For centuries people have tried to come up with strategies to reduce the negative effects of alcohol, and for the most part they don’t work. Some people say that clear spirits, like vodka, give less of a hangover and there is even a small amount of research about congeners pointing in that direction, however, it doesn’t pan out. Let me explain by detailing what causes a hangover and give a great example.

When you consume alcohol your body is well equipped to process it and remove it from the body since a variety of alcohols are found in natural products, like fruit juice and when the body metabolizes things like pectin, which produces methanol, naturally. It is estimated that a typical person clears 1 to 2 grams of methanol from their body each day just from consuming all-natural foods, mostly fruit.

There are two key enzymes that the body uses to produce alcohol and its byproducts. The first is alcohol dehydrogenase which converts alcohol into aldehydes and sometimes ketones. The aldehydes are then converted to carboxylic acids, like acetic acid (vinegar) with the enzyme aldehyde dehydrogenase (ALDH2). The problem with excess alcohol consumption is that our bodies only have so much of these enzymes and when there is more alcohol than available enzymes we end up getting intoxicated and then develop a hangover.

The majority of a hangover is caused by the accumulation of aldehydes in the body, and in the case of ethanol, it is acetaldehyde. Now, this may sound complicated, but it isn’t. In the medical world, they use a drug called disulfiram (Antabuse) to treat alcohol use disorder. The way disulfiram works is by blocking acetaldehyde dehydrogenase which stops the acetaldehyde from being converted to acetic acid, so the acetaldehyde circulates in the body causing almost immediate hangover-like effects, even with a small amount of alcohol. Disulfiram is quite effective at stopping a person from drinking because they get zero enjoyment of alcohol and just get an instant hangover.

Though poorly made spirits with excess congeners can make for a slightly worse hangover (it would be hard to quantify) the fact is that vodka can still give you a bad hangover. So why do some people say it doesn’t affect them? Youth and good health seem to be the answers.

Alcohol-Induced Acidosis

Severe reactions to excessive consumption result in Acidosis, which is a complex cascade of biological processes that lead to serious issues that often require medical attention. Part of the issue is the regulation of the body’s pH, because of excess acids, which the body responds with a compensating process and because things are so extreme the body has a hard time maintaining control. This can happen from a serious weekend binge session (so drunk you pass out) or from longer-term alcoholism.

An example of what happens when we drink alcohol is as follows. As I’ve mentioned ethanol converts to acetic acid (vinegar) in the body and 30 ml (1 oz) of pure ethanol effectively converts to roughly 30 ml of pure acetic acid. A standard drink (43 ml of spirit) at 40% ABV is equivalent to roughly 400 ml of 4% vinegar. The acetic acid then converts to Acetyl-Coenzyme A and then is burned in cells as energy forming water and carbon dioxide. That’s a lot of acid in the body.

Alcoholic Ketoacidosis

So if you ever wonder where the term “pickled” comes from, in reference to being drunk, this might be it.

Alcohol flushing syndrome is similar and caused by a genetic variation in the production of ALDH2 that causes intolerance to alcohol, which makes drinking alcohol unpleasant.