances are not interconnected with gastric juice and are excreted naturally. The action of sorbents is accompanied by some additional therapeutic effects:
- normalization of water-salt metabolism;
- restoration of intestinal flora and mucous membranes;
- improvement of blood supply to the digestive tract;
- reducing the load on the liver.
The most common drug is activated charcoal. The minimum dosage is 1 tablet per 10 kg of body weight. If intoxication is severe, then the dosage should be increased. Modern analogue of activated carbon is Enterosgel. Even with severe alcohol poisoning, it is enough to drink 1-2 tbsp. l. means to feel relief. The drug is also recommended as a prophylaxis of intoxication. Sorbents should be taken separately from other drugs to prevent a decrease in effectiveness.
No-Shpa is a popular drug used for smooth muscle spasms. Headaches are also indications for use. The active substance is drotaverine, which is able to expand the vessels of the brain, improving blood supply to tissues.
Severe heart failure, as well as some pathologies of the liver and kidneys, are considered contraindications. It is forbidden to take no-shpu at the same time as alcoholic beverages, as this can lead to a decrease in blood pressure and swelling.
Succinic acid can quickly and effectively restore cells and tissues. It is used as an active substance that improves the metabolism and energy supply of cells and tissues of the body. The components that make up succinic acid reduce tissue hypoxia.
Aspirin is an antipyretic, analgesic and anti-inflammatory drug. Used as a blood thinner. Aspirin begins to act 15 minutes after application, normalizing blood vessels and improving blood flow. Relieves hangover headaches quickly and effectively. The drug should be used with caution in people with diseases of the gastrointestinal tract.
Ibuprofen has a strong analgesic effect, but unlike Aspirin, it does not harm the digestive tract. The drug acts for 3-4 hours. Ibuprofen is effective only with the simultaneous intake of a sufficient amount of liquid.
Contains acetylsalicylic acid. It has anti-inflammatory, antipyretic and analgesic effect. Indications are pain syndrome, including headache. Produced in tablet form. The tablets dissolve easily in water. They have a pleasant taste. Alkoseltzer should not be taken with gastrointestinal diseases.
The substance has a positive effect on the basic functions of the brain, has a tonic and tonic effect. However, to achieve maximum effect, it should be taken along with other medicines.
The drug not only effectively helps with a hangover, but also prevents unpleasant symptoms if you take Antipokhmelin before a feast. However, the remedy does not have a detoxifying effect, for this reason it is ineffective in case of severe alcohol poisoning.
Any drug has contraindications, so you should consult a specialist before taking it. This will help avoid side effects.
When a doctor's attention is needed
For people who rarely drink alcohol, the headache completely disappears within 1-3 days, subject to good rest. In the presence of alcohol dependence and detection of the following symptoms, the assistance of a narcologist is required:
- nausea and vomiting;
- throbbing headache in the parietal region;
- confused mind;
- severe edema;
- blurred vision.
Severe headache that does not go away within 3 days, sometimes worsens, is a sign of acute intoxication, may indicate the onset of cerebral edema, and often serves as a harbinger of heart attack and stroke. At risk are people over 35 years of age. If you experience these symptoms after drinking alcohol, you need to consult a doctor.
After carrying out some diagnostic measures, the narcologist will prescribe the necessary medicines and give recommendations. Often a specialist prescribes a dropper. It contains antispasmodics, sorbents, vitamin complex. Drugs with intravenous administration begin to act after half an hour.
If the binge is prolonged, hospitalization will be required, especially if there are chronic pathologies or symptoms that threaten the patient's life. In a hospital setting, plasmapheresis is possible. This is an extracorporeal procedure, which consists in cleansing the blood of toxic substances. During the procedure, blood is taken, and then the purified plasma is returned to the bloodstream.