Why Some People Have Worse Hangovers Than Others

If you wake up with a pounding headache after every night out — but your friends are totally fine — here's what's happening.

french bulldog with a blue ice pack on its head

When it comes to smart drinking, you already know the basics: Down a glass of water between drinks, and no sipping on an empty stomach. So why can't you seem to skip the next-day hangover, ever — even if you follow the rules? And, even more, why is the rest of your night-out crew totally fine and ready for a morning mimosa while you're popping ibuprofen?

Hangovers (or veisalgia, if you want to get all medical) are caused by many different factors, including your body size and the quality of the liquor you're drinking, says Zachary Abbott Ph.D., the founder of ZBiotics. (Yes, top-shelf clear liquor such as vodka or silver tequila won't do as much damage as, say, a certain cinnamon-flavored whiskey.) But the cold hard truth is that some people are just biologically better able to handle alcohol.

Here's why life's not always fair when it comes to hangovers:

Why Only Some People Get Bad Hangovers

The body typically tackles alcohol with a three-step process, according to the National Institute of Alcohol Abuse and Alcoholism (NIAAA). First, it's broken down into acetaldehyde — a super toxic, naturally forming relative of formaldehyde. Then, acetaldehyde is turned into a less scary byproduct called acetate, before finally reaching its final form of carbon dioxide and water, per the NIAAA. That first step is responsible for getting you drunk and, depending on how much acetaldehyde sits in your system and for how long, it's also responsible for making you feel like crap later, explains Abbott.

While your liver gets the credit for churning out enzymes that do the heavy lifting in this process, it's actually a team effort. All the cells in your body, including the bazillions of good bacteria — aka your microbiome — pitch in to produce the enzymes that help you metabolize alcohol and determine the amount of acetaldehyde that's still accumulating.

However, different people carry different variations and amounts of those enzymes, notes the NIAAA — which could be why your bestie feels normal after a night of heavy drinking while you're ready to swear off of alcohol for life. "Some people are just naturally able to produce more or better quality of this enzyme," says Abbott. "It's not yet fully understood why. These are just human differences," he adds. It makes sense, considering individuals have completely unique microbiomes, which are constantly evolving based on lifestyle factors such as activity level, diet, and sleep patterns.

Can You Lessen the Intensity of Your Hangovers?

Okay, so can you make more enzymes — or make those you already have work harder? Unfortunately, there's no way to do that yet. "But it's a lot easier to prevent hangovers than to deal with them the next morning," says Jason Burke, M.D., an anesthesiologist and founder of Hangover Heaven, a Las Vegas–based mobile clinic that uses IV hydration and vitamin therapy to treat hangovers. Try prepping for a big night out similar to how you might prep for big workouts — which means loading up on water, sleep, and vitamin and antioxidant supplements, he suggests.

"One of the biggest misconceptions is that a hangover is just dehydration, but that's far from the truth," says Dr. Burke. "You also have inflammation and free radicals, destructive particles that harm cells and DNA, wreaking havoc," he explains. One review found that antioxidants found in the milk thistle plant (which is available in supplement form) could act as a shield against the damaging effects of free radicals produced from alcohol consumption. And Dr. Burke says he's seen similar effects from antioxidants (coupled with other remedies) in patients, too.

"Similar to finding out what kind of liquor you prefer, you may need to experiment to find what vitamins or supplements work for you," says Dr. Burke. "But there's often something that will make the next day a little more pleasant," he adds. At the very least, you can try popping a couple of vitamin B supplements, which have been shown to help hangovers, before you head out for the night.

"This is an imprecise field, but we're understanding more and more, and scientists are working on a cure," says Abbott. A cure for hangovers? Toast to that!

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