Instant Hangover?

July 24, 2012 8:16 AM

Why do I start getting a hangover almost immediately after I start drinking?

I've always been more susceptible to hangovers than the average person (at least as compared to friends and drinking buddies). In college and throughout my 20's, I could have some drinks (anywhere from 3-5) with no real problem other than a small headache in the morning solved by drinking water. When I would drink more (6-12 drinks) I would have a moderate hangover, requiring ibuprofen, lots of water, and a few extra hours of sleep. At parties where I drank a lot (12 or more over the course of the night), I would get a nasty hangover the next day - bad headache, nausea, etc. Only rehydration, ibuprofen, and lots of sleep helped. Many hangovers from large consumption would last all morning and into the afternoon, if not all day long.

Now, in my early 30's, I start getting a hangover while I'm still drinking. I will get a headache after just a couple drinks. It doesn't matter what I'm drinking - beer, wine, liquor (mixed or straight). It also doesn't matter how quickly I drink - it could be 2-3 drinks quickly or over the course of an entire evening. Occasionally I'll get tipsy before the headache starts, and keep drinking, perhaps up to 6-8 total drinks for the night. This knocks me out for the entire following day, every time, whereas it used to just slow me down in the morning. Also, my next-day hangover headaches now seem to be much more comprised of shooting pains rather than the dull, pounding, whole-brain-hurts headaches associated with dehydration and the hangovers of my youth.

I have tried everything I can think of to prevent this. I'm always well-hydrated, and make an extra effort to hydrate before I start drinking. Generally I eat healthy, and I take a few daily supplements to make sure I'm getting enough of what my body needs, specifically a daily multi, B-complex, C, and D. I'm currently on daily Flonase sprays for sinus issues, but this instant hangover thing developed before I started the Flonase. No other medications. I have tried taking ibuprofen preventively at the start of the evening, but it didn't seem to help. I have also taken extra vitamins just before going out to see if that boost would help - it did not.

I only drink alcohol 3-5 times per month, socially, and want this to continue. I know YANMD, and anything said is NMA, but can anyone shed some light on what might be going on and how to stop it? I plan on addressing this at my next physical, but that's not for a few months. I am looking for potential causes of this physiological response and prevention measures. If the only prevention is to stop drinking totally, I'll deal with that - but please no comments along the lines of "just stop drinking now" unless you can back it up with a specific medical condition matching my symptoms with that course of treatment/prevention.

posted by trivia genius to Health & Fitness (29 answers total)

Best answer: That doesn't sound like a hangover, that sounds like alcohol-triggered migraines.
posted by Holy Zarquon's Singing Fish at 8:18 AM on July 24, 2012 [11 favorites]

Are you asian
posted by MangyCarface at 8:23 AM on July 24, 2012

Welcome to getting older. I was that party girl, in the street with my cheek on the curb because I was hot. I'd drink a lot and it never bothered me.

Now, my metabolism changed and I have the tolerance to deal with about a half a drink.

You might want to check out the migrane scenario. I get them occasionally and I find that a combination of Caffiene, Aceteminophen and Aspirin works well (Excedrine. Don't worry about what formula is on the bottle, it's all the same stuff.)

Bonus points for AC&C that you can get in Canada. Can you say 8 grams of Codeine? Awesome stuff!

You might have developed a sensitivity and there's not a lot you can do about it. Caffiene is a great headache cure, so have cocktails with coffee or cola.
posted by Ruthless Bunny at 8:25 AM on July 24, 2012

Best answer: Hi, welcome to your 30s. It only goes downhill from here.

This does really sound like migraines triggered by drinking, tbh. Also, stop taking ibuprofen with your alcohol, your liver will thank you.
posted by elizardbits at 8:26 AM on July 24, 2012 [7 favorites]

Meant to say - try some imitrex or similar and see if it kicks the headache's ass.

wait do headaches have asses?
posted by elizardbits at 8:27 AM on July 24, 2012

Ah, getting older. Once I hit 30, drinking definitely started to carry a bit more baggage for me, often like you describe. Some types of booze results in pretty much instant headache for me: most grain alcohol, and most mass produced American beer, and some extra malty beers. Some people have suggested that it might be a gluten allergy.

I've had the best luck taking an ibuprofen as I'm drinking, or as I just stop drinking, as a preventative. This is obviously not a particularly healthy thing to do so.. you know.. don't do it too often.
posted by dobie at 8:30 AM on July 24, 2012

Response by poster: Sorry, I'm male, white, American, early 30's.

