This is a transcript of the Gastropod episode, The Hangover: Part Gastropod, first released on October 27, 2020. It is provided as a courtesy and may contain errors.

ADAM ROGERS: Sure. My name is Adam Rogers. I’m a senior correspondent at Wired, and I’m the author of a book called Proof: the Science of Booze. This is about a level of enjoyment and a high level of interest, but it’s not about addiction, which is a huge problem with alcohol. And it’s really—it’s not about consumption to excess, except in one specific case, which was this chapter on hangover, because of two things. First, I knew that it was everybody’s question. Whenever I told anybody I was writing a book about the science of booze, they would say, what about hangovers? And, also, it was a honey trap. Because I knew it was popular, and I knew it was going to be the thing that people would want to talk to me about. So it has succeeded yet again! The jaws of my trap have snapped shut around your excellent podcast.

NICOLA TWILLEY: We were lured in by Adam’s hangover honeytrap, and so we’re doing the same to you! Welcome to the hangover honey trap episode of Gastropod, I’m Nicola Twilley, and I never thought I’d say that sentence.

CYNTHIA GRABER: And I’m Cynthia Graber, and of course Gastropod is the podcast that looks at food through the lens of science and history. And so while hangovers aren’t food per se, they are the result of a food, or, you know, a beverage.

TWILLEY: But what are they? What is the medical basis of this unfortunate condition? And more importantly can science do anything about it? I’m picturing labs full of scientists working on the hangover, trying to come up with a cure the way they do for cancer.

GRABER: Could the cure be hidden in one of the many traditional hangover recovery recipes you listeners sent us? But also, we’re using hangovers as a honeytrap themselves to lure you in so we can talk about what was until recently the most overlooked of all the organs—the liver!

TWILLEY: You say overlooked, Cynthia, but the liver used to be more important than the heart—it was so powerful that if you asked it the right question, it could predict the future. Forget tarot: what you need to know what’s going to happen next is a juicy slab of organ meat.

GRABER: But to bring this back to food and drink, what role does the liver play in hangovers, and could we somehow unlock its secrets to help prevent splitting headaches and nausea?

TWILLEY: All my fingers and toes are crossed. This episode is all that—plus we explore the weird but huge phenomenon of hangover drinks in Korea.

GRABER: A quick note: as Adam said, alcohol abuse and addiction is a really serious issue, and it’s something we’ve covered before on Gastropod. It’s not the focus of this episode, but, if alcohol is a problem for you, we will be talking about drinking.

TWILLEY: This episode was made possible thanks to generous support from the Alfred P. Sloan Foundation for the Public Understanding of Science, Technology, and Economics, as well as the Burroughs Wellcome Fund for our coverage of biomedical research.

PRE-ROLL

GRABER: Like he said, Adam Rogers wrote a book about booze, and of course you can’t write a book about booze without writing about booze to excess. The hangover.

TWILLEY: The morning after the night before.

ROGERS: And you sort of know when it’s coming. Like you, you know, you wake up and before you’ve done the full inventory, you feel the fear—like, oh, this is going to be a bad day. It’s gonna be bad.

GRABER: This is really what a hangover is. It’s a description of a feeling.

ROGERS: Well, one of the fascinating things about hangovers is that the symptomatology varies widely from individual to individual. It’s one of the things that makes them hard to study. But some of the things that are, at least, common enough that people will recognize are: headache, sensitivity to light and sound, kind of generalized malaise, a feeling of exhaustion, inability to concentrate and focus, gastrointestinal upset of various kinds—diarrhea to stomach ache to heartburn. And kind of just a sense of like… confusion that goes beyond just being tired or inability to operate complex machinery, as the label might say.

TWILLEY: This all sounds far too familiar from my own personal history, but what is the actual history of this most horrible of sensations?

ROGERS: As long as we’ve had alcohol, which is, you know, really since human beings consumed anything made from agricultural products because things ferment spontaneously, people have experienced the bad outcomes of overdoing it.

GRABER: Hangovers show up in a number of historical documents; one of the oldest and most terrifying is from The Odyssey. And in case you were curious, scholars think The Odyssey probably is nearly three thousand years old.

ROGERS: One of the names for hangovers is “Elpenor’s Syndrome” because of a character in The Odyssey who, the night where Odysseus and his crew were going to escape from Circe’s island, they know they’re leaving the next day and so they have a huge party. And the next morning, Elpenor is so hungover—he wakes up and he’s so hungover that he falls off of the building, the roof of the building where he’s been sleeping, and he dies. And they leave him behind. They don’t notice that he’s gone. And Odysseus feels all kinds of guilt about that later and encounters him in the underworld at one point and has to apologize. It’s like the most mortifying, literally mortifying, kind of hangover. You know, embarrassment is one of the symptoms, where you’re like, I don’t remember a lot of what happened last night, but I realize I behaved poorly.

GRABER: The experience of this—minus the falling off the building and the encounters in the underworld—otherwise it’s both universal and ancient. But the word “hangover” didn’t appear until the early 1900s. Before that it was called some rather evocative phrases: morning fog, gallon-distemper, bottle ache, cropsick, busthead.

