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Hangover and Homoeopathy

© Dr. Rajneesh Kumar Sharma MD (Homoeopathy)

     Dr. Swati Vishnoi BHMS

     Dr. Preetika Lakhera BHMS

For well formatted and illustrated article, please see attached file.

Hangover and Homoeopathy.docx

Contents

Definition. 2

Signs and symptoms. 2

Causes. 3

Pathophysiology. 3

Factors causing hangover. 4

Acetaldehyde. 4

Acetic acid. 4

Congeners. 4

Dehydration. 5

Hypoglycemia. 5

Immune system.. 5

Individual factors. 5

Genetics. 5

Age. 5

Sex. 5

Cigarette smoking. 5

Treatment. 6

Rehydration. 6

Opuntia ficus-indica Q.. 6

Pyritinol 6

Homoeopathic treatment. 6

General remedies for Hangover. 6

Short repertory of Hangover. 6

Bibliography. 9

 

Definition

Hangover is a syndrome of delayed, disagreeable physical aftereffects, following heavy consumption of alcohol in a relatively short period of time, or the use of drugs, characterized by headache and sometimes nausea and dizziness (Psora/ Sycosis/ Syphilis).

Signs and symptoms

Hangover has following main symptoms that may last more than 24 hours-

  • Anxiety (Psora)
  • Changes in sleep pattern (Psora)
  • Concentration problems (Psora)
  • Dizziness or faintness (Psora)
  • Drowsiness and impaired cognitive function (Psora)
  • Dry mouth (Psora)
  • Fatigue (Psora)
  • Feeling of general discomfort or malaise (Psora)
  • Gastrointestinal complaints (Psora)
  • Headache (Psora/ Sycosis)
  • Hyper-excitability (Psora/ Syphilis)
  • Loss of appetite (Psora/ Syphilis)
  • Nausea (Psora)
  • Stomach ache (Psora)
  • Sweating (Psora)
  • Tachycardia (Psora)
  • Thirst (Psora/ Sycosis)
  • Tiredness (Psora/ Syphilis)

Alcohol hangover symptoms develop when blood alcohol concentration falls considerably and are maximum when it returns to almost zero (Psora/ Syphilis).

Causes

Many pathophysiological changes are responsible for the alcohol hangover-

  • Increased levels of acetaldehyde (Sycosis)
  • Hormonal alterations of the cytokine pathways (Psora)
  • Hypoglycemia (Psora/ Syphilis)
  • Dehydration (Psora)
  • Metabolic acidosis (Sycosis)
  • Disturbed prostaglandin synthesis (Psora)
  • Increased cardiac output (Psora)
  • Vasodilation (Psora)
  • Sleep deprivation (Psora/ Syphilis)
  • Insufficient eating (Causa occassionalis)
  • Congeners e.g. methanol (Causa occassionalis)

Congeners are complex organic molecules found in alcoholic beverages which may play an important role in producing hangover. They are metabolized to the notably toxic substances like formaldehyde and formic acid.

Pathophysiology

After being drunk, ethanol is first converted to acetaldehyde by the enzyme alcohol dehydrogenase and then to acetic acid by oxidation. These reactions also convert nicotinamide adenine dinucleotide (NAD+) to its reduced form NADH by redox reaction. By causing an imbalance of the NAD+/NADH redox system (Psora), alcoholic beverages create normal bodily functions more difficult. Alcohol also encourages the CYP2E1 enzyme, which metabolizes ethanol and other substances into more toxic substances (Psora/ Sycosis).

The alcohol induced redox alterations in the body cause-

  • Increased triglyceride production (Sycosis) 
  • Increased amino acid catabolism (Syphilis)
  • Inhibition of the citric acid cycle (Psora)
  • Lactic acidosis (Psora/ Sycosis)
  • Ketoacidosis (Psora/ Sycosis)
  • Hyperuricemia (Psora)
  • Disturbance in cortisol and androgen metabolism (Psora)
  • Increased fibrogenesis (Sycosis)
  • Disturbed metabolism of glucose and insulin (Psora)

Factors causing hangover

Acetaldehyde

Acetaldehyde, the first by-product of ethanol, is many times more toxic than alcohol itself and can remain at an elevated plateau for many hours after initial ethanol consumption. The high concentration of acetaldehyde causes the alcohol flush reaction, called as the "Asian Glow".  Acetaldehyde may also influence glutathione peroxidase, a key antioxidant enzyme, and increases the susceptibility to oxidative stress.

