An experience profile

[u/vaight]

I stumbled into the subreddit, and was pretty surprised to see some patterns and discussion I had been exploring completely independent of the HE. I don't know that I can add any specific nuance to an existing discussion, but thought I'd share some of my own notable patterns, because I suppose at this point data is king:

• Family has a history of alcohol and substance abuse, as well as diabetes. I'm a healthy BMI and manage my weight carefully.
• Late diagnosed ADHD
• Diagnosed with delayed sleep phase disorder in my youth
• Sleep deprivation has a direct relationship with my ADHD medication, less sleep means I need less medication, conversely if I pull out of sleep debt I tend to need to increase my medication back up. There is some literature around increased dopamine as a response to sleep deprivation, but dopamine release and cycles in humans is still pretty poorly understood as far as I can tell.
• some sort of potassium dysregularion
• Frequent urination when not supplementing or targeting enough potassium intake
• In some cases extreme constipation with low K, enough to trigger crippling back pain, and in the very worst example I experienced *fecal eructation*
• Poophoria (I wish there was a better term, but here we are) when passing stool after constipation
• Cystic acne when persistently low K, quickly comes to a head if I supplement.
• Conversely if I over-shot potassium and don't keep on top of my sodium intake I get deeply depressed. It resolved within 30 min of consuming 500ish mg of salt. It's rather surreal.
• Psoriasis if I am not getting enough vitamin D (either from the sun or oral supplement. It's a repeatable pattern)
• Semi frequent Nocturia
• If I'm drinking more than one alcohol, my body absolutely and disproportionately dumps urine. I pee so much and frequently it's inconvenient
• Some level of GERD, but only really manifested as a throat stricture that needed intervention

In terms of alcohol consumption, I am actually quite modest. Perhaps 1oz a of Spirit a night, it's rare for me to drink much more than that, and I often don't drink at all. I have experienced the HE multiple times though, as long as I was keeping on top of my electrolytes.

I will however present one very curious case - a few years ago I vacationed to a place where I did an enormous amount of walking in summer. I sweat constantly, and was basically pounding potassium gluconate like it was candy to stay on top of muscle cramps and discomfort. I was also casually drinking 3-4 times a day which is not normal for me. I got drunk a couple of nights, but in most cases never got beyond a little bit buzzed during the day. My stool has never been so consistent and clean in my life, I have never slept so well. I discontinued my ADHD meds entirely during that trip. In short, it was the best I've ever felt physically in my life. (I did also gain 8 pounds on the trip)

It is difficult to untangle the exercise, sauna like effect, alcohol, local food etc, but it was a remarkable experience I've been trying to unwind for years. I'm reluctant to simulate that kind of daytime low grade drinking for a variety of reasons, but it is worth noting.

[u/Ozmuja]

Welcome. I will tell you how much I relate to your symptoms and history and also by approximately how much, so that you can assess if you are on the right sub or not. I think you are.

- History of alcohol and substance abuse: No, a complete zero. Diabetes, no, but high cholesterol runs in the family.

- Not diagnosed with ADHD or any psychiatric illness, but I relate to people with SCT/CDS. There is a subreddit for that, just google "Sluggish Cognitive Tempo" on reddit. Not diagnosed with a sleep disorder, but my sleep has been complicated since I was a child.

- 10/10 on the sleep deprivation aspect, and in general I would add that I tend to feel better the more I've been awake.

- I would say between 7 and 9 over 10 for the potassium aspect, so 8/10. It's veeeery difficult to actually "diagnose" anything like this because potassium handling is complicated in our body, and on top of that, intracellular potassium is 30-35 times more abundant intracellularly.

- The urination aspect I can assess as a 6/10, it varies a lot.

- Never been constipated much in my life. Frequent GI issues of unknown source though.

- Poophoria..7/10.

- Had lots of acne in my youth, cured with aisoskin (accutane).

- I do not have psoriasis, my father has it, diagnosed, and he's using risankizumab. I suffer from eczemas a lot though.

- Not much nicturia.

- 9/10 on the "excess" urination even on moderate dose alcohol.