TWILLEY: The first recorded use of the word hangover is in a humor book from 1904; it was called The Foolish Dictionary. And in its definition for the word “brain,” it says: “Usually occupied by Thoughts and Ideas as an Intelligence Office, but sometimes sub-let to Jag, Hang-Over, and Company.”

GRABER: And here we are, stuck with hangovers. The word apparently really picked up around World War II—I can’t imagine why people were doing a bit more drinking at the time.

ROGERS: There’s a clinical term that gets used sometimes, which is more recent: veisalgia, which just means the pain and regret from the night before, essentially. But it’s rarely employed. Partially because there’s so little actual clinical study of hangover in the first place.

TWILLEY: Yeah, my vision of a lab full of scientists working on the hangover? Adam says that’s not the case at all.

ROGERS: There are a handful of researchers who study hangover. And it’s not usually their main thing. There are very few. It’s very hard to get grant money for it. It’s, it’s kind of looked down on in a weird way. And nobody who I talked to is sure of why that would be, except because there’s some kind of moral panic about it.

GRABER: Studying the hangover gets tied up with a lot of value judgements. Like, maybe if you find a cure, people would drink more because they wouldn’t have to deal with the pain the next day.

ROGERS: So you can get a lot of money, and rightly so, to study addiction, to study the consequences of drunk driving, driving under the influence, all the bad outcomes that really are bad for alcohol societally. But there’s a perception, I think, that if you’re looking at hangover, you’re studying like the—not the good outcomes but like, you’re trying to fix one of the bad things that’s supposed to keep people in check.

TWILLEY: Adam says there is a small hangover research group, and they do occasionally meet up and share results.

ROGERS: They all present some—what remain, even years after I looked at it, preliminary results with small numbers of people. There’s still some controversy over what the clinical definition of a hangover even is, much less how to objectively verify with lab tests whether somebody is hung over.

GRABER: This is a huge part of the problem when it comes to science. How do you measure all these horrible feelings you get when you’re hung over?

ROGERS: I don’t think there’s an objective metric for, you know, the fatigue and confusion and kind of brain cloud you get when you’re hung over.

TWILLEY: We can measure how drunk you are. Even before breathalyzers, people had developed ways to evaluate that.

ROGERS: In the early days of alcohol research in general, one of the metrics for how impaired somebody was, was how fast they could type compared to when they weren’t impaired. But it’s harder to find those proxy measures with hangovers, especially because the symptoms are so different from person to person. You know, even just like the fact that mine tend to sit in my gut while other people’s tend to be headache. Like, are those the same syndrome even? The symptomatology is totally different, and because the physiological measures are so hard to find, that becomes a very difficult thing to study, in addition to the societal pressures against studying.

GRABER: Researchers have developed a scale to quantify these symptoms, it’s called HSS for, yes, Hangover Symptoms Scale. It is also pretty subjective: there’s a sliding scale for a dozen symptoms. They include unpleasant things like clumsiness, dizziness, sweating, shivering, stomach pain, and nausea.

TWILLEY: I love the idea that science could help you know whether you’re having a truly dreadful hangover, like a 10 on the hangover scale. That would for sure make the whole experience so much better.

GRABER: So it’s tough to measure the ways that a hangover affects you, or me, or anyone else. But what about figuring out why we get them in the first place? Have scientists made any inroads into answering that question?

TWILLEY: Right, that is a question that I can see actually being useful information. I mean, it’s one thing to be able to measure how terrible you feel—

ROGERS: I also wanted to know why. You know, that happens to you and this—I feel terrible. What’s going on here? You know, if you have any interest in kind of the science of the universe or you’re interested in medicine and health and science, you’ll want to know how did that happen?

GRABER: There is one thing that scientists know for sure—they know the liver is involved.

ROGERS: The liver is kind of the place that makes the stuff that the body uses to process the alcohol. And people will kind of casually say, well, you know, alcohol is a poison. It’s a toxin. And that’s sort of not exactly right. You know, it’s not—like it’s not an alkaloid plant toxin.

TWILLEY: The key ingredient in alcohol is a chemical called ethanol, that’s what the yeast makes when it eats all the sugars in the grapes, or malt, or whatever. And ethanol gets broken down by enzymes in your liver.

SANGEETA BHATIA: So the liver is an organ, it’s about the size of a football. And it sits in your belly tucked underneath your right rib cage. And so if you take a deep breath in, you can kind of feel it, like poking out there from your ribs.

GRABER: Sangeeta Bhatia is a biomedical engineer at MIT and pretty much a superstar in the bio-engineering and liver worlds. She’s the first person to create tiny little functioning livers, like a liver on a chip, that can be used to study all sorts of things about this organ.

BHATIA: Simplistically, when people think about organs, you know, they say like, the heart is the pump. The kidney is the filter. People say about the liver that it’s like a factory. So it takes in lots of things and spits out lots of things. And it does a lot of metabolism.

TWILLEY: A lot of researchers think the heart is exciting—it’s this pump that keeps our body going. Or the brain—that mysterious seat of consciousness. But Sangeeta chose to study the factory—she picked the liver.

