WEBVTT - Ep 85 Alcohol: Beer for Thought 0:00:01.440 --> 0:00:04.520 Among the blossoms, waits a jug of wine. I pour 0:00:04.600 --> 0:00:08.360 myself a drink. No loved one near raising my cup. 0:00:08.400 --> 0:00:10.880 I invite the bright moon and turn to my shadow. 0:00:11.240 --> 0:00:14.720 We are now three, but the moon doesn't understand drinking, 0:00:15.000 --> 0:00:18.279 and my shadow follows my body like a slave. For 0:00:18.360 --> 0:00:21.520 a time, Moon and shadow will be my companions, a 0:00:21.560 --> 0:00:24.840 passing joy that should last through the spring. I sing, 0:00:25.000 --> 0:00:27.960 and the moon just wavers in the sky. I dance, 0:00:28.000 --> 0:00:31.400 and my shadow whips around like mad while lucid still 0:00:31.440 --> 0:00:35.639 we have such fun together, but stumbling drunk, each staggers 0:00:35.640 --> 0:00:40.839 off alone, bound forever, relentlessly roam reunited at last on 0:00:40.880 --> 0:00:41.640 the distant. 0:00:41.440 --> 0:01:30.759 River of stars. Wow. I really like that little poem. 0:01:31.040 --> 0:01:33.640 I do too. So. 0:01:34.120 --> 0:01:38.280 That poem was by Lee Bi, also known as Lee Poe, 0:01:39.120 --> 0:01:42.760 who was, according to this source, one of the greatest 0:01:42.760 --> 0:01:46.880 poets of China's Tang dynasty, or of all of history. 0:01:46.959 --> 0:01:47.440 Perhaps. 0:01:50.280 --> 0:01:54.560 Lee Bi was a martial artist, an academic genius, and 0:01:54.680 --> 0:01:58.920 also a lover of wine and a member of the 0:01:58.960 --> 0:02:02.880 group Six Eyed of the Bamboo Brook, which was a 0:02:02.920 --> 0:02:05.640 group dedicated to literature and drinking. 0:02:06.440 --> 0:02:07.440 And in general. 0:02:07.880 --> 0:02:11.760 People at the time would only indulge socially So this poem, 0:02:12.000 --> 0:02:15.720 one of his most famous, is exploring the problems of 0:02:15.800 --> 0:02:17.480 drinking alone. 0:02:17.600 --> 0:02:19.959 Yeah, all the way back from the eighth century. 0:02:20.040 --> 0:02:21.079 The eighth century. 0:02:21.720 --> 0:02:24.639 And the poem that I read was translated by David 0:02:24.680 --> 0:02:26.519 Bowles from the original Chinese. 0:02:27.120 --> 0:02:28.840 And we'll post the link on our website. 0:02:29.240 --> 0:02:34.640 Yeah. Well, Hi, I'm Aaron Welsh and I'm Aaron Ollman Updike, 0:02:35.040 --> 0:02:37.320 and this is this podcast will kill you. 0:02:37.720 --> 0:02:40.440 It is and it's a It's a big episode for 0:02:40.520 --> 0:02:42.280 a couple of reasons. 0:02:42.960 --> 0:02:47.080 Reason number one is that it's our season finale. 0:02:47.240 --> 0:02:49.920 It's our season four finale. 0:02:50.200 --> 0:02:55.440 Yeah, four seasons four finales. This is a big one. 0:02:55.720 --> 0:03:00.320 Can you can you picture us four years to go 0:03:01.200 --> 0:03:03.800 when we were doing our first season in my back 0:03:03.800 --> 0:03:07.080 bedroom in my in our tiny house, Like can you 0:03:07.240 --> 0:03:09.359 could you ever have imagined that we would be here 0:03:09.440 --> 0:03:09.960 doing this now? 0:03:10.160 --> 0:03:13.960 Eric, You know what, I don't know if I like 0:03:14.200 --> 0:03:16.640 dared to hope that we would still be doing it. 0:03:16.880 --> 0:03:17.919 Yeah, But I. 0:03:17.880 --> 0:03:21.560 Think it's kind of funny because I think that neither 0:03:21.560 --> 0:03:24.440 of us maybe would have been that surprised because we 0:03:24.520 --> 0:03:28.480 had lists of like episodes we wanted to cover up to, 0:03:28.560 --> 0:03:32.240 like five seasons worth, all the way back then. I 0:03:32.240 --> 0:03:34.480 think the thing that would have really shocked us and 0:03:34.639 --> 0:03:37.360 we would not have believed is just like, is our 0:03:37.760 --> 0:03:42.520 listenership being so incredible and so supportive and so wonderful. 