Hangover Symptoms: The Full List and the Timeline

A hangover is the set of symptoms that follows drinking too much, and the National Institute on Alcohol Abuse and Alcoholism lists them as fatigue, weakness, thirst, headache, muscle aches, nausea, stomach pain, vertigo, sensitivity to light and sound, anxiety, irritability, sweating, and increased blood pressure. Not everyone gets all of them.

The list, and how it usually arrives

Most people notice three or four of the thirteen rather than the whole set. The clusters that tend to travel together:

• Head and senses — headache, sensitivity to light and sound, vertigo when you stand up
• Stomach — nausea and stomach pain, sometimes the loudest part of the morning
• Body — fatigue, weakness, muscle aches, sweating, a measurably higher blood pressure
• Mood — anxiety and irritability, which surprise people who expected only a physical toll
• Thirst — the one that gets blamed for everything else, and only partly deserves it

Six things happening at once

There is no single cause. NIAAA names six contributors, and they explain why hydration alone never quite fixes it:

1. Mild dehydration. Alcohol suppresses vasopressin, the hormone that tells the kidneys to hold on to fluid. Urination goes up, fluid goes out, and thirst, fatigue and headache follow.
2. Disrupted sleep. You may fall asleep faster, but the sleep is fragmented and ends early.
3. Gastrointestinal irritation. Alcohol irritates the stomach lining directly and increases acid release.
4. Inflammation. Alcohol raises inflammation, which produces the same malaise as being ill.
5. Acetaldehyde. Alcohol metabolism creates this toxic, short-lived byproduct, which inflames the liver, pancreas, brain and gut.
6. Mini-withdrawal. The brain compensates for the calm while you drink, then overshoots once the alcohol clears.

When it peaks

Symptoms peak when blood alcohol concentration returns to about zero — which is why the worst hour is usually well after the last drink and not during the night. From there they can last 24 hours or longer. The full arc, including what makes one morning shorter than another, is in how long does a hangover last.

Chills, sweats and the shivery feeling

Sweating is on the NIAAA list; feeling cold and shivery is not, though people report it constantly. The plausible reading is the same mini-withdrawal that produces anxiety and a raised blood pressure — a sympathetic nervous system running hot, with sweating and the chill of evaporating sweat arriving together. Treat it as part of the picture, not as a separate illness. Persistent shaking, sweating and agitation after every drinking episode is a different matter and worth raising with a clinician.

What a standard drink actually is

Judging your own night is hard because glasses do not match doses. In the United States one standard drink contains about 14 grams, or 0.6 fluid ounces, of pure alcohol: a 12-ounce beer at 5% alcohol by volume, a 5-ounce glass of wine at 12%, or a 1.5-ounce shot of spirits at 40%. A 12-ounce craft beer at 10% is two standard drinks, not one, and a home pour of wine is rarely five ounces.

When it is not a hangover

MedlinePlus notes that most hangovers are gone within 24 hours. What should not be waited out: repeated vomiting that keeps any fluid down, confusion, difficulty staying awake, seizures, slow or irregular breathing, or cold and clammy skin. Those are the signs of an alcohol overdose and need emergency help, not a dark room.

This content is informational and does not replace medical consultation, diagnosis, or treatment. See also hangover nausea and dry mouth hangover.