It’s that time of year when cocktails are offered at every turn. Hot buttered rum. Eggnog. Mulled wine, spiked punch, cranberry old fashions. A festive, convivial warmth fills the days that run up to Hanukkah, Christmas and the New Year. Office parties, feasts, old friends, brightly lit shop windows-as well as family arguments, drunken relatives, and meltdowns from the kids. It’s time for a drink! However, one drink too many and you may end up with a hangover. The medical term for hangover is veisalgia, from the Norwegian word for “uneasiness following debauchery” (kveis) and the Greek word for “pain” (algia). And none of us want uneasiness following debauchery, right?
After the bottles, glasses and punch bowls are empty, it’s time to replenish the array of nutrients that alcohol can deplete. Even over a period of just a few weeks, significant alcohol consumption can exhaust essential electrolytes, vitamins and minerals, as well as impact the absorption of nutrients. Here’s a guide to restoring balance and knowing which nutrients you need the most after the days and weeks of carousing.
Start with Water
It’s well known that alcohol causes mild dehydration. This is the case even though alcohol contains so much water. Beer, for instance, is nearly 95% water and only 5% alcohol, yet when you drink 200 milliliters of beer, you pee out 320 milliliters of urine. Each drink causes you to pee out significantly more water than usual. A good explanation of the physiology can be found here. Essentially, alcohol reduces a hormone (called anti-diuretic hormone or ADH) that helps you conserve water and stop urinating. Alcohol reduces how much ADH your body makes, so you urinate more.
To combat alcohol-induced dehydration, try to sip hydrating water or fizzy water between each drink. Add a slice of citrus for flavor.
Replenish Your B Vitamins
Alcohol impacts nutrient absorption in a few different ways. In order to metabolize alcohol, the liver uses stores of essential vitamins, especially B vitamins such as niacin and thiamine. In addition, the diuretic effect of alcohol depletes vitamins and minerals, according to Michigan State University. Alcohol can also reduce the absorption and storage of vitamin B12. Folate, B6, and B12 are essential nutrients for the liver, and when depleted in chronic alcohol intake, are directly linked to stress on the liver.[i] Folate is important in both methylation and in glutathione synthesis, and glutathione is the premier antioxidant for defending against liver injury due to oxidative stress.
We can take a lesson from the well-studied B vitamin deficiencies found in alcohol abuse. Nearly half a century ago, a survey of 140 individuals hospitalized with liver injury due to alcohol found worrying levels of B vitamin deficiencies. Seventy-eight percent had low blood levels of folate, 60% suffered from low vitamin B6, and 25% had insufficient vitamin B12.[ii] A more recent study found that 80% of this population admitted to a hospital had low blood levels of folate.[iii]
B vitamins are our most versatile multitaskers. There are eight (thiamine or B1, riboflavin or B2, niacin or B3, pantothenic acid or B5, biotin or B7, pyridoxine or B6, cyanocobalamin or B12 and folate.) All eight work together to ensure critical biochemical reactions throughout the body. B vitamins are important for energy, immune function, gut health, and liver health.
Vitamins often exist as pro-vitamins, their inactive forms. Our body converts them into metabolically active forms. For example, vitamin B12 in food is in the form of cobalamin complexed with intrinsic factor, a protein. The body releases intrinsic factor and adds a methyl group to convert B12 to its metabolically active form: methylcobalamin. Methylated B12 is critical for many cellular processes. We can provide our bodies with the metabolically active forms as supplements, and thus ensure all the B vitamins are effectively supporting energy and the liver’s detoxification pathways. Adding in a liver protective botanical such as milk thistle may also be useful. Milk thistle contains the potent antioxidants silymarin and silybin, which specifically protect the liver from toxins such as alcohol.[iv]
Feed Your Mitochondria With CoEnzyme Q10
Mitochondria are making science headlines these days—breakthrough research into these tiny energy powerhouses that stud our cells has now connected them to everything from the evolution of species[v], to our ability to grow new neurons in the brain[vi] and directly fight pathogens and bacteria.[vii]
If there is one nutrient that is essential for mitochondria, it is CoQ10. CoQ10 is a lipid-soluble antioxidant that lives largely on the inner membranes of the mitochondria. An amazing 95% of all cellular energy is dependent upon CoQ10.[viii] CoQ10 protects mitochondria from damage and oxidative stress by acting as a potent antioxidant and free-radical quencher. When CoQ10 levels drop, mitochondrial dysfunction increases. When CoQ10 is added to aging mitochondria, their function significantly improves. CoQ10 also helps recycle other antioxidants, particularly vitamin E, which is also fat soluble. The highest CoQ10 concentrations are found in our brain, heart, liver, and kidneys.