0:03:43.000 --> 0:03:47.360 Yeah, it's you all, listeners. Thank you so much. We 0:03:47.880 --> 0:03:50.520 would not be still making this podcast without you, or 0:03:50.560 --> 0:03:52.400 if we were, it definitely wouldn't be as much fun. 0:03:52.840 --> 0:03:59.240 Yeah, it's it's true. Yeah, so after this episode, don't worry, 0:03:59.280 --> 0:04:01.920 we will be coming back. So it's it's kind of 0:04:01.960 --> 0:04:06.640 like not that sad in a way, because you know 0:04:07.200 --> 0:04:09.640 we are. I think it would be a lie to 0:04:09.680 --> 0:04:12.080 say that we're not looking forward to the break a bit. 0:04:12.160 --> 0:04:13.840 You're highly looking forward to it. 0:04:14.120 --> 0:04:16.400 Yeah, just a little bit of time to rest our 0:04:16.440 --> 0:04:19.039 brains and to get some other stuff done that in 0:04:19.080 --> 0:04:22.960 the background. And you know, if you're looking for more 0:04:23.160 --> 0:04:26.919 of tpwk hy to like fill that need while you're gone, 0:04:27.000 --> 0:04:30.920 you should definitely check out our reading lists, our bookshop 0:04:30.960 --> 0:04:34.520 dot Org affiliate account, our Goodreads list, which, by the way, 0:04:34.760 --> 0:04:37.000 I've I'm not allowed to add any more books. I've 0:04:37.040 --> 0:04:39.640 capped it at one hundred, Like I've added one hundred 0:04:39.680 --> 0:04:42.000 books so far and so I can't add any more. 0:04:42.160 --> 0:04:45.160 So if there's a helpful listener out there that wants 0:04:45.200 --> 0:04:47.680 to add the books that I mentioned that would be lovely. 0:04:47.960 --> 0:04:49.200 That's hilarious. 0:04:49.440 --> 0:04:54.320 Oh my goodness, problems of a podcaster. 0:04:57.320 --> 0:04:59.360 Okay, so that's one of the reasons that this is 0:04:59.360 --> 0:05:03.240 a big episode. The other reason is because today we're 0:05:03.279 --> 0:05:08.839 talking about alcohol. Alcohol, like all of it, just alcohol. 0:05:09.560 --> 0:05:14.240 Yeah, you know, it sounded fun. It still sounds fun. 0:05:15.080 --> 0:05:17.159 It sounded manageable. Yeah. 0:05:17.320 --> 0:05:20.760 Yeah, well we'll see if it was yeah, you'd be 0:05:20.880 --> 0:05:21.440 the judge. 0:05:21.560 --> 0:05:23.599 Yeah, you guys, tell us. 0:05:26.440 --> 0:05:30.000 Well, it wouldn't be an episode of TPWKY or just 0:05:30.040 --> 0:05:36.520 an episode of a podcast about alcohol without a quarantiney exactly. 0:05:38.000 --> 0:05:39.800 So what are we drinking this week? 0:05:39.960 --> 0:05:46.360 We're drinking poor choices? Get it like po you are. 0:05:46.400 --> 0:05:50.240 I think this is the second poor related pun that we've. 0:05:50.040 --> 0:05:51.679 Done this season. 0:05:51.880 --> 0:05:56.120 Yep, this season. But it's a really good one. It is. 0:05:56.279 --> 0:05:59.560 It is a really good one. And in addition to 0:05:59.600 --> 0:06:03.960 having a really good name, it's also a really fantastic drink. 0:06:04.279 --> 0:06:06.480 And I'm I'm not exaggerating. 0:06:06.600 --> 0:06:07.680 Tell us what's in it? Aarin? 0:06:08.200 --> 0:06:11.240 So you start with mead, and we chose mead because 0:06:11.320 --> 0:06:16.040 meat is one of the oldest alcoholic beverages also known 0:06:16.080 --> 0:06:20.000 as honeywine. And then we kind of did a little 0:06:20.200 --> 0:06:25.680 fun sidestep. We're doing a shrub and if anyone hasn't 0:06:25.680 --> 0:06:30.160 had a shrub before, it's basically like you know, drinking vinegar. 0:06:30.279 --> 0:06:34.040 Like it's you make a little recipe with macerated fruit 0:06:34.120 --> 0:06:37.200 usually or like pulped fruit, and then some sort of 0:06:37.200 --> 0:06:40.559 sweetener and then vinegar and some spices if you want, 0:06:41.160 --> 0:06:43.640 and you let it sit and then you you know, 0:06:43.680 --> 0:06:47.200 filtered out and it's absolutely delicious. I made a shrub 0:06:47.240 --> 0:06:52.679 for this of honeycrisp apples and honey apple cide or vinegar, 0:06:53.040 --> 0:06:56.359 the zest of a lemon, all spice annis and cinnamon 0:06:56.400 --> 0:06:57.919 sticks yum. 0:06:58.400 --> 0:07:02.760 Also, don't be afraid of the sound of a vinegar drink. 