It's Christmas day. The stockings are empty. The wrapping papers on the floor and hopefully there's a roast in the oven. In homes across the country families are settling down for festive food, games laughter and of course later on the King's speech. But before that, we've got a very special guest joining us fresh from his busiest night of the year. It's time for a festive coffee break. Welcome back to Coffee Break, the audio equivalent of a quiet moment with a cup of just before the Christmas day chaos starts. It's Christmas day! And whether you're full of cheer, flat out with the flu or just trying to keep the sprouts under control, we thought you'd covered with a gentle check-in and a few festive medical facts that you might have needed last night, now that it's the morning after. So put your kettle on, take five minutes for yourself and let's just keep you company. It's a Christmas special episode of Coffee Break. I'm Dr Jeff Hampt and I'm Dr Sam again me. And this is season one of Coffee Break. We are two general practitioners from beautiful dogs that are in the United Kingdom and we are happy to have you here with us for another coffee break. In our show we give you helpful and useful health and wellness information in short and easily digestible episodes. That's right and hopefully in a fun and enjoyable way as well. In today's Vat Sea of Health Information we hope to be your trusty island of reliable and impartial independent unbiased information. And we may even have some guests with us to help. So sit back and enjoy, a coffee break! Hello and a very Merry Christmas to all of you on this very festive morning. Yes, a very Merry Christmas to everybody and thank you again for joining us. Now we do have a bit of a tradition at Christmas the dark shows are a little different and a bit less, well serious. But still medically relevant of course. Previously we did a healthy Christmas food cooking show and actually we did make some really good things. I remember making some very healthy Christmas puddings. Yeah and I made some very healthy mince pies which actually all these years later I'm still making. At believe it or not we recorded those cooking and baking in our own kitchens and you could actually hear us cooking. It was good fun. It was definitely and if you want to hear something like that again then do let us know send us an email at
[email protected] send us a comment via the chat or visit our website coffeebreak.com Indeed. Now today's show is not just any old show. Look is it? It's Christmas Day and I believe we managed to line up a very special guest indeed. Is that an alright job? That is right he's dressing red. He has a white beard and he's just finished a very very long night shift. Ah that guy from the fire station. No no no bigger beard. Ah definitely the guy who plays bass guitar in that band. Not white he also drives a sleigh and eats a lot of mince pies. I think I've got here it is now. That's right he's just finished one of the busiest shifts in the world and somehow he's found the time to join us once more on our show. So who's on line one? Ho ho ho ho Merry Christmas Jeff and Sam and Merry Christmas to all the boys and girls listening. I finally put my feet up after a rather long night. My reindeer afed the sleigh's parked and washed and Mrs Claude had made me a nice cup of tea. Father Christmas hello and welcome back to the show. Do you know what I think you've earned it? You must be absolutely exhausted after flying around the whole world. Well I win pretend I'm not the little tyrant Jeff and I may have said but a few too many mince pies along the way and uh it keeps no glass of sherry. Well Father Christmas that brings us nicely onto today's topic. Lots of people might be waking up this morning with very sore heads maybe from one too many festive tipples last night. Yes so we thought we'd talk about hangovers. What they are, why they happen and how to keep so feeling merry without overdoing it. Ho ho good idea I've seen a few bleary eyes as I've kept you around the living rooms. So hangovers are basically your bodies we're saying too much. Thanks very much alcohol can dehydrate you. You can upset your stomach and it can affect your sleep which all adds up to that fogy feeling the next day. Absolutely and I'm afraid to say the best cure is actually really boring. It's time but you can make yourself feel a bit better by drinking water to make our drink resting and maybe having something like to eat like toast or fruit. I'm glad you said water Sam I think I'll stick to my tea today. And do you know what prevention is even better pace yourself have soft drinks in between the alcoholic ones and don't drink them a empty stomach. And of course it's perfectly fine to say actually note alcohol together. Christmas is about family spending time with your friends your family fun enjoying the day not necessarily about what's in your glass. Quite right at the North Pole the elves stick to hot chocolate much safer and far more marshmallows. Now that sounds like a very good prescription. Before we let you get some well-deserved rest for Christmas any final Christmas message