You wake up after a casual night with friends — literally, two glasses of Cabernet, tops — feeling like death warmed over. What gives? The drinks aren't getting stronger: you're just getting older. Hangovers change as you get older both because your body becomes less efficient at fighting off the effects of alcohol, and because you might be unintentionally glorifying the hangovers of yesteryear.
As you get older, a bodega breakfast sandwich, a sports drink, and a pain reliever aren't enough to bring you back up to 100%. For many people, hangovers evolve into day-long malaise including upset stomach, headache, brain fog, and anxiety. After a particularly wild night, hangovers can even become multi-day events, as you may have recently realized. But a merciless hangover after a great night out is different than one that comes after a few sips of wine with dinner, at home. The latter feels pretty unjust.
According to One Medical provider Natasha Bhuyan, M.D., the exact cause of worsening hangovers hasn't been studied extensively enough for a definitive answer, but there are a few theories. The most common one is that "your body isn’t metabolizing alcohol as effectively as it did when you were younger," she says.
As you age, enzyme activity in the liver decreases, and so do the liver's cells. With fewer cells, and less functionality, the liver just doesn't do as good of a job at metabolizing the alcohol, which just makes it hit you harder. As you get older, your liver volume and blood flow decreases by 20 to 40%. Drinking less, and avoiding dark liquors — which stress out the liver even more — can help to reduce the wrath of a hangover.
Though the exact age at which your body becomes less skilled at processing your party life is different for everyone, at a certain point, our percentage of total body water decreases. "As a result, this could cause higher blood alcohol concentrations, leading to worse hangovers," Bhuyan says. The less water you have in your body, the more intensely the alcohol is going to affect you, even if you make sure to drink water between beveraginos. That said, increasing your hydration, both before boozing and after, can help to minimize the effects and reduce the extent of the hangover.
Another theory Bhuyan suggests, is that our hangovers are not actually getting worse; we're just getting worse at remembering them. "Hangovers, particularly if they are infrequent, can be hard to effectively remember," she says, thanks to a phenomenon called memory bias. Positive memories are easier for the brain to hold onto, so your fond recollections of a great night out, followed by a hangover that was totally manageable, is going to hold more weight than cringing about the mornings you were totally wrecked and couldn't make it to class on time.
Regardless of why your hangovers are feeling particularly cruel with age, the best way to avoid a hangover is to decrease your alcohol intake, increase your hydration, and pay attention to the drinks that make you feel the most terrible so that you can avoid ever ordering them again.
Natasha Bhuyan, MD, One Medical provider
Kim, I. H., Kisseleva, T., & Brenner, D. A. (2015). Aging and liver disease. Current opinion in gastroenterology, 31(3), 184–191. https://doi.org/10.1097/MOG.0000000000000176