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As the years go by, it gets harder to shake off the head-and-stomach-achey aftereffects of a night of drinking. Hangovers seem to get worse as we get older — and it’s not your imagination. It is, unfortunately, science.
We all know what a hangover is: headaches, nausea, loss of appetite, diarrhea, shakiness or fatigue after drinking too much. The word practically defines itself: The medical term for “hangover” is “veisalgia,” which is from the Norwegian word “kveis” — which means “uneasiness following debauchery.”
The weird thing is scientists and doctors don’t totally understand what causes a hangover. But we do know it's a side effect of overwhelming the body with more alcohol than it can efficiently break down.
Alcohol metabolism is a two-step process in the liver, where enzymes first break the alcohol down into acetaldehyde.
“This toxin is probably the reason for a lot of the gross feelings that come with a hangover,” explains Dr. Rachel Vreeman, co-author of the book “Don’t Swallow Your Gum!” and assistant professor at the Indiana University School of Medicine.
That’s because acetaldehyde is highly toxic — between 10 and 30 times more toxic than alcohol itself. The enzymes in your liver are next tasked with breaking down the acetaldehyde further, into a non-toxic substance called acetate. But your liver can only metabolize about one drink per hour — so if you’re drinking more quickly than that, not all of the acetaldehyde gets broken down. In that case, the acetaldehyde is released into the blood stream to wreak havoc around your body, resulting in the awful feelings associated with a hangover.
There aren’t a lot of strong studies looking at how age affects the human body’s efficiency at breaking down alcohol, but a toxicology researcher in South Korea named Young Chul Kim has led studies looking at this process in aging rats. He has a few theories on why hangovers are especially unbearable as we get older.
1. Liver capacity changes.
“Many factors appear to be involved in worsening of hangover in old age. One is that the liver capacity to cope with the toxicity of acetaldehyde decreases as we get old,” Kim said in an email. Acetaldehyde is directly detoxified in the liver by an antioxidant called glutathione. “Our data indicated that, as age increases, glutathione generation capacity is decreased, so cells may not be recovered or repaired rapidly.”
It’s just like everything else about us as we get older, points out Madelyn Fernstrom, nutrition and health editor for NBC News. “You can still do it, but you do it a little slower,” she says.
2. Body size.
Another possible link between age and killer hangovers: We’ve gotten fatter. Or, thinner! Change in body size, in either direction, can potentially worsen a hangover.
“When one’s body weight has increased, blood alcohol level decreases because of its wide distribution into body mass and fat, which leads one to drink extra glasses without realizing it, subsequently resulting in generation of more acetaldehyde,” Kim says. “Or when one’s body weight decreases, greater intoxication results due to limited distribution to the body after consumption of an equal amount of alcohol.”
3. Taking other medications.
Older people also might be more likely to be on medications, or taking supplements, which may interfere with the metabolism of alcohol, experts say.
4. Retreat until we feel better.
But experts agree that perhaps the most significant, if least scientific, explanation as to why hangovers feel so much worse when we get older is simply that we're less likely to want to warrior through the headache and nausea, and much more likely to want to retreat to the couch until we feel better.
“Many people are less accustomed to having hangovers once they are older because they just do not drink as regularly anymore,” Vreeman says. “The wisdom of age?”