Four Loko

[Somekid123]

Alcohol is already hard on your liver [Not saying stop, believe me I drink]... but I wonder how much worse these are with all that sugar shit that amps you up.

[Japan]

diuretics mixed with diuretics = massive hangover and liver damage

[Hasbinbad]

Originally Posted by Japan [You must be logged in to view images. Log in or Register.]

diuretics mixed with diuretics = massive hangover and liver damage

How do diuretics cause liver damage? Just from deficient fluid volume? I wasn't aware of diuretics being a big villain behind liver damage. I believe they are used to help treat several forms of liver disease or dysfunction as well.

If that's the case, drinking water eliminates both of those problems, as hangovers are also related to deficient fluid volume.

I make it a rule to drink an 8oz glass of water every time I consume one or two "drinks" of alcohol, especially when drinking heavily. The extra trips to the head are well worth it the next day.

[Japan]

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

How do diuretics cause liver damage? Just from deficient fluid volume? I wasn't aware of diuretics being a big villain behind liver damage. I believe they are used to help treat several forms of liver disease or dysfunction as well.

If that's the case, drinking water eliminates both of those problems, as hangovers are also related to deficient fluid volume.

acetaldehyde metabolism/excretion is dependent on osmolar gradients in the blood and nephron which can't be maintained during severe dehydration. Acetaldehyde isn't very stable; cleaning it up puts a heavy enough load on your liver without it floating around in there for a prolonged period of time reacting with shit.

Drinking water does help. So does eating something sugary (lack of glucose is typically the biggest bottleneck in ethanol metabolism). Yes, orange juice will protect you from cirrhosis.

[Itchybottom]

Dehydration IS a factor in hang-over (as Japan is talking about ethanol oxidizing to acetaldehyde), but it's not the entire picture, and also it has little to do with a diuretic effect damaging your liver. Diuretics are good in most cases for liver damage, to treat ascites (accumulation of fluids) that goes along with such a temporary (or more permanent) problem. Liver and kidney load actually triggers an anti-diuretic effect and most of the problem with hang-over (according to the more recent case studies) has been correlated to higher up the chain in the endocrine system involving free radicals and glycine levels. Correlation, isn't all that amusing though and it's hard to argue the point based on that merit. Hope someone soon publishes the cliff notes, because the god damn Wiley-Blackwell journals can be pretty dizzying in rhetoric.

As far as miracle cures, staying hydrated is not going to help very much during or after intoxication; in other words, simply drinking water when you're in hepatic overload is not going to be sufficient, because the large intestine usually secretes water rather than absorbing it. MUCH too rapidly to have any gainful effect on your elevated gamma-glutamyltransferas (GGT) leakage from your hepatocytes (liver cells). Even oral re-hydration therapy is not sufficient after the fact and should be ingested BEFORE you decide to drink.

Juice is also a very BAD idea without dilution, unless of course you want super fun diarrhea along with your hang-over. It's too high osmolarity!

Digressing, if it was just dehydration and glucose levels causing hang-over, an intravenous glucose solution would cure it within the hour -- but even when plasma osmolality is 285 mOsm/l for such a solution, the hang-over persists. When you're suffering from acute ethanol toxicity, it is primarily due to your hepatocytes not being able to produce adequate enzymes (which can be shown by transaminases levels in most cases) to counter-act the net effect. It's not unlike getting too much exercise without adequate fuel, and rather than generating beneficial enzymes to filter the blood stream, it moves onto massive cholestatic liver enzyme production (GGT as mentioned earlier and alkaline phosphatase) which inflames the bile ducts causing a shit storm of bad renal activity -- leading to fun conditions like biliary cirrhosis.

The real problem [in this case] with medicine, is rather than studying the affects that cause and reduce hang-over, medical science seeks to just make you avoid ethanol all together for front line diagnostics. There are quite a few ways of curing a hang-over through blood diagnostic and for example treating it like autoimmune hepatitis with intravenous ciprofloaxin, xifaxan and then paired with an additional diuretic if there is any portal hypertension from chronic abuse - but it's costly, monetarily and in the long term for your body (antibiotic resistance, for when you do finally get sick enough to die.)


TLDR advice:
If someone gets a hang-over from two "Four-Loko" beverages, it's really time to start evaluating your dietary and life choices. That is not a sufficient amount of alcohol by volume to affect a healthy person acutely, even paired with the caffeine content -- and even with chronic alcoholism, I'm going to go ahead and say its Hot Pocket post parents' basement disorder and you're chronically dehydrated to begin with. Stop eating 30+ grams sugar based carbohydrates, 3 grams of sodium per meal and sucking on Mountain Dew all day, you retarded bastards!

