If you’re not a regular drinker, you’ve probably never seen this drug:
(Source: Qilu Evening News, a social shopping platform)
But for those who often go out to socialize and drink, “hangover soup, hangover medicine” is very popular in the circle, and even a life-saving straw to carry around.
There is also such a plot in the hit drama “Thirty Only”: Wang Manni went to the sales department to do accounts, and was drunk and hungover by colleagues at a dinner party. The next day, a kind female colleague took out a bottle of medicine and put it on the table, reminding her to “take this before drinking in the future”.
(Source: TV series “Thirty Only”)
But is there really a drug in the world that “drink the first 2 pills without fear” and “turn wine into water 10 minutes after drinking”? Are hangover pills reliable?
It all starts with the detoxification process of alcohol.
After alcohol enters the digestive tract, about 10% will be metabolized in the stomach, and the remaining 90% will soon enter the bloodstream. With the exception of a small amount that can be excreted in urine, sweat and exhalation, more than 90% of the remaining alcohol needs to be metabolized in the liver [2].
The liver metabolizes alcohol in three main steps:
Alcohol dehydrogenase converts alcohol into acetaldehyde;
Acetaldehyde is converted to acetic acid under the action of acetaldehyde dehydrogenase;
Acetic acid is converted into carbon dioxide and water through the biochemical reaction of the tricarboxylic acid cycle, which is excreted from the body.
For us, if we don’t drink too much, the above step can be completed quickly, and many people are actually stuck in step [3].
Because different people have different levels of acetaldehyde dehydrogenase.
People who are relatively deficient in acetaldehyde dehydrogenase cannot continue to completely convert acetaldehyde into acetic acid, and acetaldehyde will accumulate in the body.
This thing is much more poisonous than alcohol. It is a first-class carcinogen [4], which can cause telangiectasia, causing flushing, palpitations, nausea and other discomforts.
(Drinking and blushing looks good or not, depending on your appearance. Source: TV series “Dear Yourself”)
And among us Chinese, about 40~50% of people are born with lack of aldehyde dehydrogenase[5]!
So those who “drink and blush” are not heavy drinkers. On the contrary, they may be relatively deficient in acetaldehyde dehydrogenase and more likely to get drunk.
People with relatively abundant acetaldehyde dehydrogenase can quickly metabolize acetaldehyde into non-toxic acetic acid, decompose it into carbon dioxide and water and excrete it out of the body. This kind of talent is really “a lot of alcohol” and is not easy to get drunk.
(Source: soogif)
But if you consume more alcohol than your liver can metabolize, no matter how much you drink, the alcohol concentration will rise sharply in your body, and you will still be drunk!
In this way, there are two ways to prevent drunkenness:
1. Reduce or delay the absorption of alcohol in the body
Alcohol molecules are small, easily pass through the intestinal wall into blood vessels, and are relatively chemically stable, making them less likely to “deposit in combination with other substances” to reduce absorption.
“Delayed absorption” can be done, such as eating some staple food properly before drinking and letting the alcohol stay in the stomach for a while longer. This is why it is often said that “it’s not easy to get drunk when you put a pad on your stomach”. But this is still a temporary solution.
(Source: soogif)
2. Increase the amount or activity of acetaldehyde dehydrogenase to accelerate alcohol metabolism
The amount of acetaldehyde dehydrogenase in the human body is only related to genes. In theory, after each person is born, the amount of the enzyme in the body has been fixed. Therefore, the “amount of alcohol” is basically innate, and it is impossible to change the amount of acetaldehyde dehydrogenase by drinking a small amount of alcohol every day.
Then if a drug was invented to supplement liver acetaldehyde dehydrogenase, would it be possible to get rid of alcohol?
Too naive! The essence of enzymes is protein, and after entering gastric acid, it will lose its activity and be decomposed into amino acids. Oral enzymes do not get into the liver at all.
But some people say “drinking a little wine every day” may be able to partially increase the amount of alcohol.
Because long-term alcohol consumption will enhance the activity of another “hangover” pathway in the liver, the microsomal alcohol oxidation system, in which cytochrome P-450 plays a key role (CYP)2E1[6].