Acetic acid

It can cause adenosine to accumulate in many parts of the brain causing headaches.

Congeners

Besides ethanol and water, most alcoholic drinks also contain congeners, as flavoring agents or as a by-product of fermentation and the wine aging process. Congeners may aggravate hangover and other residual effects. Congeners include-

  • Amines
  • Amides
  • Acetones
  • Acetaldehydes
  • Polyphenols
  • Methanol
  • Histamines
  • Fusel oil
  • Esters
  • Furfural
  • Tannins

Different types of alcoholic beverages contain different amounts of congeners. In general, dark liquors have a higher concentration than clear liquors. Therefore, darker liquors produce worst hangovers. Rank of alcohols as per hangover (from low to high)-

  • Distilled ethanol diluted with fruit juice
  • Beer
  • Vodka
  • Gin
  • White wine
  • Whisky
  • Rum
  • Red wine
  • Brandy

Dehydration

Ethanol causes diuresis leading to dehydration, which may cause thirst, dry mouth, dizziness and even electrolyte imbalance. Alcohol induces hyperchlorhydria causing nausea.

Hypoglycemia

Hangover is related with a decrease in blood glucose concentration. Severe hypoglycemia by insulin shock may lead to coma or even death.

Immune system

Disturbed immune system due to alcohol intake, specially cytokine metabolism is the cause of hangover state. The highly increased concentration of several cytokines causes nausea, headache, and fatigue. These include interleukin 12 (IL-12), interferon gamma (IFNγ) and interleukin 10 (IL-10).

Individual factors

The personality, genetics, health status, age, sex, associated activities during drinking such as smoking, the use of other drugs, physical activity such as dancing, as well as sleep quality and duration are also modifying factors for hangover.

Genetics

Alleles associated with aldehyde dehydrogenase (ALDH) and flushing phenotypes as in alcohol flush reaction in Asians influence the alcohol tolerance hangover.

Age

Due to declining supplies of alcohol dehydrogenase with increasing age, some people experience hangovers with ageing.

Sex

Women are more prone to hangover than men, due to sex differences in the pharmacokinetics of alcohol. Women attain a higher blood alcohol concentration than men at the same number of drinks.

Cigarette smoking

Acetaldehyde is absorbed from cigarette smoking during alcohol consumption and is contributor to hangover.

Treatment

Rehydration

High water intake reduces all the symptoms considerably.

Opuntia ficus-indica Q

An extract of a species of cactus may reduce some effects of hangover. Opuntia ficus-indica or Barbary fig is most effective in drinks with high levels of congeners.

Pyritinol

Pyritinol is a synthetic Vitamin B6 analog, can help to reduce hangover symptoms.

Homoeopathic treatment

General remedies for Hangover

acet-ac. aesc-g. agar. ambr. anis. Ant-c. ant-t. apom. Ars. asar. astac. aur. bry. calc-ar. Carb-v. carbn-s. card-m. chel. chin. coca cocc. coff. colch. heroin. IP. lac-d. Laur. led. Luna lup. mand. nat-c. nux-v. olib-sac. plat-m. positr. Puls. querc. Ran-b. rhus-t. sabin. spect. staph. stry. sul-ac. sulph. Verat.

Short repertory of Hangover

ABDOMEN - INFLAMMATION - Liver - alcohol; from med. nux-v.

BLADDER - RETENTION of urine - alcohol; abuse of kreos.

BLADDER - URINATION - dysuria - painful - alcohol; from ars. bell. calc. hep. lach. merc. NUX-V. Puls. Sulph.

CHILL - ALCOHOL; from abuse of led. Nux-v.

COUGH – ALCOHOL arn. ferr. ign. lach. led. Spong. stann. stram. zinc.

EXTREMITIES - TREMBLING - Hand – alcoholic phos.

EYE - ALCOHOLISM agg. calc. Chin. lach. nux-v. op. sulph.

EYE - AMBLYOPIA - alcohol; from ter. tub.

FACE - DISCOLORATION - red - alcohol; after aloe bamb-a. bapt. carb-v. sulph.

Food - ALCOHOL, general - agg. – hangover luna lup. Nux-v. plat-m. ran-b.

GENERALS - CONVULSIONS - alcoholic drinks; after ran-b.

GENERALS - DROPSY - general; in - alcoholism, from ars. fl-ac. sulph.

