Do Probiotics Help Hangovers?

As a nutritional therapist I wouldn't ever recommend over-indulging on alcohol, but even with the best intentions, a fun outing sometimes ends up being ‘boozier’ than was intended! When this happens,  chances are that you will be crawling out of bed the following morning with any or all of these typical hangover symptoms: headache, body aches, nausea, vomiting, an upset stomach, and an overwhelming sense of fatigue. 
Unfortunately, there is no miracle cure for hangovers, but there are many natural remedies and recipes which people swear by to help ease their symptoms. Not many of these remedies are backed by science, but research is beginning to indicate a role for probiotics in hangover prevention and management. But before we find out how probiotics can help hangovers, we need to understand why hangovers happen.

Within this article:

• Why do we get hungover?
• How does alcohol affect the gut?
• How do probiotics help hangovers?
• How to avoid a hangover:

Why do we get hungover?

There are a number of reasons why people feel ill after drinking to excess:

• Firstly, alcohol is a diuretic which causes increased urination and therefore dehydration. Along with fluids, electrolytes are also lost, which can contribute to the headaches, nausea and fatigue.
• Due to the high concentration of sugar in most alcoholic drinks, their consumption can lead to imbalances in our blood glucose levels which again reduces cellular energy and creates that feeling of brain ‘fog’ or spaciness.
• Additionally, most people don’t sleep well after an evening of drinking, as alcohol affects our circadian rhythms through disruption of neurotransmitters such as serotonin and melatonin.
• Alcohol is metabolized (or converted) into various bi-products in the liver. These bi-products may play a role in the unpleasant symptoms of a hangover.

The first stage of the conversion of alcohol (or ethanol) involves its breakdown in the liver to acetaldehyde. This is then later broken down further to acetate. Acetate is completely non-toxic, however the intermediate break down product (acetaldehyde), is known to cause many of the symptoms associated with that ‘morning after’ feeling.

Dependent on your liver function, some people metabolize acetaldehyde more quickly than others, which partially explains why some people suffer more than others for their ‘indulgences’!

How does alcohol affect the gut?

As well as its systemic effects, alcohol is also known to impact the digestive tract in various ways:

• It is known to irritate the gut lining, by increasing acid production.
• Increased acid production can lead to inflammation of the stomach and GI tract lining, known as gastritis.
• Alcohol also appears to alter the balance of gut flora. 
• In young people, excessive drinking has been associated with poor emotional recognition⁴. 

Gut function and the health of the microbiome can have far reaching effects on overall health, so it's not hard to see why hangover symptoms are so varied. Let's find out more about how probiotics might help hangovers.

How do probiotics help hangovers?

There has been some research in the past few years looking at the effects of probiotic bacteria on the symptoms resulting from excess alcohol intake. Results do seem to suggest that yes,  probiotics are good for hangovers!

A Russian study¹ showed that study participants that drank alcohol regularly had lower levels of three types of gut bacteria, namely: Bifidobacteria, Lactobacilli and Enterococci. Within 5 days of supplementing probiotics, their levels of both Bifidobacteria and Lactobacilli had significantly increased.

However, more interestingly, the study participants liver enzymes which had previously been elevated, had decreased to within normal levels after the probiotic supplementation. Elevated liver enzymes in a drinker, are usually a sign of liver inflammation from alcohol exposure. The fact that these enzymes dropped following probiotic supplementation, means that there was some sort of improvement in liver inflammation as a direct result of the probiotic treatment.

Probiotic bacteria were also featured in a 2022 study³ with 24 participants. Results indicated that the proprietary blend of live cultures in the supplement helped to reduce alcohol absorption from the intestines, which subsequently reduced the absorption of alcohol into the body systems. This was a very small study and further research needs to be done but so far the limited research does seem to suggests that probiotics may have a part to play in hangover prevention.

Bifidobacteria are believed to help break down and detoxify acetaldehyde⁴. By preventing the accumulation of this toxic by-product of alcohol metabolism, Bifidobacteria are thought to help prevent symptoms of a hangover. Naturopaths often recommend taking Bifidobacterium bifidus before going to bed, and again the following morning to reduce the severity of a hangover.