for our listeners. Just this, make kind to yourselves and to each other. Take time to rest today and remember that the best gift you can give is love. And maybe a board came, we mostly love. Merry Christmas everyone! Beautifully said now before we do really let you go we do have to ask you as a long time guest of the show what do you think to the new show and format. Well Jeff I was really very excited when you read launch your show and I have to say Mrs. Claus to myself are regular listeners we love listening to the new episodes and I'm glad to have you back on the air. Keep up the good work both of you. Oh thank you so much thank you so very much for all the Christmas. Merry Christmas and thanks for joining us this morning. Merry Christmas! The pleasure was mine! Merry Christmas! He is such an amazing guest isn't it he is he's even better than the five in the right. Okay so what is a hangover? I think we've all had hangovers I'm aware that my British one most of us have and it's you know what it's universal therefore it's surprisingly complex though it's a human experience it's that dreaded feeling of headache nausea that deep regret the morning after the night before but what's actually happening in our bodies to make us feel like that is it just being dehydrated is there a cure? Well when we look at hangovers the actual scientific term running over is Vaisalja which is a word the derives from Norwegian and Greek and it literally means unease after all following the ball trick. But the unease isn't just one thing is it it's it's probably best sort of a multi-pronged attack on your body. Absolutely so should we look at that science? Yeah I think we've got four main areas to come up with and explain for it and we yeah so the first is to do with dehydration and/or electrolyte imbalance. So alcohol when we drink it actually has a diuretic effect it encourages our kidneys to push more fluid out of the system into our urine into our wee. We've all experienced that haven't we've all been out for a drink and after a couple of glasses we desperately need to go and then we keep needing to go. And Geoff and I will remember from our physiology lectures the hormone Vaisa Pressin which is the hormone that is then is suppressed by alcohol and that is what normally tells your kidneys to actually keep water on board, reabsorb it. So if there are every 250 mil of an alcoholic drink you consume so essentially a standard beer or half a half a beer isn't it? A pie, half a bite. Your body will eliminate up to a liter of water from that. So it's crazy in this so you drink half a pint and your body expels the pint. Yeah so it's no wonder you get dehydrated is it? Absolutely. So what are the symptoms then? Well let's look at those the classic fluid loss symptoms of dehydration. First feeding dizzy, having a headache, feeling a bit cloudy or fatigued and that's because you're losing vital electrolytes potassium and and so do you and your in and they're actually important for
nerve and muscle function so you can feel weak and apathetic. We call it that. Yeah, definitely. Okay, so that is the first way that alcohol gets you in a hangover. So the second way that hangover gets to you is actually the toxicity of what's going on. So something that we call acetaldehyde. So this is actually probably the single biggest factor that gives you a hangover without going into too much information. When you drink alcohol, you'll live and metabolise it and it does it in two steps. So step one, there's an enzyme called alcohol dehydrogenase and that breaks down alcohol into a compound called acetaldehyde. Step two, another enzyme, acetaldehyderogenase, then breaks that down into a harmless substance called acetate. So, what's the problem? Well, acetaldehyde is estimated to be between 10 and 30 times more toxic than alcohol itself. And your liver, which does a great job of getting rid of toxic things in your body, can only process so much of it at once. So, you drink heavily. The acetaldehyde builds up in your system before it can be converted to acetate and this causes this widespread stress and information across the body and your liver just is a wealthy can't cope with that amount. Yeah. What's the symptoms as it goes? So we know the dehydration gives you that thirst, that dezenous ahead of that fatigue. So this, this actual chemical makes you feel flush, that's why we flush when we drink lots, it can make you feel sick and it gives you that really nasty pounding hangover head in them. Some people might be hanging at the moment. Yes, indeed. Not pleasant. Not at all. That's awful. And actually, I think that's probably one of the hardest parts of hangover isn't it? Yes, it is. You're stuck in a vicious cycle. Yeah. So, the third component of hangingover, the immune system's inflammatory response. So, if you've got a free intake of alcohol, your body will perceive that as essentially as toxin, as a threat to the body and it will trigger an inflammation, an inflammatory response from your immune system and that involves sending inflammatory messengers around the body. They're called cytokines and actually that actual process leads