Help for That Holiday Hangover Does Not Include Hair of the Dog

Q. During the holidays, I occasionally overdo hot toddies, not to mention champagne on New Year's Eve. What can I do for a morning-after headache?

A. Everyone seems to have a hangover remedy they swear by, such as a cup of coffee, a Virgin Mary or milk. Whether they work, however, is debatable. The surest remedy, of course, is not to overindulge. But if the holiday spirit should prevail, here's what can happen and what to do about it.

Clues to the Cause, But Not the Cure. Scientists have a pretty good idea what causes hangovers. Alcohol dilates blood vessels in the brain (contributing to headaches), acts as a diuretic (causing cotton mouth from dehydration), wreaks havoc with blood sugar (triggering dizziness and fatigue) and is irritating to the intestinal tract (causing stomach upset). Alcohol byproducts, called congeners, also contribute.

Less is known about combating hangovers. The caffeine in coffee may lessen a headache by constricting blood vessels, but it can also cause stomach upset and dehydration. The old adage to drink more "hair of the dog that bit you" (i.e. more alcohol) is the worst advice, says Seymour Diamond, M.D., chairman of the National Headache Foundation. What might help, he says, is honey, a good source of fructose, a sugar that speeds alcohol metabolism.

A recent review concludes that replacing lost fluids is what helps hangovers most. And of the few nutrients scientifically tested, vitamin B6 reduced hangover symptoms by half in one study of 17 people who took 400 milligrams before, during and after drinking.

What about advertised remedies like Hangover Helper? Don't count on them. Most such products combine herbs, vitamins, minerals and other substances to purportedly replace lost nutrients and counter the toxic effects of alcohol. Alcohol does cause nutrient deficiencies in chronic drinkers, but not in the occasional overimbiber.

EN's Bottom Line. The only sure way to prevent a holiday hangover is to abstain. If you do indulge, keep it moderate. Dilute liquor (even wine) with mixers like seltzer, water or juice. Eat something before and during drinking to slow alcohol absorption. Drink extra fluids before going to bed and the next day. Be especially cautious about taking over-the-counter pain relievers after ingesting alcohol: Aspirin and ibuprofen can trigger stomach bleeding; acetaminophen can cause liver damage.