[Japan]

+rep

[Hasbinbad]

Originally Posted by Itchybottom [You must be logged in to view images. Log in or Register.]

staying hydrated is not going to help very much during or after intoxication; in other words, simply drinking water when you're in hepatic overload is not going to be sufficient

#1 theres a huge difference between hepatic overload and intoxication, and neither one happens with the first drink or so. If you start hydrating at this point, you shouldn't have any issues with a hangover.

Originally Posted by Itchybottom [You must be logged in to view images. Log in or Register.]

because the large intestine usually secretes water rather than absorbing it. MUCH too rapidly to have any gainful effect on your elevated gamma-glutamyltransferas (GGT) leakage from your hepatocytes (liver cells). Even oral re-hydration therapy is not sufficient after the fact and should be ingested BEFORE you decide to drink.

Elevated GGT levels are causative of hangovers now? Stop the press! How do you know such things? Also why would your large intestine begin secreting water after a couple drinks? That doesn't seem to make any sense. If this was true, everyone who ever went to college would have at least one story of how they had to go to the ER because they had water shooting out of their asses, and that they almost died from F&E imbalance..

Originally Posted by Itchybottom [You must be logged in to view images. Log in or Register.]

Juice is also a very BAD idea without dilution, unless of course you want super fun diarrhea along with your hang-over. It's too high osmolarity!

Not gonna argue with this.. I've had too many Mai Tais and not enough diarrhea. I guess I'm lucky? Maybe I have a magic digestive system!!

Originally Posted by Itchybottom [You must be logged in to view images. Log in or Register.]

Digressing, if it was just dehydration and glucose levels causing hang-over, an intravenous glucose solution would cure it within the hour -- but even when plasma osmolality is 285 mOsm/l for such a solution, the hang-over persists.

You're ignoring the fact that the symptoms of a "hangover" are directly tied to fluid loss in the CNS rather than the general system of the body. Your brain gets pickled as the ETOH steals water, leaving salts. Of course fluids (at this late stage) would take some time to work, that system is fairly closed, and requires some time for the body to rehydrate.

Originally Posted by Itchybottom [You must be logged in to view images. Log in or Register.]

When you're suffering from acute ethanol toxicity

Are you using "acute ethanol toxicity" as a euphamism for "drunk" or what?

Originally Posted by Itchybottom [You must be logged in to view images. Log in or Register.]

it is primarily due to your hepatocytes not being able to produce adequate enzymes (which can be shown by transaminases levels in most cases) to counter-act the net effect. It's not unlike getting too much exercise without adequate fuel, and rather than generating beneficial enzymes to filter the blood stream, it moves onto massive cholestatic liver enzyme production (GGT as mentioned earlier and alkaline phosphatase) which inflames the bile ducts causing a shit storm of bad renal activity -- leading to fun conditions like biliary cirrhosis.

Getting drunk = cirrhosis now??
I think your liver will work just fine until you drink a half gallon of whiskey all at once or you spend several years drinking a pint of whiskey a day..
It produces everything it needs to produce, just might take a bit longer. Chronic ETOH abuse is really the bigger danger don't you think? I'm getting a bit of "the sky is falling" from your post man..

Originally Posted by Itchybottom [You must be logged in to view images. Log in or Register.]

The real problem [in this case] with medicine, is rather than studying the affects that cause and reduce hang-over, medical science seeks to just make you avoid ethanol all together for front line diagnostics. There are quite a few ways of curing a hang-over through blood diagnostic and for example treating it like autoimmune hepatitis with intravenous ciprofloaxin, xifaxan and then paired with an additional diuretic if there is any portal hypertension from chronic abuse - but it's costly, monetarily and in the long term for your body (antibiotic resistance, for when you do finally get sick enough to die.)

In all seriousness, please tell me how cipro affects autoimmune hepatitis in a positive manner.. I've heard a LOT about how cipro can CAUSE hepatitis, but nothing about how it cures it. Please explain.

Originally Posted by Itchybottom [You must be logged in to view images. Log in or Register.]

TLDR advice:
If someone gets a hang-over from two "Four-Loko" beverages, it's really time to start evaluating your dietary and life choices. That is not a sufficient amount of alcohol by volume to affect a healthy person acutely, even paired with the caffeine content -- and even with chronic alcoholism, I'm going to go ahead and say its Hot Pocket post parents' basement disorder and you're chronically dehydrated to begin with. Stop eating 30+ grams sugar based carbohydrates, 3 grams of sodium per meal and sucking on Mountain Dew all day, you retarded bastards!

True. True.

[Itchybottom]

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

#1 theres a huge difference between hepatic overload and intoxication, and neither one happens with the first drink or so. If you start hydrating at this point, you shouldn't have any issues with a hangover.

