How Can This Be a Hangover?

Question

When drinking alcohol, often the next morning, regardless of how much I drink, I always seem to have a severely upset stomach and tremors, mainly in my hands and legs. I’ve been reluctant to call it a hangover because it’s never been associated with the traditional signs of a hangover such as headache, sensitivity to light, lack of energy, or anything like that. My normal drinking night consists of between 8 and 12 standard drinks (usually hard liquor). I go to bed and wake up the next morning around 10am feeling refreshed with no negative symptoms other than the nausea and tremors. Could it be I am allergic to something in alcohol, particularly hard liquor (as I don’t drink beer)? Or is it, in fact, just a hangover sans headache/other symptoms?

Answer

Symptoms of a hangover can include nausea and tremors-- although tremors are one of the less common symptoms. So yes, you could be experiencing “just a hangover,” but the reason for this is because alcohol is a depressant and inhibits glutamine, a natural stimulant found in the body. When one stops drinking, the body tries to make up for lost time by producing more glutamine than it needs and stimulating the brain (this may be why you feel otherwise “refreshed”). A severe glutamine rebound can keep you in the light stages of sleep (rather than experience full REM sleep stages), as well as cause tremors, anxiety, restlessness, and increased blood pressure. Since the liver processes alcohol at a set rate of approximately one standard drink per hour, 8-12 drinks will almost certainly result in the glutamine rebound effect the morning after. 

Another possibility is that you are going through mild alcohol withdrawal while your blood alcohol concentration is dropping the next day. Tremors are a common symptom, along with sweating, anxiety, fatigue, nausea, headache, anxiety, rapid heart beat and increased blood pressure. One doesn’t always have to be a daily drinker to experience withdrawal. Heavy episodic drinking can trigger mild alcohol withdrawal as well.

Whether hard liquor, beer, or wine, alcohol’s inebriating substance is ethanol. Try drinking fewer drinks on a typical night out. Strategies can include leaving your credit/debit card at home when going to the bars, drinking a non-alcoholic beverage between drinks (such as water, Gatorade, etc.), or making a pact with a friend to set a limit and stick to it. Fewer drinks will save you money and save you from such bad effects.

If you would like to make an appointment with a substance abuse counselor at Student Health & Wellness, call 319-335-8394.

Student Health & Wellness Staff

Written 10/25/10

Updated 05/20/13

Sources:
MayoClinic
WebMD