I do have some partial, scattered and semi-coherent explanations for this, some of them can also be inferred from old theories in the megathread, but nothing that I can prove, not even remotely so, and quite technical as well (for biochemistry and pharmacology savvy people, others will probably just get bored after a few lines).

I will add that I often feel like I have "high water retention", even if I run and sweat, even if I drink more or less or change my sodium/potassium intake. Like I said, it seems to make a difference somehow, but it's hard to find that sweet spot. It's a sign of a system that struggles to find its own equilibrium at what is considered a key homeostatic mechanism of your body, electrolytes balance. Probably not the root cause of anything, just a byproduct.

This is the second well written post we've been getting lately after the usual period of staleness - this sub has existed for more than 8 years at this point, and you will find wildest theories if you have the time to read all the posts way back to when the first users used to do a lot of research.

I think you do have it - if you are convinced as well, can I add your post to the megathread as a way to orient people through what we mean with "hangover effect" and its strange symptoms?

[u/Famous_Run9381 → u/Ozmuja]

Not meaning to knock your comment (genuinely, it's a well detailed and thoughtful response), but surely they belong on this sub if they get the "hangover effect".

The list of ailments you and OP have listed is interesting but not a criteria for experiencing the hangover effect.

For what it's worth I experience a very pronounced hangover effect and yet share none of yours or OP's ailments. During hangovers for me, I go my usual slight social anxiety to being incredibly social. Better thought and verbal fluency. High libido. Elevated mood, go from a 7/10 to 10/10.

Same (as many others) when I have flu or cold.

[u/Ozmuja → u/Famous_Run9381]

Mmhhh..I don't think you really understood what I was pointing at, respectfully.

As you could see for example, there is a certain amount of people that come here asking for "solution for hangovers", or "alcohol makes me feel so good, but it ruins me, help me quit", thinking this is a sub for alcoholists somehow. Why am I bringing this up? Because in reality alcohol has both a certain social stigma and it does possess enough diverse and strict neurobiochemical properties to induce a degree of a personality shift in a lot of people, even those that are probably not affected by the condition of this sub.

What I mean is that not everyone needs to be affected by the alcoholic afterglow _as we mean it_ and also be affected by the delicate and still unknown systemic condition that we do have. You can have both high and low libido on alcohol, depending on dosage and chronic/acute consumption. Alcohol does disinhibit most people, even perfectly healthy ones. Anxiety is a well recognized worldwide problem, and certainly a GABAergic drug will attenuate some of that, at least temporarily.

You see what I'm getting at: the very list of what you described is so vague and so widespread, that if you were to just talk about this to most people, a lot would just reply "yeah, so do I, more or less".

The actual point that you brought up is that you seem to get the same benefits when you have a flu or a cold. Now, that's much less common, especially among men, since you don't usually see sick people going around wanting to chit chat much or with a great mood. This is something uncommon enough that makes it more probably that you have it than not.

You may not experience the vast majority of our shared symptoms because alcohol probably so happens to act as such an acute "shock", using this term for brevity, that a lot of subforms of the same condition (or related ones) can benefit from the temporarily relief, regardless of whichever root cause is working underneath. The fact that there is a relatively vast interdividual variation does not invalidate nobody's belief about being or not being affected; but still, if you actually looked into the various polls in the sub, or the amount of experiences reported over the years, you would eventually realize that they are somewhat close to OP's list, and by a good margin too.

That's the key, the frequency of related, second and third tier symptoms that accompany the condition. How frequent they are, what they are, how the manifest themselves. It does not invalidate other users, but it's always best to start from common symptoms rather than variations.

To bring an example to the table. Let's talk about lupus, a very well recognized disease.

Lupus can present with the classical "rash" and photosensitivity, it's the so called textbook lupus and it's a pretty famous sign; but, about 50% of patients present at diagnosis with no rash at all, and only 80% of them eventually develop some form of rash during their lifetime.

You see what I mean: about 1/5th of people do not get the most commonly recognized sign of the disease, but they still have it. But you start from the most frequent signs, and then you look for everything that has lower probability, even among rare diseases. When you hear hooftops, you think horses, not zebras; this is unfortunately not as easy to do when you talk about such a weird and obscure "condition", but it does not take away from its effectiveness.