to symptoms in itself and that's why you can feel quite flu-like. It's almost as though you've just been given a dose of your flu vaccination. Might be worth going back to listen to our podcast on flu vaccinations. So the cytokines make you feel a bit achy in your muscles, fatigued. You might feel like you have some sort of difficulty concentrating your memory might feel quiet as it should and you just feel generally. Yeah, quite malaise. Yeah, definitely. Okay. Okay, so the fourth and final problem of the attack then is the disruption to your sleep you get. So, you fall asleep. You're mindful of the sleep. You fall asleep quickly, quite quickly after drinking. Alcohol is a sedative after all, so it makes you fall asleep. But, quality of sleep is actually pretty terrible and I think we can probably all say that we've experienced that. You can fall asleep when you wake up and you feel that just was worth sleep ever. Why does that happen? Well, as well as increasing your body's core temperature, which is one of the things it does, which makes you sleep quite badly. Alcohol also boosts the effect of GABA. And this is actually the main calming neurotransmitter in our brain. It makes us feel relaxed. It makes us feel sleepy. But your brain fights to maintain that balance. So it suppresses GABA and it ramps up something called glutamate. And this is actually our body's main excitatory neurotransmitter. So our body is trying to wake ourselves up because it's being put to sleep too quickly. And that tends to keep us more awake than we think we are probably going to. And at the same time, glutamate also raises our body's core temperature. So, middle of the night, the alcohol starts to wear off. Your GABA levels drop down, but actually your body is still making lots more glutamate. So this is what we call glutamate rebound. And that's probably why, as well as leading to empty or bladder possibly, talking about the diuretic, is probably what pulls out of your deep sleep into that light and less restful state. And why you might wake up at 4 o'clock, heart racing, feeling anxious and able to get back to sleep. Also, that's going to make you exhausted and give you that anxiety. You feel the next day. Yeah. Absolutely. Okay, so what about probably what most people were wishing they'd heard last night before the big party? How about running a hangover? Is there a difference between hangover prevention myths and hangover prevention reality? Interesting question, Jeff. Should we look at what we can tell people? Yeah, definitely. So, first myth. Okay. You might have had this one, "Bear before wine, feeling fine." I remember this one from University. Yeah. Is it true? Is it false? It's false. It's false. Yeah, your body doesn't actually care what water you drink. It cares about the total amount of alcohol, ethanol that you consume and how quickly you consume it. So, "Bear before wine, feeling fine." Nice to remember. You might forget, as the night goes on, it's still going to feel rough. Yeah. Absolutely. So, the second myth, Jeff, is lining your stomach with a big, greasy, no, floor drinking. Does that make a difference? True or false? I don't know. If one always says, "You know, have a big, greasy meal and that'll slow down the alcohol." I don't know. What's the answer? It's partially true. Okay. Physiologically, actually, you absorb liquid much more quickly from your stomach and that includes anything. So, alcohol water. So, if you have something in your stomach, you probably will absorb less liquid. More quickly. But eating anything before drinking and it doesn't have to be greasy food, slows the absorption of alcohol from your stomach into your bloodstream. And so, there is just a little bit of a delay in terms of your liver processing that. And so, your liver has more time to process the acetaldehyde. So, eating is a good idea, but it's not a magic barrier. It just listens down. It does. It does indeed. Okay. But then, you've been out. You've had one, two, three, two, many. And your home and your bed, okay, you think, "There's got to be a way of stopping me feeling rough, well, I'm in the morning. How about I take a pink color for a good bit?" Very sensible. Sounds like a sensible thing to do. You know, before you go to bed, if we have that bad sleep, before you wake up dehydrated, how about I try and get in there and cover off the symptoms? Exactly. Yeah. Hit it off at the past. Bad idea, actually. Quite dangerous. And so, the two main painkillers, we've got paracetamol, and then we've got aspirin and ibuprofen. So, paracetamol. Actually, metabolized by oliver. So, we've already said you've had all that alcohol and your liver's already working over time, really struggling. Probably the last thing you really want to do is say to it, "Here, have this paracetamol." And we know paracetamol is metabolized and breathed down quite exclusively by the liver. So, actually, that's quite bad. And then when we look at aspirin and ibuprofen, what we call non-steroidal antinglametry drugs, well, okay, then not really metabolized as much by the liver, but they are going to irritate your stomach. Alcohol is already