People with a healthy, balanced gut, and good levels of friendly bacteria may therefore have the capacity to better deal with over-indulgences, than those people that have depleted probiotic colonies. This may explain why some people seem to ‘bounce back’ faster after any dietary, or alcohol-related, ‘faux pas’ than others, presenting us with yet another compelling reason to look after our gut flora! 

My own hangover tips are below, though the best cure for a hangover will always be to drink less alcohol the day before!

How to avoid a hangover

• Drink plenty of water on a night out, and again before bed, to limit the effects of dehydration
• Take 50-75mg of B-complex before bed. B-vitamins are important in carbohydrate (and therefore alcohol) metabolising process, and also in dilating blood vessels, therefore reducing headaches. They also help to restore energy levels and balance blood glucose levels.
• The herb milk thistle, has liver protective effects as it prevents toxins from entering liver cells. It also helps to detoxify any circulating toxins.
• Feverfew, is effective at treating headaches and has none of the negative impacts on the digestive tract that aspirin has.
• Vitamin C stimulates the liver to break down alcohol. Use a mild, non acidic form of vitamin C that is gentle on the stomach, such as magnesium ascorbate, rather than ascorbic acid.
• Try taking a supplement of the green algae chlorella before bed. Chlorella contains high levels of chlorophyll which make it excellent as a detoxifier.
• Take a good-quality multi-strain probiotic before bed, and again in the morning. The formulation should include at least one strain of Bifidobacteria to help break down the toxic metabolites of alcohol breakdown.
• If you suffer from an upset stomach or diarrhoea after consuming too much alcohol, then Saccharomyces boulardii (healthcare practitioners can find out more about this strain on the Probiotics Database) might be helpful, as it helps reduce inflammation in the intestines, caused by excess alcohol.

As you can see there are lots of simple steps that you can take to reduce the effects of drinking too much alcohol. The simplest of course, is not to over-do it in the first place, but if that doesn't sound like much fun, at least you know you can rely on a few natural remedies to help put the spring back in your step.
How our gut health impacts on our general health is a fascinating topic. If you would like to read more on related topics, see: Gut Health - all you need to know or All about the microbiome.

For more about the effects of the occasional 'tipple' you might like to read this fun article: Is wine a probiotic?.

References

1. 2008 Dec;42(8):675-82. doi: 10.1016/j.alcohol.2008.08.006.Probiotics restore bowel flora and improve liver enzymes in human alcohol-induced liver injury: a pilot study. Kirpich IA1, Solovieva NV, Leikhter SN, Shidakova NA, Lebedeva OV, Sidorov PI, Bazhukova TA, Soloviev AG, Barve SS, McClain CJ, Cave M.
2. Pfützner A, Hanna M, Andor Y, Sachsenheimer D, Demircik F, Wittig T, de Faire J. Chronic Uptake of A Probiotic Nutritional Supplement (AB001) Inhibits Absorption of Ethylalcohol in the Intestine Tract - Results from a Randomized Double-blind Crossover Study. Nutr Metab Insights. 2022 Jun 23;15:11786388221108919. doi: 10.1177/11786388221108919. PMID: 35769391; PMCID: PMC9234833.
3. Jung SJ, Hwang JH, Park EO, Lee SO, Chung YJ, Chung MJ, Lim S, Lim TJ, Ha Y, Park BH, Chae SW. Regulation of Alcohol and Acetaldehyde Metabolism by a Mixture of Lactobacillus and Bifidobacterium Species in Human. Nutrients. 2021 May 30;13(6):1875. doi: 10.3390/nu13061875. PMID: 34070917; PMCID: PMC8228388.
4. Carbia C et al., The Microbiome-Gut-Brain axis regulates social cognition & craving in young binge drinkers. eBioMedicine, 2023; 104442 DOI: 10.1016/j.ebiom.2023.104442