0:07:03.760 --> 0:07:05.360 It's actually delicious. 0:07:05.520 --> 0:07:08.600 It's like really complex and delicious and you can do 0:07:08.680 --> 0:07:09.640 so much with them. 0:07:09.920 --> 0:07:12.960 Yeah, it makes a very good placy Brita. And don't worry, 0:07:13.080 --> 0:07:16.360 we'll post the full recipe for that quarantine and the 0:07:16.440 --> 0:07:19.360 non alcoholic Plasy Brita on our website, this podcast with 0:07:19.440 --> 0:07:21.720 kill you dot com and all of our social media channels. 0:07:22.360 --> 0:07:28.800 We will other business other business our website. There's lots 0:07:28.800 --> 0:07:31.240 of good stuff on there. You can find all of 0:07:31.280 --> 0:07:34.640 our sources for all of our episodes. You can find 0:07:34.680 --> 0:07:38.160 links to, like I said, our bookshop dot org affiliate account, 0:07:38.280 --> 0:07:41.680 and Goodreads list. You can find links to Patreon, to 0:07:41.800 --> 0:07:47.680 our merch to transcripts. And also I am excited to 0:07:47.840 --> 0:07:52.160 announce that Bloodmobile, who provides the music for this episode 0:07:52.160 --> 0:07:57.680 and all of our episodes, is now on Spotify, and 0:07:57.720 --> 0:08:00.320 we will post a link to that as well. So 0:08:00.640 --> 0:08:03.480 definitely check all of that stuff out. 0:08:05.720 --> 0:08:07.280 Is that all of our business today? Erin? 0:08:07.720 --> 0:08:11.240 I think? So should we dive in? Can we dive in? 0:08:11.520 --> 0:08:14.400 I think that we can. We'll take a sip and 0:08:14.440 --> 0:08:17.320 a break and then get to it. Perfect. 0:08:17.360 --> 0:08:17.840 Perfect. 0:08:44.480 --> 0:08:50.800 So alcohol, by which I mean Aaron ethanol? That's what 0:08:50.840 --> 0:08:51.760 you mean? Okay? Good? 0:08:52.120 --> 0:08:53.719 Yeah, by the way, I think we're going to be 0:08:53.840 --> 0:08:57.199 using these interchangeably throughout Okay. 0:08:56.920 --> 0:08:57.840 Well for sure. Yeah. 0:08:57.880 --> 0:09:00.720 Ethanol is the form of alcohol that we drink. It's 0:09:00.760 --> 0:09:03.840 the form that's used for recreational purposes. So when we 0:09:03.880 --> 0:09:07.120 say alcohol, that's what we're talking about in this context. 0:09:07.200 --> 0:09:13.760 All right, So ethanol. Alcohol is a psychoactive drug. I 0:09:13.760 --> 0:09:17.040 think it's important to frame it that way because a 0:09:17.920 --> 0:09:21.560 that is in fact what it is, and b it's 0:09:21.640 --> 0:09:25.160 not uncommon that we frame it either as something completely 0:09:25.240 --> 0:09:29.360 harmless or fairly harmless, or on the flip side, as 0:09:29.520 --> 0:09:32.720 a recreational substance or something that is really bad. 0:09:33.240 --> 0:09:36.920 Right, what is the definition of a psychoactive drug? 0:09:37.120 --> 0:09:38.360 So glad you asked Arin. 0:09:39.600 --> 0:09:41.600 I actually don't know if I have a formal definition, 0:09:43.000 --> 0:09:45.680 but it's a substance that acts directly on the brain, 0:09:45.920 --> 0:09:49.240 on the central nervous system. Okay, can you remember something 0:09:49.240 --> 0:09:51.520 else that we covered on this podcast that is also 0:09:51.559 --> 0:09:52.840 a psychoactive. 0:09:52.320 --> 0:09:53.640 Drug, caffeine. 