GENERALS - FOOD and DRINKS - alcoholic drinks - agg. - hangover; excessive acet-ac. aesc-g. Agar. anis. ant-t. apom. Ars. asar. astac. aur. calc-ar. carb-v. carbn-s. card-m. coca cocc. Luna nux-v. olib-sac. plat-m. positr. querc. Ran-b. stry. sul-ac. sulph. Verat.

GENERALS - FOOD and DRINKS - alcoholic drinks - agg. - intoxicated; easily adam. aids. alum. bov. chinin-m. CON. haliae-lc. lac-h. luna naja nat-sil. nux-v. ozone positr. sal-fr. Zinc.

GENERALS - FOOD and DRINKS - alcoholic drinks - agg. absin. acet-ac. acon. adam. aesc-g. aeth. Agar. agav-t. aids. ail. alco. aloe alum-p. alum-sil. alum. alumn. Am-c. am-m. ambr. anac. ang. anis. Ant-c. ant-t. anthraci. apis apoc. apom. aran-ix. arg-met. Arg-n. arn. ARS. arum-i. ASAR. astac. aur-m-n. AUR-M. aur. aven. bamb-a. BAR-C. Bell. ben-d. benz-ac. berb. bism. borx. bov. brucel. bry. bufo cadm-s. calad. Calc-ar. calc-f. calc-s. calc-sil. Calc. Cann-i. caps. Carb-ac. carb-an. Carb-v. Carbn-s. card-m. caust. cerev-lg. Chel. chim-m. Chin. chinin-m. chir-fl. chlol. chlor. cic. cimic. cina coc-c. Coca cocc. Coff. colch. Coloc. Con. cor-r. cortiso. crat. Crot-h. cupr-ar. cupr. daph. Dig. eup-per. ferr-i. Ferr. fl-ac. gaul. gels. gink-b. Glon. gran. grat. guar. ham. hed. Hell. hep. hippoz. hydr. hyos. Ign. ignis-alc. ina-i. ip. kali-bi. Kali-br. kali-m. kali-n. Lac-e. LACH. lat-m. laur. Led. Lob-p. Lob. Luna lup. Lyc. mand. Merc. mez. naja Nat-c. Nat-m. nat-p. nit-m-ac. Nux-m. NUX-V. OP. osm. ozone paull. Petr. phasco-ci. phel. Phos. phyt. pic-ac. psil. Puls. querc. RAN-B. rauw. Rhod. Rhus-t. rumx. Ruta sabad. sal-al. Sang. sars. Sec. SEL. sep. Sil. Spig. stann. staph. Stram. stront-c. stroph-h. stry. succ-ac. SUL-AC. SULPH. sumb. symph. Syph. tab. ter. thea thuj. trinit. tung-met. verat. zinc. zing.

GENERALS - FOOD and DRINKS - alcoholic drinks - ailments from alumn. ARS. aur. calc. Carb-v. Carbn-s. coff. ferr-i. guar. Kali-bi. led. NUX-V. positr. querc-r-g-s. Ran-b. sep. SUL-AC. Sulph.

GENERALS - FOOD and DRINKS - alcoholic drinks - amel. Acon. agar. androc. arg-n. bufo canth. castm. Con. dicha. GELS. Granit-m. hell. ign. kreos. lach. naja nat-m. op. phos. sel. sep. sul-ac. thea

GENERALS - HANGOVER - amel. mand.

GENERALS - HANGOVER - sensation as if from a hangover luna olib-sac. spect.

GENERALS - HANGOVER - sensation as if from a hangover luna olib-sac.

GENERALS - PARALYSIS - alcohol, after abuse of ant-t. Ars. calc. Lach. nat-s. Nux-v. OP. ran-b. sep. Sulph.

GENERALS - PARALYSIS AGITANS - alcohol; after abuse of Hyosin-hbr.

GENERALS - TREMBLING - Externally - alcoholism; from ant-t. Ars. Crot-h. Lach. Mag-p. Nux-v. sul-ac. sulph.

GENERALS - TWITCHING - alcoholism, in Crot-h. Phos.

GENERALS - WEAKNESS - alcoholic drinks amel. Canth. nit-s-d. thea

GENERALS - WEARINESS - alcoholic drinks; from olib-sac.

HEAD - ALCOHOLIC drinks-agg. acon. Ant-c. Ant-t. ars. bell. bry. Calc. carb-an. CARB-V. chin. coff. ip. nit-ac.nux-m.NUX-V. op. par.ph-ac. phos. Puls.Ran-b. rhus-t. ruta sabad. sabin. sil.Sulph. tarax. Verat.