This enzyme, also known as “liver drug metabolizing enzyme (liver drug enzyme)”, can metabolize ethanol to acetaldehyde, similar to the aforementioned alcohol dehydrogenase.
However, liver enzymes still cannot convert acetaldehyde into acetic acid, so the toxic acetaldehyde will continue to accumulate in the liver and can only be cleaned up by acetaldehyde dehydrogenase.
It’s like cleaning in the class, you just help the labor committee “sweep the floor”, but don’t take out the trash.
(Source: Internet, Tencent Medical Code Drawing)
Also, metabolizing alcohol is not the “full-time job” of liver drug enzymes, after all, it’s just an occasional cameo, and the ability to hangover is very limited. Therefore, the amount of alcohol that can be “practiced” from long-term drinking is also very limited.
In addition, the increase of liver drug enzymes and its metabolites will bring a lot of harm, and over time, it will cause serious damage to the liver [6].
Since the amount of acetaldehyde dehydrogenase is determined by nature, can it be improved to relieve hangover by increasing its activity?
There is such a drug that can relatively increase the activity of acetaldehyde dehydrogenase.
Studies have found that metadoxine is an activator of acetaldehyde dehydrogenase, which can antagonize the decrease in the activity of alcohol dehydrogenase caused by acute and chronic alcoholism, accelerate ethanol and its metabolite acetaldehyde and ketone bodies are excreted in urine [7].
Metadoxine reduced the half-life of ethanol metabolism from 7 hours 15 minutes to 5 hours 50 minutes in healthy volunteers [10].
But don’t get too excited, this medicine can’t be used casually!
Metadoxine is a prescription drug and is only used for the treatment of alcoholic liver disease. It needs to be purchased and used with a prescription under the guidance of a doctor.
(Source: Internet, Tencent Medical Code Drawing)
It is important to note that metadoxine may cause peripheral nerve disease! Moreover, bronchial asthma and children can not use.
Then there are so many hangover medicines on the market, are they useless?
The so-called “hangover medicine” claimed on the market is mostly composed of some plant extracts or raw materials for medicine and food, such as turmeric, oyster extract, gardenia, wolfberry, salvia, Poria, barley seedlings, chitin, etc.:
(Source: a shopping platform)
There are also some that contain protein, vitamins, certain minerals and other nutrients to improveOral dietary supplements are the main products. If the domestically produced health food is a regular health food, there will be a “blue hat” sign. But these are all foods, not real “medicines”.
(Ingredient list of an imported hangover and liver protection capsule. Source: a shopping platform)
There is also a class of medicines with certain chemical ingredients such as naloxone, diuretics, etc., which are printed with the Chinese medicine quasi-character.
(Source: a shopping site)
Naloxone is an antidote for overdose of opioids (including drugs such as heroin), and can also relieve the central depression of alcohol and shorten the duration of coma [11].
To put it bluntly, it can only make you sober, but it cannot speed up the “detoxification” process of acetaldehyde.
And this drug is a prescription drug, can not be used casually, and may cause mania [12]. In the hospital emergency, it is generally a direct intravenous infusion, rather than sublingual administration.
In short, no matter which of the above ingredients is an “anti-drinking drug”, there is no clear study to prove that it can increase the amount or activity of acetaldehyde dehydrogenase, so it can’t really cure alcohol. effect!
The advertisement of “a large amount of alcohol, a thousand cups without getting drunk” is only psychological comfort, and eating anti-alcohol drugs may increase the burden on the liver.
It’s scary that some people are misled by the advertisement of “a thousand cups without getting drunk”, thinking that they can “get free to drink” if they buy alcohol and medicine, but they end up in the hospital drunk…
(Source: Nanfang Daily)
Some people tried to avoid the traffic police’s investigation of drunk driving by “anti-drinking drugs”, but in exchange for “traffic police team one-day tour”…
(Source: Minbei Daily)
The cost is so high, can’t I hire a chauffeur with the money for the medicine?
A solemn reminder: The only way to prevent drunkenness is to drink less or no alcohol.
(Source: Internet)
Of course, professional wine holders also need to practice their own skills. This is the true way to never get drunk:
(Source: Southern Metropolis Daily N Video)
Unfortunately, apart from anti-alcohol medicines, the popular ” hangover food” is not helpful for drunkenness.