0:09:53.800 --> 0:09:58.720 Caffeine, Yeah, exactly. So alcohol has direct effects on our brain, 0:09:58.800 --> 0:10:01.880 both in the short and the long term, that are 0:10:01.920 --> 0:10:06.640 not only important to understand, but are also fascinating. As 0:10:06.679 --> 0:10:09.360 per usual, I'm not going to be able to cover 0:10:09.559 --> 0:10:14.079 it all, and alcohol effects a lot more of your 0:10:14.080 --> 0:10:17.640 body than just your brain. But for most of this episode, 0:10:17.640 --> 0:10:19.959 I'll be focusing on the effects on the brain. I'll 0:10:19.960 --> 0:10:21.839 get in a little bit to some of the kind 0:10:21.880 --> 0:10:25.720 of long term effects on other organ systems. So let's 0:10:25.720 --> 0:10:28.720 get into it. Here's how I'm going to break this down. First, 0:10:28.880 --> 0:10:31.680 I'm going to talk about the direct effects of alcohol 0:10:32.040 --> 0:10:35.079 in kind of the short term and how it produces 0:10:35.120 --> 0:10:40.040 what we all know of as drunkenness. And then we'll 0:10:40.040 --> 0:10:42.640 talk about one of my favorite parts, which is the 0:10:42.760 --> 0:10:49.000 dreaded aftermath, the hangover. Yeah, all right, and to discuss that, 0:10:49.080 --> 0:10:50.960 we do have to get a little bit into the 0:10:51.040 --> 0:10:54.640 metabolism of alcohol, but I promise I'll keep it biochemistry light. 0:10:56.080 --> 0:10:58.400 And then Aaron, I want to hear from you about 0:10:58.440 --> 0:10:59.079 how long. 0:10:58.920 --> 0:11:00.360 We've been giving ourselves heny over. 0:11:02.000 --> 0:11:03.880 And then at the end we'll wrap it up with 0:11:03.920 --> 0:11:06.679 like this status of alcohol in the world today by 0:11:06.679 --> 0:11:09.280 at least a couple of measures that I have data on. 0:11:09.360 --> 0:11:14.680 All right, Okay, So alcohol, ethanol. 0:11:14.880 --> 0:11:18.480 It's freely absorbed across our GI tract the same way 0:11:18.520 --> 0:11:21.880 that water is, so it can easily pass through any 0:11:21.920 --> 0:11:25.240 and all of our biological membranes, including of course our 0:11:25.280 --> 0:11:28.920 blood brain barrier. So after you drink a beer or 0:11:28.920 --> 0:11:34.000 a glass of wine or a quarantinie, ethanol rapidly reaches 0:11:34.040 --> 0:11:37.480 peak concentrations in our bloodstream and tends to go first 0:11:37.600 --> 0:11:40.440 to areas of high blood flow, which includes our liver, 0:11:40.760 --> 0:11:43.400 where it causes lots of damage that we'll talk about later. 0:11:44.040 --> 0:11:47.280 Our kidneys and what it does in our kidneys. Is 0:11:47.320 --> 0:11:52.280 it interferes with water reabsorption. It does this by inhibiting 0:11:52.320 --> 0:11:56.120 the function of proteins that usually allow water to escape, 0:11:56.440 --> 0:11:58.679 and so it functions as a diuretic. 0:11:59.080 --> 0:12:01.040 Why does it do that? Is it just sort of. 0:12:02.520 --> 0:12:05.960 Why does it do The question of why Aaron is 0:12:05.960 --> 0:12:07.600 what I'm never going to be able to answer in 0:12:07.640 --> 0:12:12.720 this episode, fair warning. But it interacts with a specific 0:12:12.800 --> 0:12:18.719 protein called vasopressin, and vasopressin normally allows aquaporins to go 0:12:18.800 --> 0:12:21.960 into our kidneys, but it basically inhibits the function of 0:12:21.960 --> 0:12:25.320 that in our kidnies. So it causes you to lose 0:12:25.360 --> 0:12:28.760 a whole bunch of water, hence you pee a lot. 0:12:29.840 --> 0:12:32.120 And then of course it also goes to our brain, 0:12:32.240 --> 0:12:37.079 which is full of blood flow for important reasons. So 0:12:37.160 --> 0:12:41.720 ethanol enters our central nervous system. And in truth, it 0:12:41.840 --> 0:12:45.120 acts on so many different receptors in a lot of 0:12:45.160 --> 0:12:48.920 ways that are very complex, and we don't fully understand 0:12:48.960 --> 0:12:53.040 them despite loads of research. But what we do know 0:12:53.800 --> 0:12:56.160 is that a large part of the effect that ethanol 0:12:56.240 --> 0:12:58.680 has is on a specific receptor in our brain called 0:12:58.800 --> 0:13:03.360 our gabba receptors. And if you think in very basic 0:13:03.480 --> 0:13:07.920 terms of our brain as having both excitatory like