BHATIA: You know, I think about it, sometimes it’s sort of like falling in love. Like, you don’t really know why. But I sort of met the liver in the first year of my graduate school when I was a graduate student, and was fascinated with it.

GRABER: At the time, she was pretty lonely in her love.

BHATIA: So when I started working on the liver, which was in the 90s, it’s not a popular organ in the U.S. for, I think, lots of almost social reasons. In terms of like, the way that you can damage to your liver is seen to be historically a bit self inflicted. And, as a result, a lot of people didn’t study it.

TWILLEY: The liver might not have been fashionable in the 90s, but it definitely was further back in the past. Sangeeta would have had plenty of company in her liver appreciation society thousands of years ago.

BHATIA: It also has a really rich kind of mythological history. The liver, it used to be said that before—you know, we say now you get a broken heart. In some cultures, the translation is actually that you have a burned liver. So it used to be the center of like, all of the different streams of life.

MARIE-LAURENCE HAACK: The liver was considered the site of the soul, and the central place for all forms of mental and emotional activity.

TWILLEY: Marie-Laurence Haack is a professor of ancient history at the University of Picardy in northern France.

HAACK: Actually, the liver is an organ full of blood and it is bigger than the heart. Many ancient peoples thought that the mind of the gods was reflected in the liver of the animal.

GRABER: This idea—that the liver was so critical that the mind of the gods was reflected in an animal’s liver—it led to what’s called haruspicy. It’s like the ancients were using the liver as a magic eight ball.

HAACK: Yeah, haruspicy is a form of divination by the inspection of the livers of sacrificed sheep or goats. People thought that the gods sent messages to decipher with the help of soothsayers.

TWILLEY: Marie-Laurence told us that this fortune-telling technique—asking questions that the gods would then answer through an animal’s liver—it seems to have first emerged in Babylonia and Assyria, and then spread to ancient Greece.

GRABER: We no longer know exactly how they read the liver. There are a couple of murals that survived in Italy that depict haruspicy; you can see a soothsayer or fortune teller holding the liver of an animal in his hand and examining it.

TWILLEY: There are also a couple of model livers that give us some clues as to what the soothsayer was looking for. There’s one bronze liver that was found at an archaeological site in southern Italy that had different constellations marked on different parts of the liver, so you could see which section corresponded with which god. A soothsayer would also look at the shape, and size, and even the color of the liver—

HAACK: When the liver was black, it was a bad sign.

GRABER: A black liver does sound like a bad sign, at least for the animal involved. Not so sure about the gods.

TWILLEY: So we were curious what the liver could tell you? What kinds of questions would you even ask a liver?

HAACK: The response of the liver could be yes or not to simple question on the state of mind of the gods. For example, were the gods angry? Were they satisfied? A good reader of the liver could predict the response of the god: yes or no. And he could predict also illness, death, victory, or defeat.

GRABER: Marie-Laurence says there is one story of liver divination that has lasted through the ages. A liver soothsayer named Spurinna sacrificed a bull that apparently didn’t have a heart and had a malformed liver—this is a story that William Shakespeare included in his play Julius Caesar. 

CLIP
ACTOR PLAYING CAESAR: Speak! Caesar is turned to hear.

TWILLEY: Spurinna took this dodgy liver as a bad sign, which seems fair, and, then, again according to Shakespeare, who definitely wasn’t there, he then uttered the immortal lines:

CLIP
ACTOR PLAYING SPURINNA: Beware the Ides of March!

HAACK: And warned Caesar that his life was in danger for a period of 30 days, which ended on March 15. And Julius Caesar was assassinated by a group of senators on that day. So the prediction was right.

GRABER: That’s one win for team liver! Unfortunately, despite this apparent successful fortunetelling event, haruspicy died out when what’s now Italy became a Christian country.

TWILLEY: But don’t worry, if you would like to consult a liver today, you can, there is a haruspex, which is the name for someone who haruspices—she uses chicken livers, because they’re easier to get hold of and she lives up the street from my old neighborhood in Brooklyn!

GRABER: A haruspex in Brooklyn. I’m shocked.

TWILLEY: So haruspicy may or may not accurately foretell the future, but one of the other major ancient myths about the liver is really true.

BHATIA: And, you know, the myth of Prometheus is that he stole fire from the gods. And his punishment was that he would be strapped on to this rock and exposed to the elements. And every day an eagle would come and eat at his liver, that was the punishment. What the hepatology community infers from that is, Oh, look, even then they knew that the liver regenerates, because the only way this myth works is that the liver is regenerating, and the eagle eats it and the liver is regenerating when the eagle eats it.

GRABER: And this is actually one of the reasons the liver is having a comeback today—the liver is the only organ other than our skin which can indeed regenerate. If you lose a part of your liver, it’ll just grow back. The ancients got that right.

TWILLEY: On a more day-to-day basis, though, the liver really is a factory, like Sangeeta said. Raw materials go in, the liver does stuff, and finished products come out the other side.

GRABER: Quinton Smith is a researcher in Sangeeta’s lab.

