176. The Hidden Biology Behind Brutal Hangovers After 40

If your hangovers have gone from 'rough morning’ to ‘Someone call me a doctor, stat!’ there's a reason for that. Several, in fact. 

And they're not just happening to you.

The wellness accounts will tell you alcohol is a poison. That's not technically accurate. 

But what is going on inside your body when you drink past 40 is genuinely worth understanding, because the actual picture is both more nuanced and more useful than the fear-first version you've been getting online.

I dig into three major biological shifts that are quietly changing the way your body responds to alcohol in midlife: an overactive immune response triggered by something called inflammaging; 

The slower processing of acetaldehyde — the compound your body converts alcohol into — the real culprit behind how dreadful you feel; 

And a cortisol cycle that, thanks to midlife hormonal changes, now takes far longer to stand down. 

This isn't about scaring you off alcohol. It's about giving you the actual science — in plain English — so that whatever choices you make around drinking are genuinely informed ones.

By the end of this episode, you'll know...

·       Why any amount of alcohol in midlife can trigger a response that feels like the onset of a cold

·       What "inflammaging" is — and why it makes your immune system overreact to every drink

·       Why it's not the alcohol itself that causes the most damage, but what your body turns it into

·       Why your hangovers seem to be lasting longer, the older you get, and the exact enzyme that's to blame

·       How cortisol and a night's drinking combine into a perfect stress storm by the morning

·       Why the "alcohol is a poison" narrative you see everywhere online is missing some important nuance

·       Why giving yourself that grace and space to recover from a night out matters more now than ever

Chapters
0:0 Why Hangovers Feel Harder Now
2:25 Inflammaging and Overeager Immunity
6:11 Alcohol Clearance and the Damage it Does
13:41 Cortisol Spikes and The Stress Hangover
19:31 Different Bodies, But We All Need Time to Recover