HEAD - ALCOHOLIC drinks - amel. naja

HEAD - CONGESTION - alcoholic liquors agg. calc-s. Calc. Glon. Lach. verat-v. Zinc.

HEAD - CONSTRICTION - Forehead - alcohol amel. granit-m.

HEAD - PAIN - nail, as from a - alcoholic drinks; after ruta

HEAD - PAIN - odors - alcohol, of sol-t-ae.

HEAD - PAIN - stunning, stupefying - morning - waking; on - alcoholic drinks; as from chin. kali-n. NAT-M. Tarent.

MIND - AILMENTS FROM – alcoholism agar. ars. asar. Bell. calc. Cocc. con. lach. Lyss. nux-v. op. ph-ac. Phos. Stram. sulph. zinc.

MIND - ALCOHOL - agg. acon. am-m. ang. arg-met. bell. chin. con. laur. Nux-v. Puls. rheum squil.

MIND - ALCOHOL - amel. olnd.

MIND - ALCOHOLISM – acute Apoc.

MIND - ALCOHOLISM - constipation; with Apom.

MIND - ALCOHOLISM - diabetes; with med.

MIND - ALCOHOLISM - drinking on the sly Med. Sulph.

MIND - ALCOHOLISM - excitement, from alcoholism stram. zinc.

MIND - ALCOHOLISM - get up at night to drink; must ars. caps. nux-v.

MIND - ALCOHOLISM - grief; after caust.

MIND - ALCOHOLISM - hypochondriasis, with NUX-V.

MIND - ALCOHOLISM - idleness, from lach. nux-v. sulph.

MIND - ALCOHOLISM - irritability, with Nux-v.

MIND - ALCOHOLISM - menses; before SEL.

MIND - ALCOHOLISM - oblivion is like; drinking to see what positr.

MIND - ALCOHOLISM - pregnancy, during or after nux-v.

MIND - ALCOHOLISM - remove the habit of drinking; to kola Querc-r-g-s. stry-n.

MIND - ALCOHOLISM - timidity; from med. merc.

MIND - ALCOHOLISM - upper limbs; with complaints of ARS. lach. Nux-v. sulph.

MIND - ALCOHOLISM - weakness of character; from ars. petr. puls.

MIND - ALCOHOLISM - withdrawal from; to support the ange. asar. bufo calc-ar. carc. Chin. kola passi. phos. querc. stroph-h. stry-n. sul-ac. sulph.

MIND - CLARITY of mind - alcohol; in spite of olib-sac.

MIND - CONCENTRATION - difficult - alcohol amel. irid-met.

MIND - CONFUSION of mind - alcoholic drinks; after cocc.

MIND - DELIRIUM TREMENS - small quantity of alcoholic stimulants, from OP.

MIND - EXCITEMENT - alcohol amel. coca-c.

MIND - INDIFFERENCE - dearest friends; even towards - alcoholism; in chronic Phos.

MIND - KORSAKOFF's psychosis – alcoholism agar. verat.

MIND - QUARRELSOME - alcoholism; in p-benzq.

MIND - SADNESS - alcoholics; in carc.

MIND - TIMIDITY - alcohol amel. nat-m.

MIND - UNCONSCIOUSNESS - alcoholic gels. Glon. hyos. Kali-br. lach. Stram.

MOUTH - PAIN - alcoholic drinks rhus-t.

NOSE - CORYZA - alcoholic drinks - agg. fl-ac.

NOSE - EPISTAXIS - alcoholics; in Acon. bell. bry. Carb-v. hyos. Lach. nux-v. SEC.

NOSE - SWELLING - pustulous - alcoholics; in alum. caust. hep.

RECTUM - DIARRHEA - alcoholic drinks, after ant-t. ars. lach. NUX-V. sulph.

RESPIRATION - ASTHMATIC - alcoholics; in coca

SLEEP - SLEEPINESS - alcohol; after drinking Glon.

SLEEP - SLEEPLESSNESS - alcohol - agg. agav-t.

STOMACH - ALCOHOLIC drinks - amel. olnd. sul-ac.

STOMACH - ANXIETY - morning - waking; on - alcoholics; in ASAR.

STOMACH - COMPLAINTS of the stomach - alcoholics; in ant-t.

STOMACH - HICCOUGH - alcoholic drinks, after RAN-B. sul-ac.

STOMACH - INDIGESTION - alcoholic drinks; after ran-b. sul-ac.

STOMACH - INFLAMMATION – alcoholic med.

STOMACH - NAUSEA - alcohol; from calc-f.

