What do we know about DHM and hangovers?
Users consuming dihydromyricetin (DHM) after alcohol ingestion have reported experiencing fewer incidents of headaches, nausea, vomiting, and anxiety than at the same level of alcohol ingestion without consuming DHM.
The unpleasant feelings that stem from a hangover are generally attributed to a combination of factors including dehydration, fatigue, glucose imbalances, as well as toxic impurities found in some alcoholic beverages (i.e. congeners) - but above all due to the toxic byproduct of alcohol metabolism, acetaldehyde.
Two enzymes help your body break down alcohol (ethanol) and acetaldehyde (‘ethanal’) — alcohol dehydrogenase (ADH) and acetaldehyde dehydrogenase (ALDH). A number of studies (Chen et al., 2006) suggest that dihydromyricetin - one of the main ingredients in Survivor - increases the activity of said enzymes, meaning DHM could help you metabolize alcohol faster.
Additionally, another recent study found that people who ingested DHM experienced less headache, dizziness, nausea, and weakness after drinking than those who did not take the DHM (Kim et al., 2017). This article discusses DHM and hangovers and how the latter affects the former.
DHM, also known as Dihydromyricetin or Ampelopsin, is a potent flavonoid. It has been seen to help accelerate your body’s ability to break down acetaldehyde, the toxic by-product of alcohol metabolisation.
Fairly new in the eyes of Western science, it has been used for thousands of years in traditional Chinese medicine - the plants from which DHM can be extracted, Ampelopsis grossedentata and Hovenia dulcis, have have been used as remedies or a supplement for hangovers for centuries and consumed as teas, powder preparations, and infusions.
DHM has recently invited considerable academic interest given its promise of an entire swathe of health-beneficial effects. DHM studies suggest Dihydromyricetin (DHM) relieves alcohol toxicity and prevents intoxication by limiting the absorption of alcohol in the gastrointestinal tract and promoting the metabolisation of alcohol in the liver. DHM has even been proposed as a ‘novel anti-intoxication medication’ (Shen et al., 2012).
Indeed, DHM ‘has been demonstrated to show anti-oxidative, anti-inflammatory, anticancer, antimicrobial, cell death-mediating, and lipid and glucose metabolism-regulatory activities’ (Li et al., 2017). There are now over 279 studies across medical publisher databases PubMed and Google Scholar, and many more in the pipeline. Definitely the flavonoid to keep your eye on!
Hangovers are particularly complex afflictions, stemming from a variety of different causes and manifesting themselves in a range of symptoms. Though the term ‘hangover’ is considered a health condition in the UK, it is an imprecise and somewhat subjective term. They are as yet not entirely understood. As such, treating the causes and symptoms of one is not entirely straightforward, nor are there ‘one-size-fits-all’ cures: because alcohol affects people differently, hangovers rear their ugly heads in different ways to different people.
There are many factors involved in the making of a ‘hangover’. They range from dehydration, deficiency of important minerals such as magnesium and potassium, vitamin depletion, to fatigue, glucose imbalances, and the glutamate rebound effect. Not to mention the variations in types of alcohol, in particular the addition of toxins such as congeners or sulphites.
Many assume that the adverse effects of alcohol are due to ethanol, but in fact it’s the latter’s first metabolite, acetaldehyde, which acts as the main wrecking ball. This compound is metabolised by the enzyme alcohol dehydrogenase (ADH), which then becomes acetate through aldehyde dehydrogenase (ALDH). Acetate is actually thought to be responsible for some of the positive health benefits of alcohol consumption, so one of the keys to alleviating post-alcohol consumption hangovers is to control acetaldehyde through the dehydrogenase enzyme.
The goal, then, is to break down ethanol (EtOH) and acetaldehyde as quickly as possible - the longer these remain unprocessed in the body, the more time they have to cause damage. This is where DHM comes into the picture.
Dihydromyricetin Hangover Review
DHM, Blood Alcohol Levels and Intoxication.
While it is unclear whether DHM decreases blood alcohol levels, studies have concluded that DHM has a dramatic effect on reducing intoxication - which can be very relevant for one’s hangover.
Studies show contradictory results on the role of Hovenia Dulcis in lowering blood alcohol-levels in mice and humans (Kim et al., 2017). Du et al. (2010) showed that with increasing amounts of administered H. Dulcis extract, blood-alcohol levels would show a negative correlation, decreasing. In this paradigm, the extract was administered to mice by gavage for four consecutive days before alcohol was given through ig injection. In the other experiment by Kim et al. (2017) human participants were asked to consume 360 mL of Korean Soju, together with 2460 mg H. Dulcis fruit extract. One, four and twelve hours after consumption, there were no differences in blood-alcohol nor breath-alcohol concentration between treatment and placebo groups.
