Why do hangovers get worse with age?

Many people know the feeling that comes after a few too many drinks: a pounding headache, clammy skin, racing thoughts and an upset stomach. Often, these hangovers seem to get worse with age; older people find that the amount of alcohol they used to drink in their youth with no ill effects now leaves them feeling debilitated.

But do hangovers really get worse with age?

Anecdotally, there are plenty of people who would tell you "yes," from personal experience — but there's no hard scientific evidence that hangovers actually intensify with age. However, there are some plausible reasons why they might do so.

"It isn't clear whether hangovers get worse for everyone as they age or just for some people," Aaron White, leader of the National Institute on Alcohol Abuse and Alcoholism's Epidemiology and Biometry Branch, told Live Science in an email. "There simply hasn't been sufficient research on this topic." But nonetheless, there are some theories.

Related: What happens to your body when you stop drinking alcohol?

Hangovers are caused by myriad changes in the body that occur after overindulging. Alcohol is toxic to cells in that it can damage DNA and impede important cellular processes. As it's broken down, alcohol is briefly transformed into a different toxic substance, called acetaldehyde, before being turned into a less-toxic compound called acetate and, finally, into water and carbon dioxide.

As people age, though, the enzymes in the liver that metabolize alcohol and its toxic byproducts can become less efficient, so those toxic chemicals might stick around in the body longer than they used to. When acetaldehyde hangs around in the liver, it can also cause widespread inflammation in the body. Cytokines, the chemical messengers that prompt inflammation, have been tied to malaise, anxiety, irritability and fatigue — all common hangover symptoms.

Plus, compared with young people, older people are more likely to suffer from chronic pain and conditions that cause knock-on inflammation, such as diabetes and arthritis. Thus, drinking too much could result in a double whammy of inflammation on top of an already-high baseline. White said this could "worsen existing physical discomfort" and ultimately result in a more severe hangover.

Both drinking alcohol and experiencing normal aging can make it difficult to stay hydrated, so the combination of the two could be a recipe for a rough morning.

Alcohol is a diuretic, meaning it expels water from the body. Scientists are still debating exactly how much of a role dehydration plays in hangovers, White said, but it's well known that being dehydrated can cause headaches and fatigue, both common hangover symptoms. And after age 60, the overall amount of water in the body starts to decline due to tissue loss. This dehydration not only tees you up for a hangover but could also boost the concentration of alcohol in your blood after you drink, White said.

"It is possible that each drink packs more of a punch as we get older," he said, "which could mean more misery the next day."

Both alcohol and age disrupt sleep, too. Downing a few drinks can speed up the initial process of falling asleep, but it can also undermine sleep quality and cause people to wake up earlier, resulting in a worse night's sleep overall. White said sleep quality tends to decrease with age anyway, so "we might feel the impact of alcohol on next-day fatigue more than when we are younger."

Though there are many potential reasons alcohol could hit harder with age, bad hangovers aren't a guaranteed part of getting older. One survey of more than 50,000 people ages 18 to 94 found that older people actually reported a lower incidence of hangovers after binge drinking, compared with their younger counterparts. The researchers couldn't explain this pattern even when accounting for each age group's usual alcohol consumption or frequency of binge drinking.

These results were echoed in a smaller, self-reported survey that found hangover severity decreased with age. Although younger participants reported drinking more, when the researchers corrected their results for the amount of alcohol consumed, they found that older participants reported less severe and less frequent hangovers than younger people. The researchers theorized that this may be the case because older people become less sensitive to pain over their lives.

While there's still some debate on exactly how aging affects hangovers, White said one thing is clear: The only guaranteed way to avoid a hangover is to avoid drinking too much in the first place.

"Time is the only universal cure for hangover symptoms," White said. "And not overindulging is the best strategy for preventing them."

This article is for informational purposes only and is not meant to offer medical advice.

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