The ads on podcasts and social media were tantalizing: over-the-counter probiotic supplements that could ward off the worst effects of a hangover if taken before drinking.
As a bourbon reviewer who enjoys the flavor of spirits but has always been easily prone to hangovers, Eric Burke was intrigued. He ordered a few bottles of Pre-Alcohol, a probiotic drink from the company ZBiotics, to test it out.
He downed the mixture of water, salt, flavoring and genetically modified bacteria. He followed it with a cocktail, a meal and two bourbons, and woke the next morning feeling considerably more chipper than he’d have expected.
The next night, emboldened by success, he drank another half-ounce bottle of Pre-Alcohol. He drank a bit more than the previous night — a beer with dinner and then four tumblers of bourbon.
That amount that typically would leave him feeling achy and sluggish the day after.
Which was exactly how he felt when he opened his eyes hours later.
“That one was unpleasant,” said Burke, 48. “I woke up that morning being just like, ‘Well, I’m not 21 anymore.’ ”
A hangover is a collection of physical and mental symptoms resulting from the inflammation and oxidative stress that alcohol wreaks in the human body.
One of many factors contributing to day-after misery is the accumulation of acetaldehyde, a chemical byproduct of the beverages’ ethanol breaking down in the body. Acetaldehyde is a carcinogen that features prominently in the nausea, stomach upset, sweats and other physical symptoms associated with over-consumption.
ZBiotic’s Pre-Alcohol and the Swedish biotech company De Faire Medical AB’s competitor supplement Myrkl both rely on live bacteria to process excess acetaldehyde. Other researchers and recreational drinkers have also experimented with probiotics for similar ends.
Reducing the amount of acetaldehyde, the hypothesis goes, should also reduce the physical symptoms caused by its buildup.
“The more you drink, the more you’ll have to deal with the effects of other things besides acetaldehyde,” ZBiotics CEO Zack Abbott said via email when asked about Burke’s results. “That being said, for the vast majority of people, acetaldehyde is a major factor, and Pre-Alcohol therefore results in them feeling better (if not perfect) the next day.”
The U.S. Food and Drug Administration considers ZBiotics and Myrkl to be dietary supplements or functional foods, not drugs, and thus doesn’t evaluate their health claims. Microbiome experts caution that a probiotic supplement alone won’t spare you from the worst effects of overindulgence.
For starters, the bloodstream carries most of the ethanol in an alcoholic beverage straight to the liver, where an enzyme called alcohol dehydrogenase breaks it down into acetaldehyde. The brain, gastrointestinal tract and pancreas process some alcohol as well. Only a relatively small amount of ethanol is metabolized in the intestines, where probiotics do their work.
Adding probiotics to your pre-party regimen won’t cause you any harm, said Karsten Zengler, a microbiologist and professor of pediatrics and bioengineering at UC San Diego.
But it’s also unlikely to have a substantial effect on how you feel the next day, as your intestines come pre-equipped with an army of bacteria capable of breaking down alcohol’s byproducts, she said.
“There is not a lot of ethanol and acetaldehyde in your large intestine to start with,” Zengler said, and “the vast majority of the bacteria in your gut already metabolize acetaldehyde for you, so just adding something more might not do the trick.”
ZBiotics has funded studies demonstrating both the safety of their product and that their bacteria effectively broke down a significant amount of acetaldehyde in simulated gut conditions in a lab. As for the real-world effects of that breakdown, Abbott pointed to an outside 2006 paper that found that rats given ethanol had fewer hangover-like symptoms the next day when acetaldehyde was removed.
Myrkl funded a small study that showed its product lowered blood-alcohol levels in some participants. Subjects were instructed to take the supplement for a week prior to drinking, rather than the single pre-party dose instructed on the packet. Myrkl didn’t respond to follow-up questions after providing the study.
The hard truth, said Joris C. Verster, a pharmacology professor at Utrecht University in the Netherlands and founder of the Alcohol Hangover Research Group consortium, is that there is currently one scientifically validated way to prevent hangovers: drink less alcohol.
“Although there are many hangover products marketed, there is no convincing scientific evidence that these treatments are effective. Independent double-blind, placebo-controlled clinical trials in social drinkers are needed,” Verster said. “Currently, the only effective way to prevent a hangover is to consume alcohol in moderation.”
Unpleasant as they are, hangovers serve a valuable purpose, said Dr. Daryl Davies, a clinical pharmacy professor and director of the Alcohol and Brain Research Laboratory at USC Mann School of Pharmacy and Pharmaceutical Sciences.
“What I tend to tell people is if you are getting hangovers, you are drinking too much,” Davies said. “It is the body trying to tell you that something is wrong.”