stimulatory 0:13:08.360 --> 0:13:14.120 and inhibitory pathways, excitatory ones making you alert and vigilant 0:13:14.320 --> 0:13:18.960 or whatever, and inhibitory ones being more sedating or more calming, 0:13:19.440 --> 0:13:23.520 which is an oversimplification. But what alcohol does is it 0:13:23.640 --> 0:13:29.480 binds indirectly to GABA receptors, which are inhibitory receptors, and 0:13:29.559 --> 0:13:33.000 it makes these more active or more receptive to the 0:13:33.000 --> 0:13:37.160 effects of GABBA. So what that does in practice is 0:13:37.200 --> 0:13:40.880 it makes us feel more calm. Okay, and it's a 0:13:41.040 --> 0:13:42.960 sedating drug. 0:13:43.720 --> 0:13:50.480 Is that how all sedatives work? Like the basic mechanism. 0:13:49.640 --> 0:13:53.880 There are so Benzodiazepines are another class of drugs that 0:13:53.920 --> 0:13:56.360 are sedating that also act on the GABA receptors in 0:13:56.400 --> 0:13:59.360 a slightly different way. But there are lots of other 0:13:59.600 --> 0:14:01.439 sedata drugs that act on different. 0:14:01.120 --> 0:14:05.160 Receptors because different pathways. Okay, yeah, yeah, I have a 0:14:05.240 --> 0:14:11.559 question about diuretics. Okay, oh God, do diuretics sort of 0:14:11.600 --> 0:14:15.280 all function in the same way that alcohol does or 0:14:15.360 --> 0:14:18.920 like lead to the same you know water loss? 0:14:19.400 --> 0:14:22.000 You mean like diuretics, like other drugs that we have 0:14:22.080 --> 0:14:25.800 for diuretics. No, there are whole like tons of different 0:14:25.800 --> 0:14:28.480 classes of diuretics. That all act in different areas of 0:14:28.520 --> 0:14:30.000 the kidney on different ways. 0:14:31.360 --> 0:14:33.400 I need to know more about diuretics. 0:14:33.440 --> 0:14:35.440 Oh, we could do a whole episode about diuretics. I 0:14:35.520 --> 0:14:35.840 love it. 0:14:36.120 --> 0:14:39.840 Okay, okay, we You know what we can do. 0:14:39.800 --> 0:14:41.760 Is do an episode about heart failure and then we 0:14:41.760 --> 0:14:43.760 can talk a lot about diuretics. 0:14:44.160 --> 0:14:47.360 Oh oh, okay, okay. Yeah. 0:14:47.560 --> 0:14:52.960 Anyways, back to alcohol. So it makes us feel more calm. 0:14:53.280 --> 0:14:57.320 It also makes us feel more happy because alcohol also 0:14:57.440 --> 0:15:01.360 serves to stimulate the dopamine pathways our brain, which are 0:15:01.440 --> 0:15:08.360 our brain's innate reward system. So then how do we 0:15:08.440 --> 0:15:11.880 generally feel after a glass or maybe two of wine. 0:15:12.760 --> 0:15:15.760 We feel more relaxed, We might feel a boost in 0:15:15.800 --> 0:15:19.240 our happiness, we might feel even euphoric or super chatty 0:15:19.280 --> 0:15:22.280 because of those effects of dopamine. We feel generally good. 0:15:23.680 --> 0:15:28.080 And then maybe a tequila shot sounds like a good idea, friends, 0:15:28.240 --> 0:15:31.800 it is rarely a good idea. And as our blood 0:15:31.840 --> 0:15:37.120 alcohol content increases, that feeling of relaxation progresses, it might 0:15:37.200 --> 0:15:41.840 progress to suppression of our anxiety. It might suppress our 0:15:41.920 --> 0:15:46.160 stress response. But at the same time, our central nervous 0:15:46.160 --> 0:15:49.920 system is also becoming more depressed. We aren't able to 0:15:50.160 --> 0:15:55.280 think as clearly we might through both central nervous system 0:15:55.320 --> 0:15:59.960 and also just GI related effects, start having some nod 0:16:00.360 --> 0:16:05.160 or vomiting. Our motor and our sensory systems can start 0:16:05.160 --> 0:16:09.800 to become impaired and you lose especially that like motor coordination. 