This morning many of you may be suffering from the combination of negative mental and physical symptoms one can experience following a single episode of alcohol consumption starting when the blood alcohol concentration approaches zero: an alcohol-related hangover or veisalgia.
Despite many theories, the cause of hangovers is unknown. Some symptoms may be directly related to alcohol and its metabolites but other factors including dehydration, immune dysregulation, congeners in alcoholic beverages, and hypoglycemia may play a role.
The skeptical cardiologist has devised an ingenious method that eliminates veisalgia. It involves avoiding excess alcohol consumption. However, this method often fails.
Like many revelers, the skeptical cardiologist and his (adult) children would like to know if there is a way to enjoy excess alcohol-infused merriment without the side effects that this often brings. As such, my children have begun taking a hangover cure called Cheers.
Everyone who has taken these pills apparently swears by them but what is the evidence that Cheers or any other OTC hangover cure really works and is safe?
As a recent Women’s Health summary of the field noted there are many companies trying to sell you a smorgasbord of unproven cures including ” Bytox, Cheers, Blowfish, Liquid IV, Morning Recovery, and Flyby, Hangover pills, powders, and patches all claim to drastically cut back on the icky feelings of a hangover by packing hangover-fixing ingredients like vitamins, electrolytes, caffeine, pain relievers like Aspirin, and more.”
Almost universally, the purchasers of these products proclaim in online reviews that they are incredibly effective.
Although Women’s Health concluded that none of these hangover cures were proven effective they are happy to provide (revenue-producing) links so you can purchase them.
New Years Eve Study of All Proposed Hangover Cures
Yesterday, a paper entitled “The efficacy and tolerability of pharmacologically active interventions for alcohol-induced hangover symptomatology: A systematic review of the evidence from randomised placebo-controlled trials” was published online in the journal Addiction which attempted to answer whether any hangover cure has proven efficacy.
The 21 studies which met criteria for review looked at Curcumin, Duolac ProAP4 (probiotics), L-cysteine, N-Acetyl-L-Cysteine (NAC), Rapid Recovery (L-cysteine, thiamine, pyridoxine and ascorbic acid), Loxoprofen (loxoprofen sodium), SJP-001 (naproxen and fexofenadine), Phyllpro (Phyllanthus amarus), Clovinol (extract of clove buds), Hovenia dulcis Thunb. fruit extract (HDE), Polysaccharide rich extract of Acanthopanax (PEA), Red Ginseng, Korean Pear Juice, L-ornithine, Prickly Pear, Artichoke extract, ‘Morning-Fit’ (dried yeast, thiamine nitrate, pyridoxine hydrochloride, and riboflavin), Propranolol, Tolfenamic acid, Chlormethiazole, and Pyritinol.
The study quality was universally low and no two studies reported on the same treatment intervention thus meta-analysis was not possible and no results have been independently replicated.
The authors noted that clove extract, tolfenamic acid, and pyritinol showed significant improvement in hangover symptoms and may most warrant further study. No significant side effects emerged.
Should We Be Taking Cheers When We Drink?
You will note that the presumed active ingredient in Cheers, the pill my children have been pushing, DHM, is not mentioned in this study.
The website for Cheers makes the dubious claim that they are the “leader in alcohol-related health” and are helping customers “enjoy alcohol on their own terms.”
Cheers likes to emphasize their unscientific origins as somehow relevant by pretending they have some connection to neuroscientists and Princeton.
Fortunately, the McGill University Center for Science and society has researched Cheers (formerly Thrive+) for us and answered if there is any scientific basis for believing it is effective. If you are seriously considering taking DHM containing compounds I recommend you read the entire article.
Brooks Powell was studying religion as a sophomore at Princeton University when he stumbled upon a scientific paper after a bad hangover. This is the Shen paper, published in the Journal of Neuroscience in 2012. The researchers injected rats with ethanol, or with ethanol and DHM, and looked at their behaviour. They also allowed other rats to voluntarily consume water containing ethanol, or ethanol and DHM. And the results were quite interesting: the injections “counteracted acute alcohol intoxication and also withdrawal signs” and the water laced with DHM “greatly reduced ethanol consumption”.
The cheers website claims that the 2012 Shen study is “the first of many, many” studies on DHM and alcohol in “animals and humans” alike. However, there are no peer-reviewed published studies in humans of the effects of DHM on hangovers. This is why it was not part of the New Years’ Eve Addiction paper.
If you search enough on the Cheers website you will find a link to the one human study that was performed. It is embedded in the company’s patent application and is incredibly poorly done. It has never been published in the scientific literature.
As described by the McGill article:
This product has been tested in 19 men and 8 women. The result? A 50% decrease in hangover symptoms. However, there was no blinding involved, and no placebo. These volunteers got drunk and reported their feelings the next day. They came back, got drunk again but this time, took Thrive+, knowing what it was, and reported their feelings afterwards.
The mere knowledge that this pill should cure your hangover can provoke a significant (though short-lived) placebo response, which this study cannot rule out.
In the patent application, three formulations of various compounds were described and evaluated in this “study” with various combinations of “therapeutically effective amounts of prickly pear extract, silymarin, ginger root extract, dihydromyricetin N-acetyl cysteine, vitamin C, vitamin E, electrolytes, and one or more B vitamins selected from the group consisting of thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, pyridoxal, biotin, folic acid, and cobalamin.”
In the final analysis, then, there is no good scientific evidence that Cheers does anything for hangovers in humans. Like all OTC supplements, the multiple ingredients in Cheers are not checked by the FDA for safety or purity of content. These ingredients may interact with prescription medications, dangerously lowering or increasing their effects.
In addition, there may be long-term adverse effects.
I don’t advise taking hangover cures for you humans but if your mice have been making too merry on New Year’s Eve by all means offer it to them.