QUINTON SMITH: So the liver aids in something called glycolysis, where it breaks down, for example, carbohydrates in our meals. So we have starches, we have sugars that are processed by the liver. The liver also breaks down fats, it also breaks down proteins.

GRABER: The liver is breaking down fats and carbohydrates—and alcohol. There are enzymes in the liver that break down ethanol and turn it into something called acetaldehyde.

SMITH: So if you look at acetaldehyde, it’s almost like formaldehyde, which is a very toxic substance that people might be more familiar with. This actually can cause an inflammatory response.

ROGERS: And it’s possible that that’s maybe the thing that causes the symptoms of hangover. Problem is, it’s very hard to detect. It’s really evanescent.

TWILLEY: Adam’s point is that the acetaldehyde is hard to measure because it really isn’t around for very long. The liver keeps pushing it along the factory line, and turns it into acetate, which isn’t as toxic—it’s essentially the same as the acid in vinegar

GRABER: But so we can find a clue to how acetaldehyde affects our headaches and nausea by studying people who can’t get rid of it.

ROGERS: People who come from countries in Asia tend to make less of or none of one of the key enzymes that breaks it down. So they sort of jump right to hangover from a drink rather than feeling intoxication.

TWILLEY: And actually, scientists have used that insight to create a medicine that is prescribed to prevent alcohol abuse.

BHATIA: And the way that medicine works is it inhibits these pathways that we’ve been talking about, and patients would get this feeling of an instant hangover, and it is a deterrent for drinking. And so that is an actual medicine.

TWILLEY: Thanks science! You’ve made a medicine for an instant hangover, now how about one to cure it?

MID-ROLL

GRABER: Part of the problem when it comes to trying to cure the hangover, at least when it comes to ethanol, is that ethanol isn’t just going through the liver, there’s also some that gets stranded in the blood. And so from there, it ends up pretty much everywhere.

ROGERS: Ethanol is a very small molecule that crosses the blood-brain barrier, which is unusual for most molecules. The body usually keeps anything except oxygen and blood out of the brain. Ethanol gets in there.

GRABER: Though it’s not super clear exactly what it’s doing in there.

TWILLEY: Adam says, because it’s in your blood, ethanol also gets into your kidneys and messes with them, it gets into the lining of your stomach and intestines and gives you a stomach upset.

GRABER: So in theory any hangover remedy should deal with the effects of ethanol. But it’s not the only problem. Scientists have a lot of theories about what else might be contributing to our hangover pain.

ROGERS: Well, right. So one of them is that alcohol suppresses a hormone called vasopressin, or the antidiuretic hormone. And that’s a hormone that keeps you from peeing too much. So alcohol has a dehydrating effect. But if you are hydrated, you still get hungover.

GRABER: So dehydration might add to your morning misery, but it’s certainly not the only cause.

TWILLEY: Another theory blames something called congeners.

ROGERS: Congeners are everything that’s in alcohol—everything that’s in a drink, that’s not the alcohol or the water.

GRABER: Vodka as you all probably know is clear. It’s technically just ethanol and water. But now picture whiskey or beer, or basically anything other than vodka. It has all sorts of other things in it that give it color and flavor. Those are called congeners.

ROGERS: So there’s all these other chemicals that are in there and there were some hypotheses that said, well, those congeners— maybe people are allergic to some of those. So people will test like, OK, well, you over there drink vodka, you drink brandy, you drink whiskey. Who gets the worst hangover? These are terrible studies—terrible. I feel bad saying that. These are not great studies.

TWILLEY: Like a lot of hangover research, these studies were done on a super small group of people and the measurements all seem to be rather subjective.

ROGERS: In some of them, people reported having worse hangovers with, say, brandy than they would with vodka. But you still get hung over from the vodka.

TWILLEY: So congeners might be part of the problem, but, again, they’re definitely not the only cause of a hangover.

GRABER: Onto the brain hypothesis. Alcohol is known to be a depressant. And so there’s a theory that your brain creates a bunch more receptors to pick up the slack when the brain’s activity is depressed from drinking too much.

ROGERS: But then once the depression is gone, you still have a lag of when the brain hasn’t cleaned out all of those kind of receptors that have been built specific to that task. When you snap awake, and you feel bad and you’re like, you’re too hot or you’re too cold and don’t feel good and you stumble to the bathroom, all that stuff—that might just be that the brain has recalibrated itself to deal with too much alcohol, but now there isn’t too much alcohol, but the brain’s still recalibrated. So now you have all kinds of hangover problems. That’s a hypothesis.

GRABER: It might be part of why your focus and energy are so messed up. But there isn’t any good evidence yet to support this theory.

TWILLEY: Yet another hypothesis is that because alcohol messes with your pancreas, that organ can’t handle all the sugar in your mixers as well as it normally would, and so your blood sugar gets all out of whack and that’s part of the hangover feeling too. But Adam says that’s also not probably the main cause.

ROGERS: But that’s really true with a lot of hangover research. The answers to almost every question that I try to ask are, like, Well, it’s this, but that’s probably wrong.

GRABER: So far, based on all the not super strong hangover research to date, the liver seems to play the biggest role in hangovers—Sangeeta and Quinton say that acetaldehyde does cause an inflammatory response. And your liver does make acetaldehyde as it breaks down ethanol.