acting as an irritant. So, if you're going to have something in your stomach that's upsetting, you're ready, taking some of your bit extra aspirin and ibuprofen might just increase that risk of you being sick and potentially even give you bleeding in the stomach. So, you're not good. Yes, absolutely. So, having gone through to myths, what actually does work for prevention and exam, or mitigation maybe? Yes, some helpful tips, I think, some of which probably sound obvious, but the first moderation. So, in fact, probably the only 100% effective method, isn't it? Drink in moderation. Temperance, isn't it? Yes, absolutely. Hydrate, definitely. So, we've talked about our dehydration. So, hydrate, how glass of water for every alcoholic drink you have, this will start to help counteract the diretty effect, but you have to be careful. You can't go too much, you have no point in trying to prevent having to have to drink lots and lots and lots of water that's a problem in itself, but keep hydrated. Yes, absolutely. And we mentioned this a little bit earlier, but having a meal before having a drink is going to slow that alcohol absorption slightly. Yes. And pace yourself. You know, we said you'd live a good only deal with so much. So, roughly as a rafferol of therm, we'll live a process as one standard unit of alcohol for hours, and that's a shot. It's a small glass of standard table wine, it's a half-itive standard week from bitter or longer. Well, these things don't exist anymore. So, if you live a process of one of those hours, so if you drink first and that, you get overwhelmed. So, just pace yourself. There's no rush to drink all the drinks. So, lastly, our point in order to make was thinking about drinking or choosing to drink. So, congenence. Yes. Our chemical compounds that are produced during fermentation, and they contribute to the taste and aroma of drinks. And so, certain lead certain drinks will have higher levels of these congeners, chemical compounds and others, and that can influence the severity of the hangover. For example, darker spirits in wines, whiskey, bourbon, red wine are high in congeners. So, our often blinks two more severe hangovers, and the clear of the vodka, gin, white rub have very few. So, a little bit on that theme, and before we get
go on to where how you're going to treat that hangover. We did just say that one of the British saying to drinking alcohol is beer before wine feeling fine, but it's remarkable actually when you look into that actually almost every culture with a history of both beer and wine has developed its own rules. And at this point we are apologise for any accents that are about to occur this Christmas morning. So in the USA I understand there's a saying beer before liquor never sicker, liquor before beer you're in the clear North America. Interesting. In Germany we phrase beer off wine, that's less sign, wine half beer, that's the fact that you did. Very good. The translation. Beer on wine let it be, I avoid it, wine on beer that I advise to you. And actually French have a very similar saying they say beer, souvenir, va se beer, air, del manier, for beer on wine is venom and wine on beer is good manners. Interesting. In the Netherlands they share a sentiment with their German name as apparently beer now we beer now wine, gift, wine, wine, na beer, gift, please, yeah. That means it means beer off to wine, gins, venom, wine after beer gets pleasure. And it's not an Italy, they have a phrase beer, savino, el vellino, again beer on wine is poison. We do apologise to all of our European neighbours and listeners for the accents just then. That's Christmas day. It is Christmas day. There are very widespread myths on how to account call without hangover, how to prevent that hangover and there are different regional variations and a lot of the time each phrase can also be interpreted differently. They can't tell me right and the truth is that none of them are. It's a wonderful contradiction to basically show that these are pure folklore and the thinking is they probably arose from social observation. In Germany for example beer might have been the more common everyday drink you start with, while wine was reserved for a meal, all day, in the evening, the correlation vessel was possibly a mistake of the causation. Well this actually tells us is that for centuries people all over the world have been trying to figure out the secret to avoiding a hangover. They've created memorable rhyming rules that you can pass down through generations. But the science is clear, your liver doesn't have a history of milk, it doesn't care what came first, it only cares about one thing. The total amount of alcohol it has to process. That just doesn't have the same ring or rhyme to it, though when you're trying to remember what order to drink in. Indeed. And actually, would you believe there was some research done into this? In 2019 research published in the American Journal of Clinical Nutrition found that there was no evidence to support the idea that you can avoid a hangover by drinking beer before or after wine. It also showed that hangovers were more or less severe when