Wednesday, December 29, 2004


I have been blogging for some time on the topic of education over at the ARE web site ( However, there are some topics on which I would like to comment that are not education related. Mostly, these relate to my professional life in medicine and science. Thus, the title metasyn for this blog - both a homophone for medicine and a combination of the roots 'meta' (across) + 'syn' (together) as in being together across a distance (or across the internet). This will be a place to put those ideas, observations, and thoughts on topics other than education. I suspect this will be an occassional blog, visited by few. More of a journal perhaps. And now, on with the blog.

Veisalgia and prickly pears.

Similar to most people, I get a large number of emails at work. Many are only peripherally related at best to my job and are quickly deleted. This week, given the slower pace over the holiday period, I spent a few extra seconds browsing a few of these maldirected emails. In one, I found a very interesting ditty.

"From the Evidence-Based Who Knew? Department:
Veisalgia Anyone? We hope not...Veisalgia is the medical term for an alcohol hangover. In the spirit of the season we've found a recent evidence-based reference for you. According to researcher Jeff Wiese and his co-authors in New Orleans (where they ought to know!) an extract from the skin of the prickly pear fruit, Opuntia ficus indica (OFI), has been shown in an RCT to inhibit the production of inflammatory mediators and thus reduce hangover symptoms. So remember prickly pear skins for New Years! "

Indeed, in the attached article (Arch Intern Med. 2004;164:1334-1340) a double-blind, randomized, cross over study in 64 healthy subjects is described. Severe hangover was associated with higher levels of C-reactive protein, which is an indicator of inflammation. The prickly pear skin extract taken 5 hours before the alcohol binge reduced nausea, dry mouth, anorexia, severe hangover, and C-reactive protein. No significant change was seen in 6 other symptoms of hangover (including headache). The pear extract is thought to work by increasing "heat shock proteins" to protect cells from stress and reducing oxidative damage.

The OFI extract is available from your local health food store. The dose? 1600 IU or two capsules. Who makes the extracts? Extracts Plus of San Diego, who was also the primary funding source for the study (other support from your tax dollars).

Now for the more important questions. Does it work if you take the extract AFTER you go on the binge? Most of us do not plan on drinking more than we should and when we do drink excessively, rarely plan 5 hours in advance. This study does not address that question and I would guess that the OFI extract would not work in this setting as the "stress" has already occurred before the extract would induce the "stress protection". Finally, one has to wonder about the public health implications of an intervention that might increase alcohol consumption. If we could take a couple of capsules and then engage in unhealthy behavior without immediate consequences, could that ever be a good thing?