0:16:11.320 --> 0:16:17.080 And as that blood alcohol content continues to increase, our 0:16:17.240 --> 0:16:20.520 brain becomes flooded with ethanol, and then the blood flow 0:16:20.600 --> 0:16:23.480 to our brain is impaired, which can cause things like 0:16:23.520 --> 0:16:31.680 blurry vision, slurred speech, dizziness, confusion, eventually possible loss of consciousness, coma, 0:16:31.840 --> 0:16:32.600 and even death. 0:16:34.120 --> 0:16:38.600 Can you put this in terms of like blood alcohol 0:16:38.760 --> 0:16:42.040 content or like number of drinks type thing, which I 0:16:42.080 --> 0:16:46.560 know varies because tolerance really varies person to person, et cetera, 0:16:46.600 --> 0:16:47.040 et cetera. 0:16:47.280 --> 0:16:49.800 Yeah, so that question gets at a couple of different things, 0:16:49.840 --> 0:16:53.080 both how much of the ethanol that you consume is 0:16:53.160 --> 0:16:56.560 absorbed and how quickly does it take effect, as well 0:16:56.560 --> 0:17:00.720 as like what specific concentration of alcohol produces those special effects. 0:17:01.680 --> 0:17:03.960 And you're right, there isn't really a clear cut answer 0:17:03.960 --> 0:17:07.480 because there's a lot of variability. The rate at which 0:17:07.520 --> 0:17:10.600 alcohol is absorbed across the GI tract varies a lot. 0:17:10.840 --> 0:17:13.240 For example, if you have a full stomach, then it's 0:17:13.280 --> 0:17:16.119 absorbed a lot more slowly. If it's an empty stomach, 0:17:16.160 --> 0:17:20.919 it's absorbed more quickly. And then you also have not 0:17:21.040 --> 0:17:25.480 only metabolic differences in how quickly you metabolize alcohol, but 0:17:25.600 --> 0:17:31.240 also tolerance effects depending on how often you drink. In general, though, 0:17:31.600 --> 0:17:35.359 so we measure alcohol in your blood by blood alcohol concentration. 0:17:35.560 --> 0:17:37.960 So you've heard like point zero eight percent is like 0:17:37.960 --> 0:17:41.560 the legal limit in the US. At concentrations below point 0:17:41.680 --> 0:17:45.120 zero eight percent, in general, you're not having as much 0:17:45.160 --> 0:17:49.280 of the motor and cognitive deficits at concentrations above that, 0:17:49.480 --> 0:17:52.959 especially approaching point one percent. That's when you have like 0:17:53.119 --> 0:17:57.119 sedation impaired motor and sensory Once you get to like 0:17:57.200 --> 0:18:01.520 point three to point four or above, especially above point 0:18:01.600 --> 0:18:04.840 five percent, that's when you can see acute alcohol toxicity 0:18:04.920 --> 0:18:08.159 or death. It's hard to say exactly how many drinks 0:18:08.160 --> 0:18:10.399 it takes. It really varies person to person. 0:18:11.280 --> 0:18:15.679 Okay, so I feel like maybe this is just something 0:18:15.720 --> 0:18:18.880 that you hear in college and that's like, oh, eat 0:18:18.880 --> 0:18:21.840 a full meal before you drink and you won't get drunk. 0:18:22.560 --> 0:18:25.320 And I always kind of thought, well, I think it's 0:18:25.359 --> 0:18:28.760 just you get drunk more slowly, or it affects you 0:18:28.800 --> 0:18:32.520 more slowly. But like, is there actually a maximum at which, 0:18:32.560 --> 0:18:35.600 like your body just can't absorb a certain amount of 0:18:35.640 --> 0:18:39.240 alcohol in a certain time period. And you'll like, you 0:18:39.240 --> 0:18:39.800 know what I mean. 0:18:40.000 --> 0:18:41.000 Yeah, it's a good question. 0:18:41.359 --> 0:18:43.600 It does seem to be the case that if you 0:18:43.680 --> 0:18:47.240 have a full stomach, it leads not only to slower absorption, 0:18:47.680 --> 0:18:51.119 but over time to lower blood alcohol concentrations. 