Hours on hours of headaches, tiredness, stomach pains, and anxiety: Hangovers stink. And sometimes they stick around for longer than they should. Instead of suffering one day of misery, you may wind up in pain for 48 hours, cursing Saturday night all the way through Monday. Call it the two-day hangover.
But what causes your symptoms to linger longer? “Hangovers are somewhat poorly understood from a medial standpoint,” says Fred Goggans, M.D., the medical director of McLean Hospital’s McLean Borden Cottage in Camden, Maine. For the most part, the symptoms are considered a form of short-term withdrawal and tend to be time-limited. Typically, Goggans says that the strength and length of your hangover goes hand in hand with how much you drank. Beyond that? “There are also some other factors that are speculated to influence the intensity and duration of a hangover,” he says. Here, six of them.
1. You Didn’t Hydrate Enough
“Alcohol has a diuretic effect—heavy drinking may maximize that,” says Vincent Pedre, M.D., author of Happy Gut. Drinking can dehydrate you—even more so if you’re vomiting or suffering from diarrhea. And this—on top of mineral imbalances (from the influx of booze and loss of fluids and electrolytes)—can slow how fast your body detoxifies itself, he explains.
Ease the pain by alternating every glass of booze with a glass of water. And reach for coconut water or H2O with lemon and a little bit of salt in the morning, suggests holistic nutritionist Danielle Pashko. The salt will help with the electrolyte loss.
2. Your Shut-Eye Suffered
You know that a good night’s sleep can help you feel your best in the a.m. But you might not realize that while a few glasses of wine could put you to sleep, vino certainly won’t help you get your deepest snooze on. “People tend to have interrupted sleep following a drinking episode,” says Goggans. And it all comes full circle: The more you drink, the worse you sleep, and—well—the worse you feel the day after (and sometimes the day after that).
3. You Drank Dark Booze
Meet congeners—they’re flavoring agents or byproducts of fermentation in booze, and they are linked to hangovers, says Goggans. “It seems like the congeners in the darker liquors and drinks are associated with a longer hangover,” he says. Stay clear to keep yourself in the clear: Liquors linked to worse next-day pain include whiskey, rum, red wine, and brandy, says Goggans; those less likely to cause a hangover: white wine, vodka, and gin.
4. You’re Not in College Anymore
If you’re 21, your ability to detoxify alcohol is different than if you’re 40, says Pedre. “As we get older, our cells age, and we might not be able to process toxins as we did when we were younger,” he says. So while three drinks was fine back in the dorms sophomore year, that amount may feel like double that 10 years later.
5. You Have a Sensitivity—and Don’t Realize It
“A lot of people have food intolerances or sensitivities to chemicals that they don’t realize,” says Pashko. Beer is packed with yeast; mixers can be super high in sugar; wine can have sulfites—all of these are things you can be intolerant to, says Pashko. “And sometimes symptoms might not show up until 24 or 48 hours later,” she explains.
6. You Threw Off Your Gut
About 70 to 80 percent of your immune system is in your gut—and when you drink a lot, you throw off the good bacteria there. This can weaken your immune function, says Pashko. The more you drink, the worse the problem and the longer you suffer. Keep your gut happy every day—whether you’re going out or not—by incorporating foods high in probiotics (think Greek yogurt or fermented foods) into your diet, she suggests.