There really isn't. There is a huge difference between hepatic FAILURE and intoxication, but overload is what happens when you've had a bit too much. Hydration, isn't all that causes a hang-over. Systemically, being drunk drops your blood insulin levels. In the blood, it's going to increase cholesterol, fibrinolysis and in turn increase the flow, which is going to backlog your liver and kidneys during the assault. Sodium intake and hydration are a key part of the puzzle, but they certainly aren't "it".

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

Elevated GGT levels are causative of hangovers now? Stop the press! How do you know such things? Also why would your large intestine begin secreting water after a couple drinks? That doesn't seem to make any sense. If this was true, everyone who ever went to college would have at least one story of how they had to go to the ER because they had water shooting out of their asses, and that they almost died from F&E imbalance..

Elevated GGT and AP levels are present when your liver can no longer process the ethanol. For the average person, that's 3 ounces of 40% abv ethanol per hour when the process starts.

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

You're ignoring the fact that the symptoms of a "hangover" are directly tied to fluid loss in the CNS rather than the general system of the body. Your brain gets pickled as the ETOH steals water, leaving salts. Of course fluids (at this late stage) would take some time to work, that system is fairly closed, and requires some time for the body to rehydrate.

I didn't ignore the fact that part of a hang-over is in part caused from dehydration. It certainly doesn't involve the central nervous system more than toxic filtration of your liver, and kidneys. As the alcohol levels in your blood elevates, your metabolic excretion slows down. Once you reach a certain point of with alcohol dehydrogenases - your acetaldehyde levels (via oxidization and free radicals) peak and your liver is no longer efficient. The central nervous system consists of your brain and spine -- and the only affect here in regards to it after too much to drink would be encephalitis.

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

Are you using "acute ethanol toxicity" as a euphamism for "drunk" or what?

Epidemiology term. I tried to dumb down my post so the layperson could understand most of it. It's a bit further than intoxicated, which is usually when you have a hang-over.

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

Getting drunk = cirrhosis now??

Hyper-vascular nodules form on the liver - as shown by ultrasound and dissection of rats when consuming over 6g/kg volume (with 10g/kg being the LD50.)

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

I think your liver will work just fine until you drink a half gallon of whiskey all at once or you spend several years drinking a pint of whiskey a day..
It produces everything it needs to produce, just might take a bit longer. Chronic ETOH abuse is really the bigger danger don't you think? I'm getting a bit of "the sky is falling" from your post man..

Chronic use is clearly more of a danger, but shocks to the liver with high consumption, are just as taxing due to cell recovery rate. The liver is a robust organ, but not quite as robust as the brain; once there is enough cumulative damage, it cannot regenerate itself due to blood flow issues. If someone were to consume a half gallon of whiskey, it would be largely up to their body weight and resting metabolic rate how it affected them. If you did this frequently, you would end up with not only chronic gastritis from the tissue irritating in your digestive tract, but you would also be lowering liver, kidney and pancreatic function. I was actually trying to insinuate higher volume than a half gallon though. I really meant binge drinking, which should be on topic since we are talking about idiots and Four-Loko here.

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

In all seriousness, please tell me how cipro affects autoimmune hepatitis in a positive manner.. I've heard a LOT about how cipro can CAUSE hepatitis, but nothing about how it cures it. Please explain.

It's rare for cipro to actually induce cholestatic hepatitis -- but it has happened before and to the general populace, it's not a problem.

Unfortunately when it comes to pharmaceuticals (just like product reviews) the negative effects often get more attention the longer the drug is used.

Flouroquinolones help clean the blood, when the liver is under stress and it inhibits cell division (gyrase). It's also super affective at being an RNA antiviral (which is what hepatitis is) In a regimen treating hepatitis, it is often used to treat the possibility of secondary infections in the body. Most studies indicate it's slope of effectiveness to drop after cirrhosis and hepatocellular carcinoma are present - but doctors of internal medicine still prescribe it even then, just in case. When it comes to the liver there is always the chance of bacterial peritonitis or hepatic encephalopathy and it's been shown to reduce that chance.

In the case of using it as part of the regimen to get rid of drunkenness, it's activity will help you by method of retarding topoisomerase (type II primarily, as it's practically a sharp shooter) enzyme production at the ligation step of the cell cycle. It's unknown why, but as a side-effect that somehow also decreases glucose repression rate which is one of the symptoms being drunk is causing.

I really hope I didn't get trolled here, and you just wanted to actually learn something, Hasbinbad.

[Hasbinbad]

Originally Posted by Itchybottom [You must be logged in to view images. Log in or Register.]

The central nervous system consists of your brain and spine -- and the only affect here in regards to it after too much to drink would be encephalitis.

I'm sorry, maybe I woke up and am now in a new dimension in which Alcohol isn't described as a CNS depressant?

You seem to know so many details, yet your grasp of the the bigger picture seems somewhat less than complete.

[Itchybottom]

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

I'm sorry, maybe I woke up and am now in a new dimension in which Alcohol isn't described as a CNS depressant?