The fructose in honey can slightly increase the efficiency of alcohol dehydrogenase [8,9], but not the more toxic acetaldehyde. Strong tea and coffee are diuretics, which may aggravate dehydration symptoms and increase the alcohol concentration in the body.
If a drunk person can still move, it is better to drink some warm water and eat some fruit (not because of fructose, but mainly to supplement sodium, potassium, and magnesium ions to relieve dehydration symptoms). If the symptoms improve after vomiting, you can rest on your side, but have someone to accompany you.
(Source: soogif)
If your friends or relatives are too drunk to wake up (coma period), remember to put them on their side to prevent vomit from being inhaled into the airway and causing suffocation! Then call 120 as soon as possible to get to the hospital.
Finally, the class representative made a point for everyone:
●The human body “hangover” mainly relies on acetaldehyde dehydrogenase, but the amount of the enzyme is innate and cannot be supplemented by taking medicine. Only metadoxine can increase the activity of enzymes, but this is a prescription drug and cannot be used casually.
●The ” hangover drugs” on the market are mostly plant extracts or vitamins, or diuretics, wake-up agents, etc., but none of them can increase the amount or activity of acetaldehyde dehydrogenase , and not really hangover.
●If you are already drunk, honey, strong tea and coffee are not helpful to hangover, it is better to drink some warm water to replenish water and sober naturally.
Reviewer: Zhao Ning |Deputy Chief Pharmacist, Peking University First Hospital
References
[1]Laurence L.Brunton, Keith L.Parker. Handbook of Pharmacology and Therapeutics [M]. 11th Edition. Beijing: Science Press, 2009.
[2] Tian Wei, Hu Jiangtao. About the metabolic rate of ethanol in the human body and the treatment measures [J]. Electronic Journal of Clinical Medicine Literature, 2019,6(18):198.
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[3]Yokoyama A, Muramatsu T, Ohmori T, et al. Alcohol and aldehyde dehydrogenase gene polymorphisms and oro-pharyngolaryngeal esophageal and stomach cancers in Japanese alcoholics[J]. Carcinogenesis, 2001, 22:433-439.
[4]http:https://samr.cfda.gov.cn/WS01/CL1991/215896.html
[5] Cao Y, Li L, Xu M, et al. The ChinaMAP analytics of deep whole genome sequences in 10,588 individuals[J]. Cell Research, 2020: 1-15.< /p>
[6]Prakash O,Nelson S.Alcohol and liver disease[J].Ochsner J,2002,4(4):241-4.
[7] Expert Group of Consensus on Diagnosis and Treatment of Acute Alcoholism. Consensus on Diagnosis and Treatment of Acute Alcoholism[J]. Chinese Journal of Emergency Medicine, 2014, 23(2):135-138.
[8]Tygstrup N, Winkler K, Lundquist F. The Mechanism of the Fructose Effect on the Ethanol Metabolism of the Human Liver*[J]. Journal of Clinical Investigation, 1965, 44( 5):817-830.
[9]Handler J A ,Bradford B U ,Glassman E B ,et al.Inhibition of catalase-dependent ethanol metabolism in alcohol dehydrogenase-deficient deermice by fructose[J].Biochemical Journal,1987,248 (2):415-21.
[10]Pellegrini-Giampietro DE, Moroni F,Pistelli A,et al.Pyrrolidone carboxylic acid in acute and chronic alcoholism. Preclinical and clinical studies[J].Recenti Prog M, 1989 , 80(3):160-4
[11] Tian Yingping, Shi Hanwen. Consensus on diagnosis and treatment of acute alcoholism [J]. Chinese Journal of Emergency Medicine, 2014, 23(2): 135-138.
[12] Chen B, Liu Y S. Randomized double-blind clinical trial of moderate dosage naloxone in acute moderate and severe traumatic brain injury[J]. Bulletin of Hunan Medical University, 2002, 27(1): 58-60.
*The content of this article is for the popularization of health knowledge and cannot be used as a specific diagnosis and treatment suggestion, nor can it replace the face-to-face consultation of a licensed physician, and is for reference only.
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