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Transcript

Why Hangovers Feel Harder Now

SPEAKER_00 1:25

You think that your body is letting you down. It feels like everything you knew about yourself has changed, and you're wondering why things feel so much harder for you now than they ever have before. Drinking in midlife is a completely different experience than it was in your 20s. Not just psychologically, but biologically too. We all know that the body changes with age, but do you know how those changes affect your drinking recovery and why moderation becomes so much more important in midlife than it ever was before? The hangovers you've been feeling these last few months or a few years, you know, the ones that hit harder and last longer and feel more like you're on the verge of some sort of severe illness than they ever used to, those are not in your imagination. And the fear that you've been fed by every wellness account on the internet is only giving you half the picture. Hangovers do hit differently now. And this episode is the biology behind why that no one is telling you about. You're listening to the Mindful Drinking and Moderation in Midlife podcast, where it's my goal to help you take back the power of choice from alcohol. I'm your host and mindful drinking mentor, Denise Hamilton Mace, and this is the start of your journey to a life less intoxicating. Listen, biology is a huge subject, and I am by no means a qualified medic in any way, shape, or form. This is not medical advice for you, and I'm not going to go through every system in the body and tell you what's changed now that we've reached midlife. But there are three major considerations that have a huge impact on the way we are able to handle hangovers and bounce back after a session, even a small one or a large one, whatever it is, they hit us differently now in midlife. And it's not just because I'm getting older, obviously that's the underlying cause, but it's because of the changes within our bodies as we age and how those changes interact with the alcohol that we consume that are making a lasting and significant impact on how well, how quickly, how efficiently we can bounce back after we've had a night on the town or on the sofa, wherever you may be. So the first thing that we're going to look at, and we've got three that we're looking at today. So the first one that we're looking at is that our immune systems are just too damn eager. Um, I learned a new word whilst researching this episode. I love a good word, and the what this one made me chuckle. It's inflammaging. And no, I'm not making it up. Honestly, it's a real and scientifically recognized term that refers to the increasing baseline level of bodily inflammation as we age. The thing about inflammaging, okay, is that it is there to keep the body in a slightly heightened state of readiness for anything that it thinks it needs to defend against, which is a good thing. We all want an efficient and hard-working immune system. However, when we drink the ethanol, okay, so just the ethanol alcohol in your glass, not the water, not the uh sugars, not the other ingredients, doesn't matter what type of alcohol you're drinking, whether it's beer, wine, spirits, the ethanol in the glass is seen as an intruder into the body, which needs to be forcibly removed. More on that in a moment. But what's happening is while that removal is taking place, whilst your body is trying to get rid of the ethanol, your immune system is activated and it sends out signaling proteins called cytokines that activate the same conditions as when you're fighting a virus or an infection. And what happens is you end up feeling nauseous as your stomach gets ready to empty. You end up feeling uncomfortable as the other end does the same, you know what I mean? Okay, but you might be eating, I don't want to go into too much detail. Uh, we feel dehydrated as any remaining water in our bodies uh gets used to flush the system out, uh and we get headachy as there's not enough water left to soak the brain as much as it likes. Our brains actually like to be quite soggy. Now, if you ever had a hangover and felt like you were coming down with a cold at the same time, not only does that suck, okay, but it's a very real response to your body behaving like an over-protective parent, trying to wrap their precious little child in a bit of preventative bubble wrap. But these cytokines, they're not a bad thing. Inflammaging in itself is not a bad thing. Like I said, we want a functioning immune system. But their overzealous nature is not only quicker to fire due to the underlying inflammation. So the underlying inflammation, your body's always sort of ready to defend itself, but they can attack more fiercely and they can take longer to clear. In short, less alcohol in your 40s triggers a stronger unwell response than more alcohol did in your 20s. Now, obviously that's a generalization, and less and more are relative terms, depending on how much you're drinking now, how much you used to drink before, and with everything that we'll talk about today, as with most things, it always depends on your own personal circumstances. But inflammaging, I love that word, I really do. Sorry, inflammaging and that underlying bodily increased inflammation as we get older only moves in one direction. And it's all relative to your physical state and the way that you look after yourself and all the other things that that make up who you are. But as we get older, our body's defense systems are more sensitive to the fact that they need to protect us more because we're not 21 anymore and we don't bounce back the way that we did. Okay, the second reason that hangovers last longer in midlife, and this one, I'm gonna say hold on to your hats, okay, because my little um nerd sensors in my brain lit up when I was researching this one for you. Um, it does take longer for alcohol to clear. And it is the clearing of the alcohol that actually does the damage, not so much the alcohol itself. So let's start with something a little bit controversial. You know, all of those memes and those guilt-laden posts you see on Instagram about um and TikTok and Sinterest and wherever you live online socially, but you see all these posts about alcohol being a poison. Well, they're not technically true. Now, I know that this is a part where some people listening might say, Well, it is, it is a poison. It's not technically a poison. I'm going to explain why. So just bear with me before you start writing in. I do want to hear your opinions, but listen through to this one and let's see if we can unpack this a little bit. Okay, so here's how it