On the other hand, DHM has been shown to significantly curb intoxication. In one study, the equivalent of 20 beers were injected to hapless rats. Alcohol intoxication was measured through the loss of righting reflex (LORR) – essentially the ability of a rat to turn itself upright after being placed on its back. Without administration of DHM, the rats ‘sobered up’ on average in 90 minutes. However, with DHM administered parenterally, they sobered up in 5 minutes (Shen, 2012). This leads to the conclusion that, through the LORR measurement, DHM dose-dependently decreases the effects of alcohol intoxication in rats. This interesting effect leads to the next point.
Dihydromyricetin (DHM) Reduces Alcohol (EtOH) Withdrawal.
Alcohol withdrawal is often seen as an extreme, as something recovering alcoholics have to deal with. However, clearing even a small amount of alcohol from the body has a rebound effect. Alcohol acts a physiological depressant: it slows down brain function and changes the way your nerves send messages back and forth (What Causes Alcohol Withdrawal, WebMd, 2017). Having a hangover shares many of the bodily processes as seen in withdrawal as the body recovers from having consumed a large quantity of alcohol.
In addition to enhancing alcohol clearance and alcohol metabolic enzymes, DHM has a direct and complex interaction with GABA-A receptors that likely accounts for many of its anti-alcohol effects. DHM counteracts acute alcohol intoxication and helps to reduce alcohol withdrawal symptoms. DHM reduces susceptibility to anxiety and seizures (Shen et al., 2012). DHM can normalize blood sugar levels, reduce liver damage, and even restrain tumor growth (Hase et al., 1997).
Dihydromyricetin Helps the Liver.
A number of studies have come to the conclusion that DHM can help protect the liver. Hase et al. (1977) performed one of the first studies here, by using an extract of H. Dulcis fruits to study the effects on ethanol (EtOH) intoxication. They mimicked alcohol toxicity by inflicting liver damage on rats, while measuring liver serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The latter two are metabolites that are often used as a measurement when assessing liver damage. AST and ALT levels in the liver rise when large quantities of alcohol are consumed. Hase et al. showed that ALT and AST levels increased when the rats were exposed to certain chemicals that cause liver damage. However, when these rats were co-fed with H. Dulcis, ALT and AST levels were significantly lower compared to the equivalent AST and ALT levels in liver-injured rats not fed with the H. Dulcis extract.
Hangover Factors Unaffected by DHM.
DHM is not a cure-all - given the complexity of a ‘hangover’, there are many factors that contribute to a ‘hangover’ to which DHM administration would not impact.
Sleep is probably the most significant one: not only lack of sleep, but also sleep displacement (going to bed at 4 AM post-party is generally not routine for the body - your circadian rhythm is thrown out of whack), and above all quality of sleep.
Glucose imbalances (low blood sugar) is another one: drinking impacts your liver’s functionality, and more specifically, its ability to release the appropriate quantities of glucose into your bloodstream. Blood sugar can both increase and decrease to a dangerous point - a moderate amount of alcohol will make your blood sugar rise, while excess consumption can bring your blood sugar very low, caused in part by an imbalance in the hormones that regulate blood sugar levels. Drinking increases insulin secretion - so the above is particularly relevant in the context of diabetes.
There are many other aspects, such as dehydration, vitamin and mineral depletion - see what aspects Survivor's formulation can help with.
Chen et al. 2006. Influence of Hovenia dulcis on alcohol concentration in blood and activity of alcohol dehydrogenase (ADH) of animals after drinking. Zhongguo Zhong Yao Za Zhi. (2006). https://www.ncbi.nlm.nih.gov/pubmed/17048612/
Du, J. et al. Semen Hoveniae extract protects against acute alcohol-induced liver injury in mice. Pharm. Biol. 48, 953–958 (2010).
Hase, K. et al. Hepatoprotective effect of Hovenia dulcis THUNB. on experimental liver injuries induced by carbon tetrachloride or D-galactosamine/lipopolysaccharide. Biol. Pharm. Bull. 20, 381–5 (1997). https://www.ncbi.nlm.nih.gov/pubmed/9145214
Kim et al. A standardised extract of the fruit of Hovenia dulcis alleviated alcohol-induced hangover in healthy subjects with heterozygous ALDH2: A randomised, controlled, crossover trial. Journal of Ethnopharmacology. (2017). https://www.ncbi.nlm.nih.gov/pubmed/28750942
Li et al. The Versatile Effects of Dihydromyricetin in Health. Evidence Based Complementary Alternative Medicine (2017). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602609/
Shen, Y. et al. Dihydromyricetin as a novel anti-alcohol intoxication medication. J. Neurosci. 32, 390–401 (2012). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292407/
‘What Is Alcohol Withdrawal?’ Article. WebMd. 2017. Accessed online on 14 September 2019. https://www.webmd.com/mental-health/addiction/alcohol-withdrawal-symptoms-treatments#1