someone started to want type of drink and didn't mix alcohols. However, what I also know is how did they actually ever do that study? Yeah. It's interesting. How did they? How did they think clear proof people to drink enough to get? Yeah. And also, I'm sure that we're probably overwhelmed with people who want to stick up and join us. Yeah, definitely. Okay, now for a little Christmas history lesson. Given that we're talking about hangovers and we've mentioned ibuprofen, Sam has a little history lesson for us all this Christmas day about ibuprofen, hangovers and where it came from. So, who needs the King's speech? Sam, it's over to you. Indeed. So, let's go back to the 1950s. Picture time, Nottingham UK, Boots Pure Drug Company was keen to develop a new treatment for arthritis, particularly rheumatoid arthritis. And at the time, people were using afsprin and steroid treatments widely, but there were significant trouble with these medicines. afsprin was causing irritation to tummy and causing bleeding problems. Steroids had very powerful benefits, but also serious long-term side effects. So, a doctor's student Adams was the research department lead for the company. And along with some colleagues, John Nicholson and Colin Boros set out to discover a safer anti-inflammatory drug. They weren't chasing a painkiller initially, but something that would treat arthritis effectively with hopefully fewer risks associated. So, they had a trial and error approach really. They tested loads of different chemical compounds and after a long series of refinements, they landed on a compound actually in 1961, which had a very long name that they later called ibuprofen. Stuart Adams himself actually tested it on himself, which was quite a famous thing to do at the time. In fact, there's a well-tolled anecdote before giving an important lecture. He took a dose of ibuprofen to cure hangover and found that it actually worked. So, ibuprofen was first launched in the UK in 1969 as a prescription only treatment, believe I'm not. Arumatoid arthritis actually was under the brand name Brufen. And then it became very quickly reputable for being very effective and safer on the stomach compared to aspirin. It became available in America in 1974 and now actually it by the early 1980s was widely used over the counter in the UK and then later worldwide. So, today it's one of the most widely used non-steroidal anti-inflammatory drugs and we use it for pain, fever and inflammation. So, Dr. Stuart Adams lived to see ibuprofen become a household name and was actually awarded an OBE for his work and continued to lecture about the discovery well into his later years. And so, having started it off as a targeted search for rheumatoid arthritis, it turned into a really important drug for successful pain killing in the one-age. Amazing, isn't it? The most interesting story. Yeah, definitely. Okay, so, prevention failed. You've woken up feeling terrible. You're not working for the boots-pure drug company and trying to develop new drug. What now? Is there a magic pill? Is there a special breakfast? Is there a drink? Is there something that's going to cure this hangover? The heart-truths? No, there is no cure for a hangover. The only real cure, as Sam mentioned earlier, is time. Your body needs time to rehydrate, clear the acetylidide and calm the inflammatory response. So, what are some of the things that really don't work or make it worse? Any ideas? Things that really not do. The hair of the dog. Yeah, something I've never understood. Yeah, if you're not, as I've obviously ever found, anyway, near as bad as this, but surely, if you're feeling that rough, then lastly, you want us to another alcohol or drink. Yeah, drinking more alcohol, the worst thing you could do. It might make you feel trampoline better because you're basically reintroducing something that puts your brain into a more suppressed state again. So, basically just subdues everything down again, but actually your overexcited brain is not going to like that and you're going to get a glutamate rebound. So, you just didn't know everything, really, forcing your liver to have to process even more toxins. Yeah, sweating it out. Often people think, you know, if we sort of sweat out, we're going to go for a heavy workout, go for a run, have a sauna. It doesn't really work. You only sweat out. Actually, really, he's a very small amount of alcohol and doing something that's going to make sweat is going to dehydrate you further. It doesn't make you feel even worse. It's not going to make you feel better at all. No, absolutely. And the other one that we hear all the time is the big greasy cryo. Thanks, Lordy. Yeah. You might crave it, but actually, again, you're just putting more stress on your liver, your gut, and you're probably going to get some side effects from that. And I honestly, again, I didn't think that the stomach would be a big greasy breakfast for our next morning. Not if you're feeling that bad. Mine used to be spicy bean soup and a Scotch egg. So, we've said the things that don't work and what are some of the things that will, what are the things that can treat the