TWILLEY: Even though that acetaldehyde is not normally around for very long, because the liver keeps on breaking it down. So we don’t really know exactly why it would trigger such a horrific response. But still.

ROGERS: So that’s the one that seems like the best account the people have so far. And the idea there is that if you think about it, the symptoms of a hangover feel very much like the flu. Right? I mean, they kind of do.

TWILLEY: And so this theory goes that that’s because after you’ve consumed too much alcohol, your immune system is going into overdrive trying to fight off inflammation—the same way it would if it was fighting the flu.

ROGERS: So a lot of hangover symptoms look like inflammation. And, in fact, they probably are.

GRABER: So, long story short, while inflammation seems to be maybe the primary cause, nobody’s totally sure exactly why we end up with all of the nausea and dizziness and aches and pains. But it doesn’t mean people haven’t been trying to fix hangovers for thousands of years.

MID-ROLL

TWILLEY: We decided to mine the wisdom of Gastropod listeners for this episode, thinking that maybe some of you, perchance, might have had a hangover in your lives and thus might know a cure or two. Turns out that having another drink is a concept that is popular worldwide.

AIZA: Hi Gastropod. So in Mexico we have some remedies. So some people cure hangovers here with even more beer.

ANJA: Hi Cynthia, hi Nicola, this is Anja from Germany. Here people will tell you to chug a Konterbier, which literally translates to a counter beer. It’s the same idea as “hair of the dog,” I guess.

TWILLEY: I mean, if you think about it, one obvious way to avoid a hangover is to never stop drinking.

ROGERS: That’s right. Good plan! LAUGHS Here’s what I’m gonna do: I’ll just never be sober again.

GRABER: Just stay—stay drunk. LAUGHS

TWILLEY: Wait, you don’t think that’s a good plan? How so?

ROGERS: Here’s the problem. You develop tolerance. So you just have to keep upping the ante of your alcohol consumption. That’s the problem with that plan.

GRABER: This is actually one of the oldest known hangover cures described, at least in Western traditions. The ancient Greek comic poet Antiphanes is as far as we know the first person to have coined the term the “hair of the dog,” in reference to the hair of the dog that bit him and his drinking buddies the previous night. Adam says this approach has been popular til—well, til today.

ROGERS: There were a whole set of very specific cocktails that were expressly designed to be breakfast-y, hangover-y remedy things. The Bloody Mary is one of them. But, basically, any of the drinks that had an egg in them were most likely pick-me-ups designed to make you feel better if you had a hangover. There’s one that I love to drink, I still love now, called the Corpse Reviver Number Two. That’s not about, you know, anything mystical or Lovecraftian. The corpse, in that case, is the person who has the hangover. It’s a drink meant to revive them.

GRABER: Totally delicious cocktail—I’m a fan. Not sure that’s the best way to deal with a hangover.

TWILLEY: We did some advanced data analysis on all your responses, and some key themes emerged—pickles and also soupy broth things— those seem like popular hangover remedies for a bunch of you.

VERONICA: Hi, my name is Veronica, I come from a Polish background, and our cure for hangovers is dill cucumber juice. So lots of vinegar, dill, garlic, and despite the horrified looks I get from my partner when I glug it down after a big night, I find that it works and it’s actually quite delicious.

LIONEL: This recipe is called l’aiga boldite. And L’aiga boldite in Occitan means “boiled water.” So it’s a very simple recipe, perfect for a hangover. In this recipe, you cut much, much garlic—again with the garlic, we’re always the French with the garlic—into pieces. You boil the garlic in water with some thyme, and you pour this soup onto a big slice of buttered country bread.

GRABER: That sounds delicious. A lot of you also pointed to super spicy foods and said they’d help you sweat out everything from your system. And then there were a lot of votes for fatty foods.

RUSSELL: Hi Gastropod. When I was a student, we believed there were three things that could cure a hangover. The first one was to drink a pint of milk before you actually went out for a drink—this was to line your stomach. The second one was to have a greasy kebab just as you finish the session, and then there was the full English the morning after.

LINDA: Hello Gastropod, this is Linda from Houston, Texas. I am actually a certified toxicologist, but I’ve known for a long time that the best cure for a hangover is none other than a large Sprite and large french fry from the golden arches of McDonalds.

TWILLEY: I mean if a certified toxicologist says it, it must be true. I will say I have had the full fried English breakfast many times after a night out—eggs, bacon, sausage, fried bread, and baked beans all drowned in some lovely gloopy brown sauce. It does feel good in the moment but it can backfire.

GRABER: I have to admit, as a hangover cure, that sounds really painful.

TWILLEY: A fried breakfast is delicious, but you do have to have a stomach of iron, which is not necessarily the case the morning after a big night out. In his book, Adam has a whole list of remedies that people have claimed work—there’s something called pyritinol, which is a vitamin B6 analog, and a pill called Liv-52, which has a bunch of Indian plants in it and is based on ayurvedic medicine, and then some extract of prickly pear, which is supposedly anti-inflammatory.