STOMACH - PAIN - burning - alcoholic drinks agg. carb-v.

STOMACH - PAIN - burning - alcoholics; in Sul-ac.

STOMACH - PAIN - cramping - alcoholics and gluttons; of calc. Carb-v. lach. NUX-V. sulph.

STOMACH - SLOW digestion- alcoholics; in ars.bell.Carb-v.chin. Lach. merc. nat-c. NUX-V. puls. Sulph.

STOMACH - ULCERS - alcoholics, in alum.

STOMACH - UNEASINESS - alcoholics, in alumn.

STOMACH - VOMITING - alcohol - amel. Olnd.

STOMACH - VOMITING - morning - alcohol; after ars. caps. nux-v.

STOMACH - VOMITING - morning – alcoholism CAPS.

TEETH - ALCOHOLIC drinks - agg. acon. chin. IGN. Nux-v.

THROAT - ANESTHESIA - alcohol; from hyos. kali-br.

Toxicity - DRUGS, general - hangover, from a night of reveling agar. ambr. Ant-c. Ars. bry. Carb-v. chel. chin. coff. colch. IP. lac-d. Laur. led. nat-c. NUX-V. Puls. ran-b. rhus-t. sabin. staph. sulph.

URINE - ALBUMINOUS - alcohol, after abuse of ARS. aur. bell. Berb. Calc-ar. CARB-V. Chin. Crot-h. cupr. ferr. Lach. led. Merc-c. merc. Nat-c. Nux-v. sulph.

VERTIGO - ALCOHOLIC drinks, from - sensation as if from alum. caust. Coloc. Nat-m. Nux-v.

VERTIGO - ALCOHOLIC drinks, from caust. COLOC. kola NAT-M. NUX-V. verat.

VISION - ALCOHOL agg.; abuse of aur.

VISION - DIM - alcohol; from habitual use of NUX-V.

Bibliography

Step Two: Assess for Substance Use Disorders and Substance-Related Problems" height="48" width="38"> Alcohol & Substance Use > Step Two: Assess for Substance Use Disorders and Substance-Related Problems Behavioral Medicine: A Guide for Clinical Practice, 4e .... • Alcohol-specific: Any spontaneous mention of drinking behavior, such as “partying” or hangover, family history, Alcoholics Anonymous attendance, arrests for driving while intoxicated, withdrawal symptoms, tolerance, blackouts. Table 24-5. CAGE screening test for alcohol dependence risk...

NERVOUS SYSTEM" height="48" width="37"> Alcohol and Alcoholism > NERVOUS SYSTEM Harrison's Principles of Internal Medicine ..., and fatigue the following day, a hangover syndrome that is responsible for much missed time and temporary cognitive deficits at work and school. Chronic high doses cause peripheral neuropathy in ~10% of alcoholics: similar to diabetes, patients experience bilateral limb numbness, tingling...

A. Management of Alcohol Addiction" height="48" width="39"> Alcoholic Liver Disease > A. Management of Alcohol Addiction CURRENT Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy, 3e ... of a hangover (eye opener)? Two or more “yes” answers are considered clinically significant. Successful rehabilitation from alcohol addiction is difficult and usually requires mental health expertise and complex cognitive-behavioral modification strategies delivered in structured and stepwise programs. Few...

CLINICAL HISTORY" height="48" width="37"> Approach to the Patient with Liver Disease > CLINICAL HISTORY Harrison's Principles of Internal Medicine ... you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)? a One “yes” response should raise suspicion of an alcohol use problem, and more than one is a strong indication of abuse or dependence. The clinical history should focus...

Patient Story" height="48" width="36"> Chapter 237. Alcoholism (Alcohol Use Disorder) > Patient Story the Color Atlas of Family Medicine, 2e ... that she is drinking about 2 bottles (10 drinks) of wine nightly. She acknowledges going over limits repeatedly and a persistent desire to quit or cut down, as well as continuing to drink in spite of hangovers and nausea in the morning. She denies withdrawal symptoms, driving while intoxicated, job...

 Encyclopedia Homoeopathica

Disease Highlights" height="48" width="37"> Headache > Disease Highlights Symptom to Diagnosis: An Evidence-Based Guide, 3e...) Withdrawal from chronic exposure Caffeine Opioids Multiple other medications including estrogen, corticosteroids, TCAs, selective serotonin reuptake inhibitors, and NSAIDs. Of these headaches, caffeine withdrawal, hangovers, and carbon monoxide poisoning are probably the most common...

 Radar 10

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