HZSF - holy smokes! I didn't realize alcohol could trigger migraines! I used to get them quite often in my early teenage years (before I started drinking) but they dropped off in frequency to almost zero by adulthood. This seems a likely explanation.

elizardbits - I only tried the ibuprofen once as a test. I never take it while still drinking, specifically so I can keep my liver alive :)

Thanks everyone for the quick answers! This at least gives me a jumping off point to talk to my primary about during my next physical. Until then, I'll further limit my drinking and take better notes to see if there are any more specific details about what triggers the headaches.
posted by trivia genius at 8:33 AM on July 24, 2012

Also, fascinating trick that it took me decades to discover - if you stay awake long enough to feel soberish again (like stop drinking ~5h before bedtime) you will not be hungover the next day. It is some kind of crazy dark magicks.
posted by elizardbits at 8:33 AM on July 24, 2012

I know it's a YMMV thing for some, but really, 6+ drinks in the course of an evening is borderline hell-of-a-lot territory. If spread out over a few hours and taken with some food, it may not make you stinking drunk, but it's still a lot of alcohol for your system to process. Some of the quantities you've described sound more like binge drinking than social drinking to me.
posted by randomkeystrike at 8:34 AM on July 24, 2012 [2 favorites]

Response by poster: randomkeystrike - I agree, the amounts I consumed in college and at parties in my early 20's were binge drinking territory - that's the whole point at that age, right?

Just to clarify though, my current consumption is almost exclusively 2-4 drinks over the course of an evening, with food, usually averaging out to less than a drink per hour - meaning my liver is processing it as fast or faster than I'm taking it in (assuming it's working correctly).

At parties where I drink more, it's still no more than 8 drinks over 5-6 hours, again with food and non-alcoholic beverages in the mix. So again, nothing I would categorize as binge drinking considering the timeframe involved.
posted by trivia genius at 8:37 AM on July 24, 2012

It does sound like a migraine triggered by alcohol. Vitamins (unless prescribed by a doctor for a specific deficiency) are an expensive way to lace your urine with expelled supplements, so I wouldn't bother with vitamin regimens in an attempt to prevent hangovers.

You're technically not supposed to mix ibuprofen or acetaminophen with alcohol, and caffeine just exacerbates the main cause of hangover symptoms, which is dehydration.

My rule of thumb to prevent hangover is one full glass of water per drink/glass of wine/bottle of beer, then another full glass before bed.
posted by xyzzy at 8:39 AM on July 24, 2012

Also, stop taking ibuprofen with your alcohol, your liver will thank you.

For the record, ibuprofen is processed by the KIDNEY not the liver. Other painkillers are processed by the liver and not to be taken with alcohol. Your risk of stomach bleeding does increase if you take both alcohol and ibuprofen though so it is not strictly good.

It just won't overload your liver like other alcohol + OTC painkillers might.

This has been your handy body tip for the day.
posted by OnTheLastCastle at 8:46 AM on July 24, 2012 [15 favorites]

I wouldn't bother with vitamin regimens in an attempt to prevent hangovers

Truth, BUT! Magnesium supplements are fairly good as migraine prophylaxis. They have a bit of a laxative effect, unfortunately.
posted by elizardbits at 8:47 AM on July 24, 2012 [1 favorite]

Acetaminophen is the liver-killing painkiller. Don't OD on that either.

And yeah, alcohol in general can trigger migraines. Most people who get the headaches from booze are only susceptible to a specific kind of drink - red wine is a common culprit - but you may be one of the lucky few. Definitely check with a doctor, but especially with your history, I'd put money on migraines.
posted by Holy Zarquon's Singing Fish at 8:50 AM on July 24, 2012

My husband swears by alternating a drink or two with an entire bottle of water. He says it works wonders for preventing feeling terrible during and after drinking. For me, that's a lot of bathroom breaks but maybe you could try it. Maybe just drinking a lot (A LOT) of water prior to going out would help? Hydration is a powerful thing.
posted by als129 at 8:56 AM on July 24, 2012

If this was me, I'd set up a test pretty much the same as I would with a suspicious food. Control: two drinks over 1.5-2 hours, ideally at home (so no smoke/perfume/Axe, no noise, blinky lights, odd bar foods, etc). Take notes every 15 minutes.

If you get a result, I'd suggest trying the test again a couple of nights later, except this time take an antihistamine 2-4 hours before. Because while I agree with the migraine theory, allergies could be a close runner-up and would explain the across-the-board reaction, whereas most migraine sufferers usually have some option that doesn't set them off. Also, if you know what a migraine feels like, you should be able to tell if what you are having are, in fact, migraines.
posted by Lyn Never at 9:01 AM on July 24, 2012

I've noticed that it happens with certain liquors (bye gin) and beers (bye Blonde Fatale), especially if I have 1-2 of those drinks then stop drinking.

The only solution I've found is sleep.
posted by OnTheLastCastle at 9:16 AM on July 24, 2012

Take Emer-Gen-Cee or whatever that is (you mix it up in water).

Or stop drinking.
posted by discopolo at 9:23 AM on July 24, 2012

Arggg, this started happening to me once I hit 28. In my "party days" I could drink 10-12 drinks and not have a single symptom of a hangover.

Now... I can have 1-2 drinks and get a migraine.

I do suffer from headaches and migraines which started getting worse when I hit 30 (I'm 32 now). So - I'm guessing the alcohol is now a trigger for my worsening migraines.