ROGERS: People make a lot of these cases, but there’s almost never a large scale, randomized controlled trial with a lot of people behind any of this stuff. They are claims based on anecdotal evidence and, you know, mouse studies and stuff.

GRABER: Those were all crappy studies. So Adam decided to do a very scientific study of his own and try these out on some friends after a hard night boozing.

ROGERS: My group experiment was a terrible, a catastrophic failure. But I had the best of intentions.

TWILLEY: The intention was that they would get drunk and then each of them would take a different remedy and report back

ROGERS: I don’t want to call it data. We’d report our response, let’s say.

GRABER: So a couple of friends came over to Adam’s house, he made them all sorts of drinks—he was pretty well set up at the time because it was right in the middle of his research on his book about booze. They got completely hammered.

ROGERS: And then I sent everybody home safely and they all sort of reported in saying, like, yes, that was the worst hangover I ever had. And maybe it helped a little bit and maybe it did. I can’t really tell. I woke up with one of the worst hangovers I’d ever had and took a handful of everything that I had in the house. So like, I took like a handful of all of the remedies that I had in one gulp and then went back to bed and woke up at about 3:00 with a bad hangover. So I would characterize that as an unsuccessful experiment. What did I learn? Don’t do that, that’s what I learned. LAUGHS

TWILLEY: Honestly, Adam says one of the best things is probably something you have every morning, not just the morning after. And we have a listener who agrees.

DALILA: Well, not surprisingly, in Italy, the main cure for hangover is espresso.

ROGERS: That’s the thing, that’s going to make you feel better because, you know, caffeine works, man. Caffeine is great for making you not feel as fatigued and improving your ability to focus and stuff.

GRABER: But really, we should be able to do better than this. There’s got to be a cure out there, somewhere. And as it turns out, we have someone on our team, Gastropod fellow Sonja Swanson, she’s lived in a country where they are famous for hangover cures.

SONJA SWANSON: I lived in Korea for about seven years, right after college. And my mom is Korean. So there is this kind of draw back that I had been feeling for a long time. And I ended up staying there for quite a while. But while I was there, as one does in one’s early and mid 20s, you go out and you drink and then sometimes you have a hangover in the morning.

TWILLEY: Sonja says there are a lot of hangover cures in Korea because there are a lot of hangovers there.

SWANSON: Yeah, you know, alcohol has definitely been a part of Korean traditional culture for a long time. Like they have these traditionally brewed rice alcohols that are an important part of holidays and ancestral rites, welcoming guests at weddings and things. I mean, still at some ancestral ceremonies, like at one that my family does for my grandmother called jesa, we take a glass of rice wine and we circle it around some incense before pouring it on her grave.

GRABER: Sonja told us the culture around drinking changed over the past century. Alcohol production became industrialized when Japan occupied Korea in the first half of the 1900s. And that meant that the traditional Korean rice alcohol soju became really cheap.

SWANSON: So you can get a 12 ounce green bottle of soju today—it’ll be less than two dollars from the convenience store.

TWILLEY: Of course, there are plenty of higher end drinks available and being consumed in Korea too—frankly, Sonja said that there are plenty of all kinds of drinks being consumed, on a pretty frequent basis.

SWANSON: You know, honestly, drinking culture is really pervasive. I mean, there’s a side of it that’s kind of delightful. I mean, I remember going to picnics where we would order fried chicken and have cold beer by the side of the Han River. And we’d be out at these wonderful, tiny little cozy bars and we’d sip soju with these yummy side dishes inside this pojangmacha, which is like a tent that they set up on like streets in the wintertime. There’s parts of it that are just really wonderful and delightful. But the pervasiveness of drinking has also infiltrated work culture. So South Korea has a really intense and kind of notorious office work culture. And there is this afterwork event called hoesik, which is kind of an obligatory party. Not so fun because it involves this kind of hazing and an intense pressure to drink. So it’s all part of this very, like, “work hard, play hard” office culture.

GRABER: And all this drinking comes at a literal price. Even in the U.S., where the drinking culture isn’t quite as pervasive, it’s a big deal.

ROGERS: There are some estimates that range into the billions of dollars of lost productivity, you know, which is a euphemism for people who call in sick the next day. And that’s just in the U.S. You know, places that are heavy drinking cultures, this is a consequence of that. They’ll have lost wages, lost work hours. People who mess up their work because they’re hung over. All that kind of stuff is a real—it’s real consequence.

TWILLEY: And so in these places that do have heavy drinking cultures, there’s also been a lot of effort and ingenuity devoted to avoiding the resulting hangovers.

GRABER: Like in most countries, Korea did have traditional hangover remedies. Sonja told us about one that included a bunch of herbs like arrowroot and gingko and pea flour. But the real boom in hangover remedies occurred as drinking got more popular.

SWANSON: Over the course of the 20th century, a category of foods known as haejang, those started to gain popularity. So haejang is this idea of a restorative post-drinking cure or hangover cure. And so this haejang kind of category is primarily, I would say, composed of maybe hot soups that you’re supposed to eat in the morning. So the most famous of those is his haejang-guk, which is—it’s like this really hearty stew. It’s got like blood cake and fiddlehead fern and chili paste.

