5 Common Ingredients in Alcoholic Drinks That May Worsen Hangovers

It’s likely if you’ve drunk a lot of alcohol at one time, you’ve woken up feeling pretty awful. Maybe you felt nauseous or tired with no desire to eat. In other words, you had a hangover. That morning-after hangover can be disorienting and downright painful. And while those feelings are a result of the ethanol in alcoholic drinks, there could also be other ingredients and substances in your drink that are contributing to how you’re feeling.

What is a hangover?

A hangover refers to the symptoms a person experiences once blood alcohol starts leaving their system- in other words, after your body starts to process alcohol. These symptoms vary from person to person, but some common symptoms include:

• Fatigue

• Difficulty concentrating

• Nausea

• Loss of appetite

• Thirst

• Diarrhea

• Headache and dizziness

• Tremulousness (jitters)

Researchers still haven’t pinpointed a single culprit for hangovers. It’s known that people have an inflammatory response (increased inflammation in the body) to ethanol (the chemical that makes you drunk) in alcoholic drinks. This response is similar to what happens when people are sick, which may explain why people feel generally bad after drinking, just as they would if sick. Some people’s genes also cause them to process alcohol differently and this can lead to worse hangovers.

Alcohol can also cause stomach irritation, dehydration, and difficulty sleeping which can make you feel even more terrible. 

It isn’t only the ethanol in alcohol that’s the culprit for how you feel after drinking alcohol though. Additives and byproducts that are in common drinks, from red wine to bourbon, may also be at fault, even if you don’t have a hangover the next day. Here’s what you need to know. 

What ingredients may worsen a hangover?

Histamines

You may be familiar with the term “histamine” if you’ve ever seen a commercial for allergy medications. 

“Histamines are chemical substances released in the body by white blood cells when the immune system encounters an allergen,” said Taylor Graber, MD, physician, and owner of ASAP IVs in San Diego, CA. Some alcoholic drinks contain high amounts of histamines. For most people, histamines are not a problem, but for some who cannot metabolize the substance well, they can cause various symptoms, including:

• Facial flushing

• Nasal congestion

• Diarrhea and gastrointestinal upset 

• Headache

• Rarely anaphylaxis

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Histamines are also a common reason why some people get red wine migraine headaches. “These are actually not migraines, but a problematic reaction that is a headache due to histamine intolerance,” said James Pratty, M.D., who serves as the medical director of psychiatry and behavioral health for Brand New Day in Westminster, CA, and assistant professor of psychiatry at the University of California Riverside School of Medicine.

Drinks that are especially high in histamines, aside from red wine, include:

• White wine

• Fermented beer

• Champagne

Congeners

Congeners are compounds produced as part of the fermentation or distillation process and add color and flavor to some liquors. And they may be partially to blame for making hangover symptoms worse. It’s also thought that congeners can trigger migraines. 

Drinks that often have congeners include:

• Brandy

• Whiskey

• Red wine

• Bourbon 

Keep in mind the amount of ethanol may trump congeners when it comes to hangovers. So drinking a higher amount of vodka, which contains a low amount of congeners, can still cause a worse hangover than drinking a smaller amount of bourbon, which has a much higher congener content.

Sulfites

Sulfites come from sulfur compounds and are naturally occurring in grapes used for wine and the grains used to make beer. They are also often added to wine and beer to reduce the growth of harmful bacteria. 

For most people, sulfites aren’t a problem. However, it’s possible to have a sensitivity or allergy to them, especially in people who have allergies or asthma.

And if you’re in the latter group when you consume alcoholic drinks with sulfites, you may experience:

• Worsened asthma symptoms such as wheezing and coughing

• Very rarely, anaphylaxis

It’s also thought that a sulfite sensitivity may be partially responsible for headaches after drinking wine in some individuals.

When choosing a wine, consider that red wines often have fewer sulfites than white wines. 

Tyramine

“Tyramine is also a well-known chemical that can cause migraine headaches,” said Graber. It naturally occurs in foods and drinks, especially those that have been aged. It’s thought that consuming tyramine-rich foods causes a tightening of brain blood vessels, leading to throbbing head pain.

Whether the tyramine in wine is a cause of headaches isn’t fully known. But what is known is that tyramine-rich foods and drinks are problematic if you’re taking a certain type of medication called a monoamine oxidase inhibitor (MAOI). When you’re taking a MAOI, your body cannot process tyramine very well. Consuming high-tyramine drinks in excess could cause a rapid and severe rise in blood pressure (hypertensive crisis).

Most alcoholic drinks are low enough in tyramine to be considered safe. But, only if drunk in moderation — no more than 2 drinks every 2 hours. Although for overall health it’s best to limit your alcohol to 1 drink or less per day for women or 2 drinks or less per day for men. And avoid drinking on an empty stomach, as this can result in higher tyramine absorption.

Fermented tap beer should be avoided entirely. 

Gluten

Some people may have gluten intolerance or sensitivity where they experience certain symptoms after consuming foods that contain gluten. Some of these symptoms can mirror those of a hangover, such as:

• Diarrhea or constipation

• Headache

• Fatigue 

• Unexplained mood changes

• Lack of ability to think clearly (sometimes called “brain fog”)

Keep in mind that gluten sensitivity is different from Celiac disease, which is an autoimmune condition with over 300 symptoms, some of which can also be similar to a hangover. 

Most liquors undergo a distilling process that makes them gluten-free. However, since beer is fermented, not distilled, it contains gluten and should be avoided if you have Celiac disease (unless it’s a gluten-free beer). If you’re gluten-sensitive, you may be able to tolerate alcoholic beverages with lower amounts of gluten, but everyone’s reactions may differ. Also, be on the lookout for hidden gluten in liquors with flavorings or other additives after distillation, such as malt. 

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Written by:

Terri Williams, BA

Terri Williams is a journalist with bylines at The Economist, American Bar Association Journal, Livestrong, Time, Yahoo, USA Today, The Balance, U.S. News & World Report, Verizon, Real Simple, and The Houston Chronicle.

Edited by:

Kelsey Abkin

Kelsey Abkin has been working as a journalist since 2016. She has held many titles throughout her career, including editor, content strategist, digital strategist, and writer.

Reviewed by:

Aunna Pourang, MD

Aunna Pourang, MD, graduated from the University of Florida College of Medicine’s Medical Honors Program and is board-certified in family medicine (Mayo Clinic). She is also fellowship-trained in integrative medicine (Academy of Integrative Health and Medicine).

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