Alcohol can deplete CoQ10.[ix] Supplementing with this nutrient has been found to protect the liver from oxidative stress[x] and improve inflammation associated with fatty infiltration of the liver.[xi] It has also been shown to protect the liver from alcohol-related damage.[xii]
Add Antioxidants like Glutathione and Vitamin C
When you drink alcohol, your liver uses an enzyme called alcohol dehydrogenase to break the alcohol down. It forms acetaldehyde, which is more toxic than alcohol itself. Your body then uses glutathione and another enzyme, called acetaldehyde dehydrogenase, to break down the aldehyde into harmless acetate. Adequate levels of glutathione, our most potent endogenous antioxidant, ensure this process goes smoothly.
Vitamin C should also be replenished. Drinking alcohol can deplete levels of Vitamin C. In particular, alcohol can affect your pancreas, by reducing levels of a protein (sodium-dependent vitamin C transporter 2 or SVCT-2) that helps transport vitamin C to pancreatic cells.[xiii]
Liposomal forms of both Vitamin C and glutathione are rapidly, almost instantaneously absorbed, bringing these nutrients to the cells just when needed.[xiv]
[i]Halsted CH. B-Vitamin dependent methionine metabolism and alcoholic liver disease. Clin Chem Lab Med. 2013 Mar 1;51(3):457-65
[ii]Leevy CM et al. Incidence and significance of hypovitaminemia in a randomly selected municipal hospital population. Am J Clin Nutr 1965;17:259 – 71.
[iii]Herbert V et al. Correlation of folate deficiency with alcoholism and associated macrocytosis, anemia, and liver disease. Ann Intern Med 1963;58:977 – 88.
[iv] Abenavoli L, et al. Milk thistle in liver diseases: past, present and future. Phytother Res. 2010 Oct;24(10):1423-32.
[v]Levin L et al. The genomic landscape of evolutionary convergence in mammals, birds and reptiles. 2017 Nature Ecology & Evolution,
[vi]Lewis TL et al. MFF-dependent mitochondrial fission regulates presynaptic release and axon branching by limiting axonal mitochondria size. Nature Communications, 2018; 9 (1)
[vii]Abuaita BH et al, Mitochondria-Derived Vesicles Deliver Antimicrobial Reactive Oxygen Species to Control Phagosome-Localized Staphylococcus aureus, Cell Host & Microbe (2018)
[viii]Sohal RS et al. Coenzyme Q, oxidative stress and aging. Mitochondrion. 2007 Jun;7 Suppl:S103-11
[ix]Vidyashankar S Alcohol depletes coenzyme-Q(10) associated with increased TNF-alpha secretion to induce cytotoxicity in HepG2 cells Toxicology. 2012 Dec 8;302(1):34-9.
[x]Tarry-Adkins J. et al Coenzyme Q10 prevents hepatic fibrosis, inflammation, and oxidative stress in a male rat model of poor maternal nutrition and accelerated postnatal growth Am J Clin Nutr 2016;103:579–88
[xi]Farsi F et al. Functions of Coenzyme Q10 Supplementation on Liver Enzymes, Markers of Systemic Inflammation, and Adipokines in Patients Affected by Nonalcoholic Fatty Liver Disease: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial. J Am Coll Nutr. 2016 May-Jun;35(4):346-53.
[xii]Bertelli A et al. Protective action of L-carnitine and coenzyme Q10 against hepatic triglyceride infiltration induced by hyperbaric oxygen and ethanol. Drugs Exp Clin Res. 1993;19(2):65-8
[xiii]Subramanian VS et al. Uptake of ascorbic acid by pancreatic acinar cells is negatively impacted by chronic alcohol exposure . Am J Physiol Cell Physiol. 2016 Jul 1; 311(1): C129–C135.
[xiv]Davis J. Liposomal-encapsulated Ascorbic Acid: Influence on Vitamin C Bioavailability and Capacity to Protect Against Ischemia–Reperfusion Injury Nutr Metab Insights. 2016; 9: 25–30.