The last time I drank, I had a big bottle of gatorade and took some excedrin beforehand. Then drank a bunch of water afterward and I didn't get a headache or hangover. I think I only had 2-3 drinks, though.
posted by KogeLiz at 9:24 AM on July 24, 2012

I second Lyn Never's test suggestion, and for the antihistamine, try taking Pepcid, Tagamet, or Zantac (all OTC meds). They are marketed as antacids, but they also have an action on a histamine receptor. I have a friend who has headache/flushing reactions to wine, but if she takes one of those a couple hours before, she can have a glass with no reaction. (IANAD, this was recommended to me by a doctor, you might want to ask yours before actually trying this, etc.)
posted by bedhead at 9:25 AM on July 24, 2012 [2 favorites]

I get alcohol-triggered migraines pretty regularly when I have more than a couple drinks (so I rarely do). sticking to clear liquors and white wine helps somewhat; red wine, beer and champagne are head murder.
posted by changeling at 9:27 AM on July 24, 2012

I am allergic to the sulfite preservatives in wine, and they trigger a headache soon after I begin drinking and make me feel bad for the next day. Sulfured apricots trigger the same reaction. I can drink grain alcohol just fine. So you may try testing for sulfite sensitivity.
posted by effluvia at 9:42 AM on July 24, 2012

nthing that this sounds like alcohol induced migraines instead of a hangover. Are you always mixing alcohol while drinking? You might want to stick with one type of booze for the evening and see if there is something that doesn't trigger a headache. My dad gets severe migraines triggered by alcohol, but can drink bottled beer without an issue--but not beer on tap. I forgot the reason, though.
posted by inertia at 10:27 AM on July 24, 2012

Nthing what everyone else said about alcohol-induced migraines. But also...you might consider checking out other foods that you've eaten within 24 hours of the alcohol, too. I have migraines and alcohol is a trigger for me, but it will usually only trigger a headache if I've *also* experienced some additional trigger as well, e.g. rapid weather change, having eaten citrus (esp. lime) or chocolate, lack of sleep, etc.

In other words, if the weather has changed + I've had some chocolate + I've been burning the candle at both ends, I know that having a drink will likely push me over the edge so I'll skip the drink. And yeah, champagne or red wine will tip the balance faster than a nice single malt. YMMV, of course.
posted by skye.dancer at 12:28 PM on July 24, 2012

I don't know of a way to reverse an aging liver, but I have found that the quickest way to get rid of a hangover in addition to re-hydration is intense exercise. Go out and run as fast as you can for at least a half an hour. I imagine that boosting your metabolic rate will hasten removal of excessive NADH and acetaldehyde that have built up as a biproduct of -OH metabolism. It's painful but a hangover is painful anyway, and after an intense workout and shower you will feel much better for realz.
posted by waving at 1:01 PM on July 24, 2012 [1 favorite]

You may have developed an allergy to alcohol. Suggestion: try taking the ibuprofen half an hour before drinking.
posted by deborah at 3:56 PM on July 24, 2012

I know you said it happens when drinking everything, but have you really drunk everything? Can you try, say, a different brand of beer than what you're used to, or maybe mixing drinks with things other than what you're used to. I've started to get the exact same feeling when I drink champagne, though I used to be able to drink it fine.

no more than 8 drinks over 5-6 hours.... nothing I would categorize as binge drinking considering the timeframe involved.

Whether you do or not, 8 drinks on one occasion looks similar to the cdc's classification of binge drinking.

I think you're just doing severe damage to your body with your drinking, and this pain is the result.

I am not telling you : "just stop drinking now" because I know you don't want to hear that. But even over two drinks goes into "heavy drinker" territory. It doesn't sound like you need to stop drinking - you need to stop drinking so heavily. By your own accounts the headaches might start after a couple (minimum 2) drinks - so stop drinking more than two drinks and see how that works.

Also hydrate WHILE you drink.

I'm super-headache prone, but I have only gotten a hangover once in my life, and I have no doubt it was because that time I wasn't able to get to water while drinking,
posted by Lt. Bunny Wigglesworth at 11:04 PM on July 24, 2012 [1 favorite]

if you stay awake long enough to feel soberish again (like stop drinking ~5h before bedtime) you will not be hungover the next day.

There's much to be said for this. If you're a nighttime partier, this technique may be a non-starter, but if you can change up your drinking patterns it may be effective. Try drinking at lunchtime, or shortly thereafter. At bedtime, you'll be stone sober and mostly at the tail end of your hangover symptoms.

The other positive benefit of this system is that you can rehydrate through the afternoon--or even while drinking.

I've heard that noontime consumption of other, er, products can eliminate the fog-on-the-brain symptom that appears the next day.
posted by Gordion Knott at 3:10 AM on July 25, 2012

Are you a redhead? Apparently, red heads have a more than average chance of inheriting a genetic expression where a busted protein necessary for the metabolism of alcohol is in short supply.
posted by clvrmnky at 7:14 PM on July 25, 2012