FIRST CALL™ AND THE ALCOHOL-INDUCED HANGOVER

Dr. Charles Cochran

According to a report prepared for the National Advisory Council on Alcohol Abuse and Alcoholism (NIAAA), 65% of the U.S. population consumes alcohol, with 29% consuming alcohol weekly and 3.9% consuming more than 5 drinks at least once per week . In 1986, 5.8 billion gallons of beer, 585.3 million gallons of wine, and 394.7 million gallons of spirits were sold in the U.S. . Most reports focus on the emotionally charged issues of alcohol’s involvement in automobile accidents, homicides, suicides, assaults, child abuse, health concerns, and premature death. Less traumatic, and often trivialized, is the alcohol-induced hangover. From a socio-economic perspective, however, the hangover has a big impact on related job absenteeism and poor performance. This absenteeism, lost wages, and decreased work productivity costs the U.S. $148 billion annually, which averages $2,000.00 per working adult per year . Interestingly, according to Dr. Jeffrey Wiese, although hangover is associated with alcoholism, most of this cost is incurred by the light-to-moderate drinker and not with the heavy drinker, as we would most likely think. Fifty-four percent of all alcohol-related problems in the workplace are caused by light drinkers, and 87% are caused by light-to-moderate drinkers . With this in mind, a product that had the ability to reduce or eliminate the hangover would have a major health and economic benefit throughout the United States.

The Alcohol-induced Hangover

The medical term for the hangover is Veisalgia. Kveis is Norwegian and is defined as uneasiness following debauchery. And, algia is Greek meaning pain. The hangover defined is having, at least, two of the following listed symptoms with sufficient severity to disrupt the performance of daily task and responsibilities (percentage of population experiencing each symptom): headache (66%), poor sense of overall well being (60%), diarrhea (36%), anorexia (21%), tremulousness (20%), fatigue (20%), and nausea (9%). Experimentally an alcohol dose of 1.5 - 1.75 gms/kg body weight (5 to 7 standard cocktails) will almost always produce hangover symptoms in those susceptible individuals .

Wouldn’t it be wonderful if the hangover were a result of dehydration as many of us thought when we first started drinking? Unfortunately preventing a hangover is much more complicated than just drinking lots of fluids along with our alcoholic beverages. Aside from dehydration, hangovers are a result of alterations in endocrine function, dysregulation of cytokine pathways, and proper elimination of toxins produced during alcohol preparation and normal liver metabolism.

Anti-diuretic hormone (ADH) is produced by the pituitary gland and causes the body to retain water. While drinking and during acute intoxication, ADH production is decreased and so we see an increase in urination resulting in dehydration. However, during the hangover phase, ADH production is increased causing a retention of body fluids resulting in puffiness in tissues for example in the face and around the eyes .

Other hormonal alterations include the adrenal cortex hormones, aldosterone and cortisol. Aldosterone helps regulate blood levels of sodium, chloride, and potassium. During drinking aldosterone levels decrease causing a decrease in sodium and an increase in potassium levels resulting in decreased blood volumes and a temporary decrease in blood pressure. However, during the hangover period aldosterone increases causing an increase in serum sodium levels and an increase in blood volumes and blood pressure. These electrolyte imbalances can be responsible for muscle weakness, fatigue, vomiting, and loss of appetite experienced during the hangover.

Cortisol is a regulator of fat, carbohydrate, and protein metabolism. It also works with aldosterone to balance electrolytes, and functions as an important anti-inflammatory. During times of hangover, cortisol causes an increase in blood sugar levels by converting amino acids into glucose in the liver known as gluconeogenesis. Increased blood sugar levels would cause in increase in insulin production and abnormal stress on pancreatic and liver function. Cortisol also decreases protein in skeletal muscles and causes a redistribution of body fat from the legs and arms to the trunk and shoulder blade regions of the body.

Next, rennin production, an enzyme produced by the kidneys and responsible for regulating blood pressure, is increased. Rennin acts on angiotensin to form a vasopressor substance known as angiotensin I. This causes an increase in blood pressure and an increase in heart rate and left ventricular ejection . This may be responsible for increases noted in mortality rates due to myocardial infarction during hangover periods.

Other important factors involved in the intensity and production of hangover symptoms include the production and elimination of toxins (conversion of ethanol into acetaldehyde and acetate in the liver) and the increased production of thromboxanes. Thromboxanes are products of fatty acid metabolism and are responsible for blood vessel constriction (raising blood pressure), blood platelets sticking together (increase in clot formation), and decreases of natural killer cells (decreased immunity). An increase in thromboxane-B2 during the hangover has also been found to cause symptoms similar to those in a viral infection, including nausea, headache, and diarrhea .