0:18:51.560 --> 0:18:52.400 So part of. 0:18:52.359 --> 0:18:54.720 That might be, and I'll get into this a little 0:18:54.760 --> 0:18:58.040 bit more in a minute, is that alcohol is metabolized 0:18:58.080 --> 0:19:00.879 by what's called zero order kinetics, so the rate of 0:19:00.920 --> 0:19:06.240 excretion is constant regardless of the concentration. So it could 0:19:06.320 --> 0:19:08.600 just be that if you're absorbing it more slowly because 0:19:08.600 --> 0:19:11.080 of a full stomach, then you are excreting it at 0:19:11.119 --> 0:19:14.920 a rate that is such that when you're absorbing it slowly, 0:19:15.280 --> 0:19:18.159 you don't your blood alcohol concentration doesn't rise. 0:19:18.040 --> 0:19:21.440 As high, Right, you keep up with the absorption exactly. 0:19:21.440 --> 0:19:23.120 Okay, Yeah, interesting. 0:19:22.880 --> 0:19:27.240 Yeah, eating does help, And as we can continue talking about, 0:19:27.359 --> 0:19:30.040 it's important the day after too, So let's talk about it. 0:19:30.400 --> 0:19:34.880 Yeah, Shall we move on to the biochemistry of a hangover? 0:19:35.440 --> 0:19:40.840 Perfect so to be eliminated from our bodies. Alcohol has 0:19:40.880 --> 0:19:44.680 to be metabolized, which just means broken down. Eventually, it's 0:19:44.680 --> 0:19:47.320 broken all the way down into carbon dioxide and water 0:19:48.560 --> 0:19:50.840 and at some point can be used for like actual 0:19:51.080 --> 0:19:57.040 energy production. But along the way, it's metabolized first into 0:19:57.080 --> 0:20:01.800 a toxic intermediate. We already talked about the direct effects 0:20:01.800 --> 0:20:04.320 of alcohol, so now we get to talk about these 0:20:04.440 --> 0:20:09.960 toxic intermediates and the aftermath. So alcohol is metabolized first 0:20:09.960 --> 0:20:14.320 into a compound called acid aldehyde, which is toxic in 0:20:14.400 --> 0:20:19.720 a whole number of ways. It first induces oxidative damage 0:20:19.800 --> 0:20:23.040 both directly and then, as we'll continue talking about, it 0:20:23.040 --> 0:20:24.800 has a lot of other downstream. 0:20:24.280 --> 0:20:25.200 Effects as well. 0:20:26.440 --> 0:20:30.520 Alcohol dehydrogenase is the enzyme that breaks alcohol down into 0:20:30.520 --> 0:20:33.240 acid aldehyde, and while it's present in a lot of 0:20:33.280 --> 0:20:38.000 our body, primarily alcohol is metabolized in our liver, like 0:20:38.040 --> 0:20:40.560 over ninety percent of it, and so this is where 0:20:40.640 --> 0:20:43.679 acid aldehyde tends to build up, and that's why drinking 0:20:43.720 --> 0:20:48.560 alcohol can have such drastic impacts on our liver and 0:20:48.680 --> 0:20:52.960 result in things like cirrhosis, which is chronic liver damage. 0:20:53.160 --> 0:20:56.760 But since this intermediate is toxic, our body obviously wants 0:20:56.760 --> 0:20:58.360 to get rid of it as quickly as it can, 0:20:58.480 --> 0:21:02.360 so it further breaks it down via another enzyme called 0:21:02.440 --> 0:21:06.760 aldehyde dehydrogenase, right, and then it breaks it into acetate, 0:21:07.040 --> 0:21:09.080 further breaks it down, et cetera, et cetera, et cetera. 0:21:10.080 --> 0:21:14.119 What's important to know about this metabolism of alcohol. What 0:21:14.280 --> 0:21:19.080 I think is so interesting is that this process inadvertently 0:21:19.320 --> 0:21:23.000 ends up interfering with a whole host of our normal 0:21:23.320 --> 0:21:27.840 metabolic processes, which explains some of the symptoms that you 0:21:27.960 --> 0:21:32.320 feel when you've been drinking alcohol. But also it explains 0:21:32.400 --> 0:21:35.639 a lot of the symptoms of a hangover, which anyone 0:21:35.640 --> 0:21:38.119 who's experienced a hangover knows. These symptoms can last a 0:21:38.119 --> 0:21:41.359 long time and really make you feel like trash. So, 0:21:41.440 --> 0:21:44.159 without getting into the weeds too much of the different 0:21:44.200 --> 0:21:46.920 biochemical cycles, let me just say this. 0:21:47.880 --> 0:21:48.600 We talked in our. 0:21:48.520 --> 0:21:53.280 Diabetes episode about how glucose is one of our main 0:21:53.440 --> 0:21:54.760 substrates that our body uses. 0:21:54.880 --> 0:21:55.920 We talked a lot about it. 