On This New Year's Day...

Given that it's New Year's Day, a few of you may be experiencing what the medical world terms a hangover.

Although if you are, you're probably not up yet.

Whilst the causes of a hangover are still not completely understood, several factors are known to be involved, including acetaldehyde accumulation, changes in the immune system and glucose metabolism, dehydration, metabolic acidosis, disturbed prostaglandin synthesis, increased cardiac output, vasodilation, sleep deprivation and malnutrition. A lot of alcohol the night before, however, is understood to play something of a role.

Though many potential remedies have been suggested, and many folk-cures sworn by, there is no evidence to suggest that any are effective in preventing or indeed treating an alcohol-induced hangover. Not drinking alcohol or drinking only in moderation, whilst both equally unattractive concepts, are certainly among the most effective.

A number of symptoms of a hangover may present themselves, a few of which are:

Drowsiness, headache, concentration problems, dry mouth, deepening regret, dizziness, the wonderfully euphemistic term 'gastrointestinal complaints', fatigue, sweating, an empty wallet, nausea, unwise facebook friend requests, hyper-excitability, anxiety...

...as well as a feeling of general discomfort (including the already mentioned deepening regret) that can last more than 24 hours.

Suggested cures for a hangover include:

• Rehydration: Drinking water before going to bed or during hangover may relieve dehydration-associated symptoms such as thirst, dizziness, dry mouth, and headache. Give it a whirl, can't hurt.
• Non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen have been proposed as a treatment for the headaches associated with a hangover. There however is no evidence to support a benefit, and there are concerns that taking alcohol and aspirin together may increase the risk of stomach bleeding and liver damage. Still worth a shot.
• A Full English Breakfast: Beans optional, also worth a shot.
• Tolfenamic acid, an inhibitor of prostaglandin synthesis, in a 1983 study reduced headache, nausea, vomiting, irritation but had no effect on tiredness in 30 people. Unfortunately, virtually no-one knows what this is, even fewer know where to get it.
• Pyritinol: A 1973 study found that large doses of several hundred times the recommended daily intake (which is your first warning sign) of Pyritinol, a synthetic Vitamin B6 analog can help to reduce hangover symptoms. Possible side effects of pyritinol include hepatitis (liver damage) due to cholestasis and acute pancreatitis. For availabilty, see tolfenamic acid above.

• Yeast-based extracts: The difference in the change for discomfort, restlessness, and impatience have been statistically significant but no significant differences on blood chemistry parameters, blood alcohol or acetaldehyde concentrations have been found, and it did not significantly improve general well-being. People seem to either love or hate this one.
• Hair of the dog: Otherwise known as drinking more; the belief is that consumption of further alcohol after the onset of a hangover will relieve symptoms, based upon the theory that the hangover represents a form of alcohol withdrawal and that by satiating the body's need for alcohol the symptoms will be relieved. Nice try.
• Kudzu (Pueraria montana var. lobata): The main ingredient in remedies such as kakkonto (Non intellego var. deliramentum). A study concluded, "The chronic usage of Pueraria lobata at times of high ethanol consumption, such as in hangover remedies, may predispose subjects to an increased risk of acetaldehyde-related neoplasm and pathology. Available in the same aisle as tolfenamic acid.
• Artichoke: Research shows that artichoke sadly does not prevent the signs and symptoms of alcohol-induced hangover. On the upside it's widely available, even as antipasti.

Please note: in case you skim-read the 'cures list', or are still having difficulty with bright lights / focusing, literally none of these work.

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