It’s Not in Your Head: Hangovers Really Do Get Worse With Age


There’s no doubt about it—hangovers suck. They can ruin your whole day and make you regret last night’s actions. Hangovers are also a sign of someone who can’t handle their liquor, something a novice would do. Over time, a seasoned drinker knows to eat beforehand, drink water to stay hydrated, what drinks to choose, and when it’s time to stop. But there’s one factor people need to consider when planning a night out: age.


“It is biologically true that hangovers get worse when we get older,” says Flow Advisory Council member Kellyann Niotis, MD, a preventative neurologist at Early Medical. For example, your alcohol tolerance goes down as you age because your body cannot process it efficiently. Another issue is whether your body is in good shape to handle alcohol. This might explain why you could pound down shots in your twenties with no problem but wake up with a wicked hangover from two glasses of Merlot.

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This doesn’t mean you need to cut alcohol out of your life, but your relationship with drinking does need to change. We spoke with neurologists to get the scoop on what’s happening in the body to cause these next morning blues. They also offer several tips to stop hangovers for good.

Why Hangovers Worsen with Age

Alcohol metabolism slows down


The liver has enzymes that break down alcohol, creating both toxic and nontoxic byproducts that are later excreted from the body. But as we get older, Niotis says these enzymes take longer to metabolize alcohol, making it linger longer. The buildup of alcohol metabolites such as acetaldehyde is associated with severe hangover symptoms.

Bodies don’t retain as much water

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Alcohol is a diuretic. By blocking a hormone called vasopressin, it boosts urine production. An increase in urination flushes out water from the body, making you more dehydrated. James Giordano, PhD, a Pellegrino Center professor of neurology and biochemistry at Georgetown University, explains that younger people have a lot more water in their system so the dehydration is not too severe. But unless you exercise regularly, your muscle mass goes down as you get older. This loss in muscle leads to a loss of intramuscular water volume and an overall decrease in total body water volume. For this reason, some individuals feel the dehydrating effect more as they age.


Perimenopausal and menopausal women are at higher risk for hangovers because the drop in estrogen and progesterone makes it more difficult for the body to hold on to water and dilute the ingested alcohol.

Sleep quality goes down


Sleep quality changes as you get older. The internal clock inside that tells when it’s time to sleep and time to be awake starts to deteriorate. This makes it harder to fall asleep at night.


One stage of sleeping alcohol interferes with is the phase involved in flushing out toxins. “That’s when your body itself gets rid of not only alcohol but excess sugars and toxic proteins that lead to Alzheimer’s and Parkinson’s,” says Niotis. “Alcohol is doing its own vicious cycle by preventing you from getting the sleep you need to help you get rid of it.”

How to prevent a hangover

Avoid drinking on an empty stomach


When you eat, you’re slowing the absorption from your gut into your bloodstream. This, in turn, gives the liver time to break down the alcohol without it building up in your blood and causing its toxic effects.

Stay hydrated while drinking


Drinking water helps replenish the body from all the fluids being excreted from your system. Niotis advises drinking one full glass of water for every alcoholic beverage.

Drink in the daytime


Because alcohol messes with your sleep, Niotis says it’s better to day-drink so that your body has time to break the alcohol down before you go to bed. Drinking earlier will not stop you from getting the deep sleep you need to feel rejuvenated.

Avoid mixed drinks


Sweet and salty mixed drinks can increase the chances of a hangover, says Giordano. This is because both sugar and salt are dehydrating and these effects are compounded with alcohol’s dehydrating effects. If you want to avoid a nasty hangover, Giordano advises choosing clear liquors like gin and vodka instead of dark ones like whiskey.

Restore B vitamin levels


Restoring your electrolytes is important in recovering the minerals you lost and hydrating the body. Giordano says one important vitamin to replenish is vitamin B. Alcohol flushes out most of your B vitamin levels, which contributes to a hangover.

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