Alcohol is without a doubt a depressant, no one is arguing the validity of that observation.

Most cells (damaged or not) have an effect on the central nervous system. I was refuting the non-sense that it had something to do with fluid loss in it specifically --

Originally Posted by Hasbinbad

You're ignoring the fact that the symptoms of a "hangover" are directly tied to fluid loss in the CNS rather than the general system of the body.

There is far more depression being caused in your endocrine system, than your central nervous system; unfortunately in the case of most sciences (psychology, comes to mind as a prime example) labels are often in need of review for years before they've been updated. I don't think it's the case that alcohol needs reclassification, but it's effects need to be more widely published and not just available to those of us forking money over for peer reviewed articles. I tried to give you a heuristic evaluation of the biological reaction of ethanol in the body, and ultimately the "real" cause of hang-over and you're replying with word play. I do not appreciate being led by uncritical acceptance of invalid understanding. The current theory in the field, differs greatly (and thereby falsifies) the original postulation that the public layman likes to harp about hang-overs, the newer evidence which has been published by medical journals provided by Acta Neurologica Scandinavica (published by Wiley-Blackwell, as I mentioned in my first post), The Journal of Clinical Endocrinology and Metabolism and similarly (though not as in depth) in part the Journal of Studies on Alcohol and Drugs greatly differs from our understanding of the past. What I'm basically saying is, a decade ago I would have been agreeing with you (aside from the obvious problem with fluid in the nervous system being depleted) -- now, not so much.

I'd like to re-iterate, medical science does not spend much time on alcoholism, other than it's prevention. The timeline for study and break-through on the subject is longer than it should be.

A similar discovery in another field (toxicology) as an example, is the monitor lizard. For the longest time, we thought the bite of the lizard, due to the amount of bacteria in it's mouth is what slowly disabled it's prey. As it turns out, it actually has venom sacks. How was this missed? It is absurd to think bacteria would work that way, which in turn lead Dr. Brian Grieg Fry (PhD, not MD) to take a closer look. It's been causing a big storm in peer-reviewed journals for the last few years, and PhD candidates all over the place are examining lizard species of all walks (last I checked, there were about 1,700 of them with venom, and that was 2009) to break ground with. The amount of those creatures [monitor lizards] that have been dissected over the years, and no one noticed a venom sack pretty much describes my feeling on public opinion turning into fact in sciences and often makes me roll my eyes on Internet forum posts without citation, or full grasp of the concept at hand.

Ideas != hypothesis or theory, yet somehow they still hold just as much water in some circles.

Originally Posted by Hasbinbad [You must be logged in to view images. Log in or Register.]

You seem to know so many details, yet your grasp of the the bigger picture seems somewhat less than complete.

So you're insinuating that I am making a compositional fallacy, or ignoring the common cause? Because in both cases, just no. This conversation seems to have de-evolved into a semantics debate (language barrier, terminology) rather than anything constructive. I didn't challenge your idea of "pickling" the brain, because of this. Did you mean cerebral edema or "wet brain" associated with alcoholism? I didn't see how the two processes (pickling and edema) could relate, but I did see mention of the term used for alcohol dementia in non-medical texts which descriptors lead me to edema. That's beyond the scope of hang-over and in most cases end-stage cirrhosis - academically that dives pretty deep down the hole into glial cell membranes and other cytolytic activity.

There's a gastroenterologist locally to me by the name of Dr. Lin Huang MD, he's often referred to as #2 in this field per peer recommendation and I've had conversations with him in length on the subject. What fascinates me the most about his work, is that he actually found when it comes to glycine production and liver function (primarily in the scope of cirrhosis prevention, but would also apply to causation of hang-overs) that you could use bacteriophage activated escherichia coli to boost glycine levels in the body. Not dissimilar to treating hepatitis C by infecting the person with A (mortality rate is 40%, which means 60% chance get better according to the German study) That [glycine boost] would certainly insulate you from some of the effects of hang-over, especially if it was treated with the proper protocol to lessen the a-typical symptoms associated with viral stage infection (of potent e.coli). Of course, this wouldn't relate to compound infections (hepatitis, cirrhosis, diabetes, and/or other immunologic-suppression) or late stage cases, but it could give people a fighting chance when caught early. Then again, last I checked people aren't to keen on using tape worm for dieting either.... So it might not be so great presenting such a treatment to your patient. There are also some specific toxins being studied that alter the endocrine and nervous system directly, that could be applied to future methods of therapy (and abuse by college kids.)

If people think things like Four Loko are bad now (clearly if it's being banned), wait until a "supplement" from some random herbal remedy company comes on the market that enables you to drink more than you should. It's already working well enough (sales volume anyhow) with a placebo from Merck -- in the case of South America and Hepabionta. I'm shooting myself the moment a "low toxicity" gin or scotch come out though.