Lastly, the level of congeners found in alcoholic beverages can be a major causative factor in the production of hangover symptoms . Congeners are the by-products of alcohol preparations. Higher concentrations are found in dark liquors such as brandy, wine, dark tequila, and whiskey. Lower concentrations are found in clear liquors, such as rum, vodka, clear tequila, and gin. Experimental studies revealed that 33% of test subjects who consumed 1.5 gms/kg of bourbon experienced hangover symptoms while only 3% of those who consume the same volume of vodka experienced symptoms .

FIRST CALL™

FIRST CALL™ is a flavonoid, polyphenol-rich extract derived from the hybrid artichoke bud, Cynara floridanum, and the root of the sarsaparilla plant, Smilax aristolochiaefolia. This totally unique material has been created by using two plant materials that have been historically used as liver regenerative, detoxify, and blood-purifying agents combined prior to being extracted using a proprietary, two-step method in which the plant materials are allowed to interact within the solvent. Partial analysis has revealed a complex of active flavonoids, including quercetin, kaempferol, isorhamnetin, (+)- catechin, silymarin, cynarin, and chlorogenic acid. Oxygen Radical Absorbance Capacity (ORAC) studies measuring the ability of this material to protect against attack by free radicals (antioxidant capacity) has also been performed. It was found to be a powerful antioxidant twenty-three times more effective than blueberries.

This artichoke/sarsaparilla extract was tested in a hospital randomized, double-blind, placebo study and found to improve liver function in patients diagnosed with chronic alcoholic liver disease. In only 30 days, this extract was found to improve liver function and pathology by an overall 56.36%, while the placebo group experienced a 6.5% worsening of symptoms. These dramatic results were presented at the International Hepatology Convention on June 7, 1996 .

It has also been found to work exceptionally well in improving liver metabolism and preventing alcoholic-induced hangovers. Anecdotal evidence has shown that it is over 90% effective in completely eliminating the hangover with the light-to-moderate drinker. With this last statement, I hope that you’ve just got a glimpse of the huge socio-economic and health impact of this product. Once the symptoms of the hangover have occurred, it’s too late to prevent any of the harmful physiological processes previously mentioned; the damage has already been done! Hangover treatment, along with the alcohol, can be very detrimental. Anti-inflammatory drugs can cause stomach irritation and bleeding and are responsible for thousands of deaths every year. And others, like acetaminophen, are potentially harmful to the liver and may increase the risk of liver damage when used with alcohol. Prevention of the hangover is key!

First Call™ is being manufactured by Natural Bridges Products, Inc., 294 Green Valley Rd., Suite 327, Watsonville, CA 95076.

Report of a Subcommittee of the National Advisory Council on Alcohol Abuse and Alcoholism on the Review of the Extramural Research Portfolio for Prevention, National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, October 1998.

Doernberg D, Stinson F. U.S. Alcohol Epidemiologic Data Reference Manual. Vol 1, U.S. Apparent Consumption of Alcoholic Beverages Based on State Sales, Taxation, or Receipt Data. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, 1985.

Stockwell T. Towards Guidelines for Low-risk Drinking: Quantifying the Short and Long-term Costs of Hazardous Alcohol Consumption. Alcohol Clin Exp Res. 1998;22(2 Suppl);635-95.

Wiese JG, Shlipak MG, and Browner WS, The Alcohol Hangover, Ann Intern Med. 2000; 132:897-902.

Sainio K, et al. Electroencephalographic Changes During Experimental Hangover. Electroencephalogr Clin Neuro-physiol. 1976:40:535-8.

Linkola J, et al. Plasma Vasopressin in Ethanol Intoxication and Hangover. Acta Physiol Scand. 1978;104:180-7.

Linkola J, et al. Renin-aldosterone Axis in Ethanol Intoxication and Hangover. Eur J Clin Invest. 1976;6:191-4.

Kangasaho M, et al. Effects of Ethanol Intoxication and Hangover on Plasma Levels of Thromboxane B2 Formation By Platelets in Man. Thromb Haemost. 1982;48:232-4.

Damrau F, Goldberg AH. Adsorption of Whisky Congeners by Activated Charcoal. Chemical and Clinical Studies Related to Hangover. Southwest Med. 1971;52:179-82.

Chapman LF. Experimental Induction of Hangover. Q J Stud Alcohol, 1970;5(Suppl 5):67-86.

Diaz A, et al. Comparative Study Between A Complex of Flavonoids and Polyphenols and Placebo in Hepatic Disease Due To Alcohol. General Hospital of Mexico. International Meeting of Hepatology. Military School of Medicine.