TWILLEY: Sonja told us this was a traditional breakfast for dockworkers and night shift workers to eat on their way home. But when clubbing culture started being a big deal in Korea in the 60s, people who had been dancing all night would join them for a dawn bowl of stew with blood cake.

GRABER: Nourishing brothy soups caught on first, but then companies saw the huge market for hangover remedies and began selling all sorts of hangover drinks.

SWANSON: This is basically a category of canned or small bottled beverages. You can actually buy these at the very same convenience stores where you can also buy the cheap booze. Smart move. And they’re kind of a relatively new invention. They came to market in South Korea in 1992, with a drink called Condition. So they are really popular. In Korea the hangover drink market grossed over $165 million dollars in 2014 and it’s growing. So globally, Korea and Japan lead the world market in hangover drinks.

TWILLEY: Sonja graciously offered to act as our guide to this glorious world of hangover drinks, so we could do an experiment of our very own. But first there was a problem. We had to get drunk in order to get a hangover.

TWILLEY: So Cynthia prepared for this call with a full-on headache. And it is because she has been out all night getting completely wasted. Cynthia was trashed. LAUGHTER And she—I want a round of applause for Cynthia’s dedication to the cause. Thank you.

SWANSON: Bravo, bravo Cynthia.

GRABER: Actually, the headache was the result of a stress-induced case of insomnia, coupled with dehydration. No alcohol involved. But aren’t dehydration and sleep-deprivation hangover symptoms? So maybe I did prepare?

GRABER: Nicky, how about you? Are you prepared for today’s discussion?

TWILLEY: I had two glasses of very nice white wine. And then called it a night.

GRABER: So yes, is what you’re saying. You’re such a lightweight these days. LAUGHS.

TWILLEY: So, yeah, basically under the table. I mean, wow. They had to drag me to bed. Incredible. LAUGHTER

TWILLEY: Even Sonja, our resident expert, let us down.

SWANSON: I chickened out. I had most of a beer but, but couldn’t finish it last night.

TWILLEY: Most of a beer.

SWANSON: So that’s kind of where I’m at with the tolerance levels.

GRABER: So we’ve had most of a beer, two glasses of white wine, and zero alcohol, all in preparation for today.

TWILLEY: This is pathetic. And we should do better. Our listeners deserve better, honestly. But anyway. LAUGHS. Sorry.

GRABER: We couldn’t get blood cake, so Sonja suggested another hangover breakfast soup that’s made with bean sprouts and dried anchovies and garlic and scallions.

TWILLEY: But, I am sorry to say, we couldn’t get it together to get half of those ingredients either.

TWILLEY: So it turned out I didn’t—I only had a 250 gram package of bean sprouts. Also, I had mung bean sprouts, not soy bean sprouts. But it turns out they’re more or less the same? I think? Maybe? Sonja?

SWANSON: Yeah. Oh yeah. Yeah. You can totally make soup with mung bean sprouts. You’re all good.

GRABER: So I am not so good, although mine still looks and smells beautiful, because my grocery store was entirely out of bean sprouts, zero sprouts of any kind in my grocery store.

TWILLEY: Who knew that in COVID-19 people would be—

SWANSON: Everyone was hungover. LAUGHTER. Everyone was hungover.

GRABER: Everyone wanted bean sprouts. Everyone wanted sprouts. So I know it’s called bean sprouts soup, but I’m considering it a beautiful fish, like a fish broth. You know.

GRABER: So we gave our various attempts at bean sprout soup a try.

TWILLEY: All right. EATING SOUP. I’m trying.

GRABER: Mmm! That’s delicious. Without the beans sprouts. So I don’t know about that tender bean sprout thing. But the scallions are very tender. LAUGHS

TWILLEY: The broth is freaking amazing.

GRABER: Yeah, it’s really, really good.

TWILLEY: Basically, we were fans, hangover or no.

TWILLEY: That feels very restorative. I feel restored. I wasn’t even like…

GRABER: I do too.

TWILLEY: …hungover and I feel restored.

SWANSON: Oh good.

GRABER: I feel great. I just—mmm. I had a lot of that. That was good.

SWANSON: So…! Get ready for the world of hangover drinks. LAUGHTER

GRABER: Hangover drinks. These were actually pretty hard to find in the U.S.. Sonja had to scour Koreatown in Los Angeles. She did manage to find three different versions and bought us each one.

SWANSON: I actually got some funny looks from the checkout ladies at the Korean grocery store when I had a basketful of hangover drinks.

GRABER: Really?

SWANSON: So—yeah.

GRABER: That’s so funny.

TWILLEY: I love it.

SWANSON: And then I quickly explained that I was like getting some for some American friends who wanted to try some. And then she nodded, Ohhhh.

GRABER: You had to explain yourself. LAUGHTER

TWILLEY: Throw us under the bus, why don’t you, Sonja?

SWANSON: Right? I had to. I had to. LAUGHTER It was the disapproving auntie stare. And I couldn’t deal. I couldn’t deal.