goes. When we drink alcohol, the body views it as toxic, okay, and it wants it out pronto. So here's where the first caveat is: toxic is not the same as poisonous. Toxins cause generic harm, whereas poisons cause illness, uh severe damage, or death. All poisons are toxic, but not all toxins are poisonous. Uh think of it just like all thumbs are fingers, but not all fingers are thumbs. Okay, so back to the actual toxic response. So when the body uh consumes alcohol, it seems sees it as toxic and wants to get rid of it straight away, which is fine, we get that. When we process alcohol, we use an enzyme called alcohol dehydrogenase. All right. Don't worry, I haven't got too many um technical Latin medical terms in this, but I do want to give you the correct information. All right. So we use an enzyme called alcohol dehydrogenase, which takes the alcohol and it and it says to it, I don't want you here. I'm going to turn you into something that a friend of mine can easily get rid of. Okay. That raw alcohol is then turned into a compound called acetaldehyde. And acetaldehyde is actually the big bad mofo that causes all the damage. Acetaldehyde, so the thing that alcohol gets turned into in our bodies, is actually the carcinogenic element. It binds to proteins and to DNA in the body, causing damage at a cellular level. Once the alcohol in our body has been turned into acetaldehyde, which is the thing that causes the cellular damage, along comes another enzyme that says, Well, I need to get rid of this because this is even worse, and we've got to kick it out. And that enzyme is called aldehyde dehydrogenase. Okay, it does the heavy lifting. The aldehyde dehydrogenase enzyme turns the poisonous because acetaldehyde now is poisonous, not just a toxin. It turns it into a very harmless and easily removed compound called acetate. Now, acetate is easily removed from the body. We breathe it out and we wee it out. So it goes out through your urine and through carbon dioxide in our breath. Um is one of the reasons, by the way, when when you can smell alcohol in someone's breath in the morning, it's the uh acetate, among other things, obviously, um, that's leaving the body. So, where's the connection to hangovers? This process, okay, the the transformation of ethanol alcohol into this more poisonous substance that we want to get rid of, and then into the harmless one, which we do kick out, this happens in the body wherever alcohol is found. And as alcohol is carried to major soft tissue organs, like the liver, of course, which does most of the work, but it also goes to the brain and to the lungs, for example. Acetaldehyde, the bad one, sits in all of those organs, messing things up for them until it's been processed and removed. But the enzyme that does the heavy lifting, the one that kicks it out, as we age, it gets less and less efficient, meaning that it takes longer and longer to remove the poisonous element that we don't want. So that feeling that you've had, that I know I had many times of feeling like death warmed up. There is some accuracy to whoever, whoever came up with that phrase, they kind of knit the the nail on, hit the nail on the head. Okay. As we age, that feeling starts to last longer and longer, as the acetaldehyde starts to stay in our system for longer and longer because it's harder for the body to process it out. Hence why, as we get older, our hangovers can feel like they're lasting for longer and they can feel more intense. Now, I did try to find some research on the specific rate of decline, but there are so many variables: age, gender, ethnicity, uh, baseline, health, diet, all of these things kept coming up. So I think the safest thing for me to say here is that as we age, the decline becomes progressive and cumulative. So, in other words, you'll never be as efficient at removing alcohol from your body as you are today. Okay, and today you are not as efficient as you were yesterday. Now, really important, I've used a couple of words in this one that I don't normally use. I never refer to alcohol as a toxin or a poison because I don't want to uh add to the fear and the pressure and the judgment. So, from this one, I really want you to take away that I'm not saying that you should stop drinking because it's a poison, not at all. I really want to arm you with the facts, with the correct information. And I just want you to know what's going on so that you can make your own choices. And this acetaldehyde situation where it sits in the body and causes cellular damage. I don't think that there's anyone listening today who doesn't know that alcohol is bad for you. So hopefully that won't come as too much of a shock to the system. But what you now know is exactly how and why it's bad for you. And you can make uh an educated choice now as to how much you want to consume and how often you want to go through that removal process and how strong you feel about it. You know, you might be in a situation where actually, not that you can you sort of check and and call up, call down and ask it, but you might process alcohol quite well. You might not find that you get these absolutely awful hangovers. They're already just starting to creep up a little bit. So, you know, perhaps you feel you've got a bit more wiggle room. I don't know. It's your body is different to mine, it's just different to everybody's. So do what's right for you. This isn't about scaring you into um not drinking, it's just about arming you with the facts and the information and a couple of funny words. Okay, our third reason why hangovers uh hit harder in our 40s and beyond, in midlife and beyond, is to do with our old friend cortisol. I think it's possibly one of the most well-known hormones uh for non-medical people. Uh, but cortisol, the primary stress hormone, it gets a bad rap, but it does do some good things. Okay, some stress is good for the body. Stress gets us up in the morning, gets us out of bed, gives us the energy to do hard tasks, it helps us to exercise, gets us in the mood for a little bit of rumpy pumpy, should the uh occasion call for it, or running away from danger when you need to. Stress runs the gamut of usefulness in the body. So it does a lot of good stuff. But cortisol is only ever meant to be a temporary visitor. Okay, stress that we feel, good or bad, is only ever meant to be temporary. As we age, unfortunately, it can become a little bit more like um a house guest who's outstayed their welcome. You know, the ones that don't take the hint to leave, like your weird Uncle Gary. Yeah, just like that. Um, and adding alcohol to the mix is like when your weird Uncle Gary starts pulling out an