symptoms? Well, number one, rehydrate aggressively. It's got to be in a more top priority. Sit water constantly. If you want to, there's all rehydration solutions. There's isotonic sport drinks. You're replacing electrolytes there for as well as salt and fluid. But do you know what a simple cup of vion or miso soup works wonders even do they want a flat lemon over the bit of salt in it, to be honest. Yeah. Apple juice, dilute apple juice. Yeah. And bland food. So, yeah, keep what you put in, bland. Yeah. You need to get that blood sugar up. And alcohol will cause it to crash down quite, quite quickly. So, you will feel tired, we toast crackers or a bit of that. Or very easy, almost no, and can provide relevant necessary carbohydrates. Yeah. Dairy and milk. You talked about in some of our other episodes where we talk about upset tummies. Dairy is not good for an upset stomach. Absolutely. If you're tempted by a cup of tea with milk, probably best than it. Have it. Have it. Have black to your coffee. No hot chocolate. Yes, absolutely. It does literally the milk will curdle with it. I think you still got that. Yes, I'm saying. Pain killers. Now is the time very carefully to take that painkiller, but you ought to be smart. So, we've already said the non-steroidal is our ibuprofen. Well, we know that we know the history behind that now, but it's generally thought of if you can take ibuprofen to be better than paracetamol for that headache, it helps because it's a painkiller, but it's also an anti-inflammatory and you have got inflammation across your system. So, it will help take it with food.
Yeah, very like what we've just said it isn't metabolised by the liver so you're not putting extra strain on the liver But take it with care take it with caution make sure you're not taking on an empty stomach You just be really really careful absolutely So this one sounds quite obvious, but resting is Important your body is trying to recover so if you have perhaps think about going back to sleep You need to let your immune system never do their work. Yeah, definitely and last of all we talked about coughing But caffeine with a very small caveat cup coffee or black tea can help with the groginess and their headache caffeine is actually what we call a Veso-conscriptor so it helps constricts shut down those blood vessels and that actually helps with some sorts of headaches Not all headaches but some but caffeine is also a very mild Diuretic so if you're already a bit dehydrated and you're not actually keeping your fluids up that much caffeine could potentially contribute is not really massively dehydrated, but it's taking with caution. Yeah, absolutely So they have it that hangover is a very complex beast driven by dehydration top-sleeved byproducts inflammation or sleep. There's no magical cure. You can be smart about prevention. You can hydrate. You can eat and you can pay yourself and if the worst happens your path recovery is a with water, bland food and rest and probably not a Christmas roast The only cure is time. Do you want to take some closing comments? Yes, on that note We want to wish you all a happy Christmas and we actually really hope that you're not lying there listening to us We're bad hangover But this helps protect you from a future learning all about how it happens and why it's best to actually avoid yourself into that situation Definitely and we hope you have a fantastic Christmas. What are you doing? I hope you have a lovely time with loved ones and people close and dear to you and that you drink this once more and Don't eat too early chocolate Thank you once again to Father Christmas. Yes, fantastic guests as always and we will see you in the new year. Merry Christmas, and Merry Christmas This has been a Christmas episode of Coffee Break and we hope you've enjoyed it. I know I did. If you enjoyed it then we hope you'll join us for another coffee break soon. If you want to get in touch or if you have any ideas or suggestions then please feel free to email the show at Hello at Coffee Break.com. That's hello at COUGHYbreak.com Do you see? Very clever. You can listen and subscribe to the show on any of the podcast platforms and via your computer smartphone and home smart devices. A variety of resources have been used for the information in the show to try and ensure that it is up to date and the most applicable. Any important links we've discussed in the show are in the show notes. Coffee Break is a coffee break production and is created written and hosted by Dr. Jeff Hemp and Dr. Seb McGinley. Dr. Jeff Hemp is the producer. Today's episode also featured me. Father Christmas. All the content provided in the show is for general informational purposes only. The content does not constitute medical or health care advice. The content is valid in England at the time of recording. The content should not be relied upon as a substitute for professional medical or health care advice applicable to your specific circumstances. Your advice to always consult a qualified medical professional for any medical matters. Until next year, Happy Christmas!
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