TWILLEY: Sonja had found us a little can of tropical-island themed hangover drink that tasted like orange-flavored mouthwash—

GRABER: There was one written entirely in Korean, luckily we had Sonja to translate for us.

TWILLEY: And then a bottle of 808 Dawn, which Sonja told us is one of the most popular hangover drinks of all.

TWILLEY: This one has a very handsome gentleman on the front. LAUGHTER. Tell us about him.

GRABER: Who is he?

SWANSON: Yes. I am guessing he must be the inventor. It says—oh yeah. It says, inventor. LAUGHTER. Under his portrait.

TWILLEY: I love this can. It’s awarded supreme prizes…

SWANSON: Oh yes.

TWILLEY: Cum laude invention and supreme gold medal at the invention New Product Exposition in Pittsburgh, LAUGHTER which as everyone knows is the shizzle.

OPENING CANS

TWILLEY: Ew! The smell smells like Marmite.

SWANSON: Wow.

GRABER: Yeah. It smells a little Marmitey but a little like plummy. Like a little dried fruity.

SWANSON: Exactly like a Flintstone vitamin to me. LAUGHTER

TWILLEY: Oh, that’s disgusting.

GRABER: Oh, it’s totally disgusting.

SWANSON: Way too sweet.

GRABER: We liked the taste of only one of them, the one where the bottle is entirely in Korean. But two of them contained the same ingredient.

SWANSON: So that would be hovenia or—I think it’s Hovenia dulcis, is the Oriental raisin tree. That’s also another ingredient that is used in traditional Korean medicine.

GRABER: In traditional medicine, it has actually been used to treat both hangovers and liver disease.

TWILLEY: As it turns out, the Oriental raisin tree contains a compound that I’m going to call DHM, because it’s much easier to say than its full chemical name. And DHM is being studied right here in my own backyard, at the University of Southern California.

SWANSON: And what they found is that DHM kind of triggers this enzyme that helps metabolize alcohol in the cells. And it kind of triggered this, like, what they called a “cascade of effects.” So it kind of reduced inflammation, and it, you know, helped process the alcohol more quickly. And then that kind of helped the liver, you know, repair itself more quickly. So it seems like, at least in mice and cultured cells, DHM does have an effect on the hangover, or at least on the liver.

GRABER: Of course this study comes with a boatload of caveats, as Sonja pointed out. The results are in mice. And in cultured cells. Not in humans. And, anyway, who knows how much you’d need or how much is in any one bottle. So this is not settled science.

TWILLEY: But Sonja says it’s not like everyone who buys these drinks thinks the science is 100 percent.

SWANSON: It’s a little bit more of a, maybe a—I don’t know how to explain. Like maybe it just seems like a kind of a, sure, why not? kind of approach. That’s been my general impression.

GRABER: Sonja doesn’t keep any of the bottles around herself.

SWANSON: I think I’m just getting a little too old for any hangovers at all. So I think I’m…

GRABER: So your cure for hangovers is not to get them in the first place.

SWANSON: Yeah. To do my best not to. For sure.

TWILLEY: This is also the conclusion I have arrived at after much suffering. But sometimes accidents happen. And because we love you, dear listeners, we do not want to leave you entirely without hope. So here is the best remedy science currently has to offer.

ROGERS: There was a pretty good study a few years ago where they again they took those hapless but drink-poor postdocs to a lab, made them get really drunk, then the next day gave them a kind of nuclear-powered anti-inflammatory called Clotam. You can’t get it in the United States. But it’s used to treat migraine. Again, another set of symptoms that look a lot like hangover or vice versa. And it had a really good effect. And so there are people now who are looking at using combinations of various anti-inflammatories, antihistamines to try to deal with hangover.

GRABER: Adam says you can only buy Clotam over the counter in Finland, but he says that anti-inflammatories like ibuprofen and aspirin might be a good idea.

TWILLEY: There you go. We tried. But when you’re raiding your medicine cabinet, Sangeeta says to avoid Tylenol. It hurts the liver. Which is already hurting enough.

BHATIA: So, you know, one thing that everyone who’s ever been in my lab has learned is: Don’t take Tylenol for a hangover. So if your listeners learn nothing else today, that would be a good thing to know.

GRABER: This episode was supported in part by the Sloan Foundation for the Public Understanding of Science, Technology, and Economics, as well as the Burroughs Wellcome Foundation, for their support of our coverage of biomedical research.

TWILLEY: Thanks to Sangeeta Bhatia and Quinton Smith at MIT, Adam Rogers, author of Proof, Marie Laurence Haack at the University of Picardy, and to all of you who sent us voice memos and left us voice mails with your hangover remedies! We, of course, couldn’t use them all but we loved listening to them—thank you!

GRABER: Thanks of course to superstar Gastropod fellow Sonja Swanson, for her coverage of hangover remedies in Korea. And for getting us dried anchovies and teaching us how to take the guts out for the soup, as well as putting up with disapproving stares at the Korean grocery store when she bought us the hangover drinks.

TWILLEY: We’ll be back in a couple of weeks with my favorite fruit and one of Cynthia’s preferred beverages! Like in any long term relationship, it’s important to keep us both happy.