overnight bag and starts settling in for the weekend. It means that the stress that you feel, the quarterzole that's been um released, that was only supposed to be temporary, starts to stick around for a bit longer than we should, than it should, rather. Now, we've all used alcohol as a stress reliever in the past, and that's because it does work. Booze does temporarily suppress the release and recognition, importantly, of cortisol. So it makes you feel more relaxed in the moment. Again, I don't think that's breaking news for any of us who are listening today. Um, however, as you sleep, so you've you've had a couple of drinks to relieve some stress, uh, you've gone home, you've gone to bed, you've gone to sleep. As you slept, your adrenal glands, they were really busy over-correcting your initial earlier artificial suppression of cortisol. And what happens is when you wake up, you find that all the stress that you were trying to get away from the day before has landed smack bang in the middle of your chest like a cartoon anvil. But that's not all. The initial hangover impact itself, so some of the things we spoke about before, like the removal of the acetaldehyde and the overactive cytokines, increased inflammation, nausea, headaches, all of those things, all the stuff we recognize as a hangover. Yes, Denise, I know what a hangover feels like. Okay, they all generate even more cortisol. It's a stressor for the body. Being a hangover is a stressor for the body, so therefore it produces more cortisol. As we get older, as we're into midlife and beyond, the system that switches off cortisol release after a spike becomes less responsive. So it takes longer to stop. So there you are. You've woken up in the morning, you're sitting in a stew of yesterday's woes, you've added to that the overnight overcorrections as your adrenal glands tried to compensate for the fact that they weren't allowed to release cortisol in the way that they felt that they should. And then you've also got the Saturday morning repercussions of your hangover and a stress system with a worsening off switch. Add to that as well all the psychological anxiety of wondering uh what you said, what you did, whether or not it was a good idea to try to recreate that scene from Coyote Ugly. And uh it's a really good bar dancing scene. I love that movie. Um, and all of these, these are all new triggers for new cortisol spikes. Okay, all of that together uh are more reasons for cortisol to be released, uh, for more spikes to occur. And therefore, that all takes the body longer and longer and longer to level out as we get older. Uh, the final thing in the cortisol section is that it's likely that your blood sugar levels have also crashed, um, mostly when we overdrink, we undereat. Uh, and if you haven't eaten for a while, which is stressful on your body, your body gets stressed when it under eats. Plus, all the energy stores that you did have left have been used up trying to process everything that it's been through. As you can see, there are a lot of cortisol spiking activities that take place when we consume alcohol and when we deal with it the day after. You put all of those together and you end up with a full-body physiological physiological, easy for me to say, physiological stress response that settles in for the weekend, like um dear old Uncle Gary, the unwanted house guest. Almost forgot his name there. Um, and until your body stands down and clears the excess stress hormone, the excess cortisol, you remain in that sort of heightened and on-edge state. Now, annoyingly, as we age, that return to normality, that stand down, what doctors call uh homeostasis, that takes longer and longer. Like I said, the the off switch isn't as efficient. We keep adding more cortisol, and it takes the body longer to clear it all. So, there you have it: inflammation, slower acetaldehyde removal, and increased cortisol. Three biological reasons why hangovers really do hit harder as we age. As I said earlier on, all of our bodies are different, uh, and some of these might impact you more or less, depending on all sorts of biological markers and general life circumstances, not only just how much you've drunk uh in the past and how much you drink now, but things like how well you look after yourself in other ways, any underlying illnesses you might have. Like I said, we're all different, and every circumstance uh looks different. This is not meant to be a diagnosis for what you are dealing with. Did I tell you I'm not a doctor? Just to make that very clear, uh, I would love to be, but I was far too busy partying to do that much studying. Um, but I do want you to know the truth about what's going on in your body, what your body's doing, and why things feel so much harder when you drink now than they did 20 years ago. Because I don't want you to just beat yourself up about it and just think, well, I'm lame or I'm rubbish or I'm just 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. You need to give your body a bit more space and a bit more grace to deal with a night out or a night in than you did before. You know, it there was a time when you could go out on a Thursday night and a Friday night and a Saturday night and still be functioning, reasonably functioning for work on Monday, or if you did shift work like I did, you know, you could go out on three, four different nights a week and still be able to get up and turn up and do your shift well. But now you might need to give yourself a little bit of extra recovery time, and that's absolutely okay. So by all means, make the decisions around alcohol that are best for you. But just remember that when you do decide to indulge a little, you'll need to give your body the same level of indulgence in recovery time too. If you have found this episode to be uh interesting, educational, and entertaining, I'm going for a trifecta here. Um, I would love it if you could let me know by leaving me a rating and review. It does a couple of things, it lets other people. Know that there is value to be had in this podcast. It lets those algorithmy things know to show this show to other people and it makes me feel good. Even if what you've got to say is more constructive and complimentary, I'd still really like to know so that I can continue to make the episodes that serve you the most. Now, having said all that and taking you through why hangovers hit so much harder after 40, I would love for you to go forth and grow old disgracefully. Enjoy every morsel of time you have on this planet. It's precious and it's fleeting. And that is why I want you to say cheers to a life less intoxicated. I'll see you next week.