The hidden biology behind brutal hangovers after 40
Prefer to listen? Find ep. 176 wherever you get your podcasts.
Drinking in midlife is a completely different experience than it was in your 20s.
Not just psychologically, but biologically too.
The hangovers you’ve been feeling these last few months or years — the ones that hit harder, last longer, and feel more like you’re on the verge of death than they ever used to — are not your imagination.
Hangovers do hit differently now, and this is why…
1. Our immune systems are too damn eager
I learned a new word while researching this article. I love a good word, and this one made me chuckle: inflammaging.
Nope, I’m not making that up. Inflammaging is a scientifically recognised term that refers to the increasing baseline level of bodily inflammation as we age.
Inflammaging keeps the body in a slightly heightened state of readiness for anything it thinks it needs to defend against.
Enter alcohol.
When we drink, the ethanol in our glass is seen as an intruder into the body, which needs to be forcibly removed (more on that in a moment).
While that removal is taking place, your body’s immune system is activated, and it sends out signalling proteins called cytokines that activate the same conditions as when you’re fighting a virus or infection.
You feel nauseous, uncomfortable at both ends, dehydrated because alcohol makes you pee more, and headachy for a whole combination of reasons—including that dehydration.
If you’ve ever had a hangover and felt like you were coming down with a cold at the same time, not only does that suck, but it’s a very real response to your body behaving like an overprotective parent trying to wrap their precious child in preventative bubble wrap.
Now these cytokines aren’t a bad thing. We want a functioning immune system, right?
But against the backdrop of inflammaging, that immune response may be stronger and take longer to settle.
In short, less alcohol in your 40s can trigger a stronger ‘unwell response’ than it did in your 20s.
2. It takes longer to clear, and that’s where the damage is done
When we drink, the body receives alcohol as a harmful substance that it wants to remove, pronto.
When the body processes alcohol, it uses an enzyme called alcohol dehydrogenase, which turns to the alcohol and says “I don’t want you here, I’m going to turn you into something my mate can get rid of”.
That alcohol is then turned into a compound called acetaldehyde.
And acetaldehyde is the big bad mofo responsible for a significant amount of damage.
It is carcinogenic and binds to proteins and DNA in the body, causing damage at a cellular level.
So, along comes alcohol dehydrogenase’s friend, aldehyde dehydrogenase (don’t worry, you don’t need to remember all these names), to do the heavy lifting.
The aldehyde dehydrogenase enzyme then turns acetaldehyde into acetate, which the body can break down further into water and carbon dioxide and merrily excrete through our urine and breath.
If you were skimming, this is the end of the sciency bit. The TLDR is that the body converts alcohol into a carcinogenic compound before breaking it down into something less harmful. That process is responsible for a lot of the biological harm you hear so much about.
So, What Does This Mean for Hangovers?
Most of this processing happens in the liver, but alcohol and its effects are felt throughout the body—including in the brain, stomach and other major organs.
But the enzyme that does the removal becomes less efficient as we age, meaning it takes longer and longer to remove the nasties.
So when you feel like ‘death warmed up’? Yeah, there’s some accuracy to that.
And as we age, that decline can be progressive and cumulative—in other words, you may never be quite as efficient at removing alcohol as you are today.
3. Cortisol spikes
Cortisol gets a bad rap.
Some stress is actually good for the body.
It gets us out of bed in the morning, gives us the energy to do hard tasks, helps us exercise, and even gets us in the mood for a little rumpy pumpy, should the occasion call for it, or for running away from danger when you need to.
The infamous stress hormone does a lot of good stuff in the body.
But cortisol is only ever meant to be a temporary visitor.
Unfortunately, as we age, it can become more like a house guest who’s outstayed their welcome and won’t take the hint to leave.
And adding alcohol to the mix is like when that guest starts pulling out an overnight bag and settling in for the weekend.
Alcohol may feel like a stress reliever in the moment, but physiologically it places the body under additional stress.
As its effects wear off—and sleep, hydration and blood sugar have potentially been disrupted—you can wake feeling more anxious and on edge, finding all that stress you were trying to escape has landed smack bang in the middle of your chest like a cartoon anvil.
But that’s not all.
The initial hangover impact itself (the acetaldehyde, the overactive cytokines, increased inflammation, nausea, headaches, etc.) can prompt the release of even more cortisol.
And as we get older, the system that switches off cortisol release after a spike can become less responsive, so it takes longer to settle.
So there you are, sitting in a stew of yesterday’s woes, Saturday morning repercussions and a body that isn’t bouncing back as quickly as it used to.
Add to that the psychological hangxiety of wondering what you said, what you did and how much of a fool you looked trying to recreate that bar top scene from Coyote Ugly, and these are all fresh triggers for the stress response when your body is already dealing with the physical impact of the night before.
Add to that your blood sugar levels may also have crashed as you likely haven’t eaten for a while (more stress, more cortisol), and it feels like every scrap of energy has been used up trying to process everything you’ve been through.
Put all that together, and a full-body physiological stress response has settled in for the weekend, just like Gary, the unwanted house guest.
And until your body ‘stands down’ and clears the excess stress hormone, you remain in that heightened, on-edge state.
Annoyingly, as we age, that return to normality takes longer and longer.
It’s About Time
So there it is: inflammaging, slower alcohol removal and increased cortisol. Three biological reasons why hangovers can feel harder, and recovery can take longer, as we age.
Of course, all our bodies are different, and some of these might impact you more or less depending on all sorts of biological factors and general life circumstances like how much you’ve drunk before, how well you look after your body in other ways and underlying illnesses you might have.
Heck, you may even be one of the lucky ones whose hangovers don’t get worse at all but somehow feel easier to manage.
By the way, this is not meant to be a diagnosis – did I tell you I’m not a doctor yet, because I’m not, I’d love to be, but I was too busy partying to study that hard.
But I do want you to know the truth about what your body is doing and why things feel so much harder when you drink now than they did 20 years ago.
It’s not just “I’m getting old, and I can’t cope”. There are real, demanding, stressful and ongoing biological processes that you need to give yourself more time to deal with.
So by all means, make the choices around alcohol that are best for you, but just remember that when you do decide to indulge a little, you might well need to give your body that same level of indulgence in recovery time.
Now, go and grow old disgracefully and enjoy every morsel of time we have on this planet.
It’s precious, and it’s fleeting, and that is why I say cheers to a life less intoxicated.
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