0:21:56.840 --> 0:22:00.720 But our cells have a lot of different complex cycles 0:22:00.720 --> 0:22:03.760 that they use to break down different compounds to create 0:22:03.840 --> 0:22:07.240 ATP for energy so that our cells can use them. 0:22:08.359 --> 0:22:13.080 And all of these different cycles are interdependent. They overlap 0:22:13.119 --> 0:22:15.760 with each other and by overlap. What I mean is 0:22:15.800 --> 0:22:19.000 that these different metabolic pathways use a lot of the 0:22:19.040 --> 0:22:25.160 same cofactors. And cofactors are substances that are necessary as 0:22:25.240 --> 0:22:27.959 part of a chemical reaction, but they aren't the actual 0:22:28.000 --> 0:22:30.639 parts of the chemical reaction. They're like helpers that you 0:22:30.720 --> 0:22:32.000 need for this reaction to happen. 0:22:32.720 --> 0:22:36.400 This is like way flashbacks to sell bio and it's 0:22:36.480 --> 0:22:37.600 kind of given me the hebgen. 0:22:37.720 --> 0:22:43.280 I'm sorry, I'm trying to avoid saying like the TWCA cycle. Okay, 0:22:43.680 --> 0:22:46.960 So let's get back to alcohol, the process by which 0:22:46.960 --> 0:22:51.639 alcohol is metabolized first into acid aldehyde, and further and 0:22:51.760 --> 0:22:55.440 further all the way to like acetic acid. These steps 0:22:55.480 --> 0:23:00.800 of metabolism use up certain cofactors in our body and 0:23:00.960 --> 0:23:05.960 change the ratio of what's available for other essential cycles 0:23:06.040 --> 0:23:08.920 in our body. So what that looks like is a 0:23:08.960 --> 0:23:11.200 whole host of screw ups in the way our body 0:23:11.280 --> 0:23:13.600 is supposed to do basic metabolism. 0:23:14.200 --> 0:23:15.399 HM. Okay. 0:23:16.240 --> 0:23:18.720 So it's not alcohol directly, but it's the process of 0:23:18.760 --> 0:23:22.960 alcohol metabolism and the metabolites themselves that cause a lot 0:23:22.960 --> 0:23:25.120 of the symptoms that we know of as a hangover. 0:23:25.200 --> 0:23:27.840 So we can go through some specific examples if you 0:23:27.840 --> 0:23:28.200 want to. 0:23:28.920 --> 0:23:33.120 That's yeah, I do. But that's really interesting because one 0:23:33.160 --> 0:23:37.360 of the ways I remember hearing hangovers described is sort 0:23:37.400 --> 0:23:42.040 of the result of stealing happiness from tomorrow. 0:23:45.080 --> 0:23:46.440 Yeah, that's kind of true. 0:23:46.560 --> 0:23:49.040 Like you go out, you go drinking, you have lots 0:23:49.080 --> 0:23:53.080 of fun, and then you have used up the happiness 0:23:53.080 --> 0:23:55.160 that you like, the ability to kind of have a 0:23:55.240 --> 0:23:58.000 good day the next day, the night before you're the 0:23:58.040 --> 0:23:59.320 same as with cofactors. 0:24:00.440 --> 0:24:02.840 That's exactly what it is. You're using up your bodies 0:24:03.720 --> 0:24:08.760 NAD plus, which is a happiness. Okay, yeah, yeah, So 0:24:08.800 --> 0:24:10.760 we can go over some of the specifics. 0:24:10.920 --> 0:24:15.359 Okay, if you want to, Yeah, all right, course great. 0:24:16.440 --> 0:24:18.920 So one of the things that happens as a result 0:24:19.000 --> 0:24:24.440 of stealing these happiness cofactors is that the metabolism of 0:24:24.480 --> 0:24:28.520 alcohol ends up blocking the process of gluconeogenesis. 0:24:29.560 --> 0:24:31.000 This is the process. 0:24:30.880 --> 0:24:34.199 By which you make more glucose in your body in 0:24:34.280 --> 0:24:38.200 times when your glucose is low. So without the ability 0:24:38.240 --> 0:24:40.840 to do this, you end up with hypoglycemia, which we 0:24:40.840 --> 0:24:44.080 talked about in our diabetes episode. That can make you 0:24:44.160 --> 0:24:49.760 feel shaky, it makes you feel super hungry, probably nauseous, weak, trembling. 0:24:51.080 --> 0:24:54.119 But the thing about this is it's not always even 0:24:54.200 --> 0:24:59.320