There are 574 results on Amazon if you search "hangover remedy." Scroll, and certain buzzwords jump out. Milk thistle. Dihydromyricetin and prickly pear. There are capsules and patches and beverages, things aimed at recovery and others at "precovery." The category has exploded in the past three years, a surprising counterpoint to decreased alcohol consumption among American millennials and Generation Z.

A raft of these remedies has cropped up on the "Shark Tank" television show and nabbed up to $10 million of Silicon Valley venture capital money. There have been start-ups in this arena that have rocketed out $1 million in sales in three months. Some estimates by market research analysts put the global hangover recovery market at nearly $1 billion. Still dwarfed by the global alcoholic beverages market, valued at $1.4 trillion in 2017, it's not a small niche if it can be tapped effectively: The market researcher Euromonitor puts the total number of hangovers in the United States each year at 2.6 billion.

This uptick reflects Americans' growing enthusiasm for "life hacks" and raised expectations about functional foods and drinks: ingredients that can improve mental clarity, boost energy, ameliorate mood, lower stress and more broadly get folks back to work pronto.

The Internet allows companies to market health and wellness products directly to consumers. But that direct access makes it exceedingly difficult for the Food and Drug Administration and the Federal Trade Commission to track and police efficacy claims.

"We're entering a super trend where if you look at everything from gluten-free to ketogenic diets, it's no longer about comfort food. It's about foods that make you perform better," says Andrew Herr, founder of Helicase, a company that makes supplements that claim to enhance mental and physical performance. "There's a zeitgeist around wanting to perform. There's a bigger discussion about how what you put in your body affects you."

Herr says technology sector workers are early adopters of performance tools such as dietary supplements, meditation, sleep calibration and light therapy. It's just a step further to seek a product that reduces inflammation, provides liver support, promotes hydration, restores essential nutrients and boosts energy - a salve to that constellation of agonies that cause us to seek greasy eggs and make penitent promises about our future imbibing habits.

According to Mary Zalla, global president of consumer brands at the consulting firm Landor, the trend fits with consumers' increasing expectations that foods and beverages be carriers of additional benefits beyond just nutritive ones. Also, there's a tradition of seeking similar remedies for things other than hangovers.

"There's a proliferation of drinks with electrolytes. There's Pedialyte for kids, the sports market with Gatorade and the senior market with Ensure," Zalla says. "The idea of chemical rebalancing is not off-putting."

Morning Recovery. Washington Post photo.
Morning Recovery. Washington Post photo.

And she says a greater acceptance of Eastern medicine practices makes some of the remedies' Asian ingredients - Korea and Japan are the world's hangover cure leaders - more appealing.

For Brenna Haysom, founder of the hangover remedy Blowfish, which is in 11,000 stores nationally, the proliferation may have more to do with the Wild West that is the Internet.

"The barriers to starting a new business are so low now," Haysom said. "If you gave me $5,000, I could have a new hangover cure on Amazon in three weeks and buy a bunch of fake reviews. Before, to get to consumers, it took years. There are no gatekeepers anymore."

(Amazon founder Jeff Bezos owns The Washington Post.)

Haysom, one of the few women in the hangover remedy business, wrote the business plan for Blowfish while at Harvard Business School in 2006. In 2010, she left her job and started working on Blowfish full time.

"At the time there wasn't credible competition for over-the-counter products specifically formulated for hangover symptoms," she said. Blowfish makes effervescent lemon-flavored water-soluble tablets, a bit like Alka-Seltzer, that combine aspirin and about the amount of caffeine found in a cup of coffee. Haysom says the rise of the hangover cure fits into a cultural shift.

"For older generations, having a hangover was exhibiting a lack of control, something that got away from you," she said. "Today on Instagram, people talk about this patinaed image people want to project, but with slacker culture there's bragging about a hangover, reveling in what a mess I am. Very different from older generations, hangovers have less of a stigma."

Hangover remedies are largely treated by the Food and Drug Administration as dietary supplements. Manufacturers and distributors of dietary supplements, including ingestible hangover remedies (as opposed to patches or topicals), are responsible for evaluating the safety and labeling of their own products.

The FDA does allow certain combinations of active ingredients for over-the-counter hangover remedies to be marketed as drugs. These include analgesic-antacid combinations, which offer temporary relief of minor aches and pains and upset stomach, and help restore mental alertness.

But the FDA and Federal Trade Commission forbid curative claims that cannot be supported by scientific studies. Companies are not allowed to call these hangover "cures" or position products as drugs "intended for use in the cure, mitigation, treatment or prevention of disease."

According to Haysom, online remedies routinely do precisely this, flouting the FDA's rules without repercussion.

"FDA top brass isn't super focused on enforcement these days. Hangover remedies don't get legitimate scientific inquiry. There are legitimate companies trying to grow and build the category, but my sense is a lot of hangover products are one and done. A lot fail, and it's a revolving door," Haysom says.

The FDA did not respond to questions about how frequently warnings have been issued to hangover companies making illegal claims or about why, as Hayson suggests, some illegal claims go unchallenged.

Steve Mister, president of the Council for Responsible Nutrition, the lobbying organization for the dietary supplement industry, says a company can make specific claims about hangovers only if it has evidence to support them.

"Have they done a randomized clinical trial? Do they have adequate scientific research to make their claim?" he says.

A spokesman for the FTC said the agency gets hundreds of thousands of complaints about false advertising each year - for dietary supplements, homeopathic remedies, weight loss tools, CBD-infused products, and even things like baby food, formula and orange juice - and that health and efficacy claims must be substantiated by randomized, double-blind and placebo-controlled clinical testing.

But with the proliferation of products online and increased marketing opportunities on social media platforms such as Instagram, monitoring claims can be like a game of whack-a-mole, and even finding the correct mailing address for a warning letter can be difficult.

So what, specifically, are the recovery and precovery (products taken before the revelry commences) remedies supposed to be doing? Ethanol, the alcohol in booze, makes it into the bloodstream if a person drinks faster than the liver can process. Alcohol is oxidized into a substance called acetaldehyde, which is part of what makes you feel terrible: dehydration, inflammatory response, sleep disturbance, headache, sensitivity to light, nausea, fatigue, emotional lability. Alcohol also speeds the production of stomach acids that inflame the stomach lining, so add stomachache into the mix.

Sisun Lee is the founder of More Labs, which makes Morning Recovery, now valued at $33 million and employing 19 people. A former employee of Silicon Valley's Tesla, Uber and Facebook, he visited South Korea in 2016, which he says has a massive drinking and hangover remedy culture, much of it fueled by homeopathic and herbal ingredients.

"Hangovers are interesting because there's not a lot of science on it, and [while] Americans will consume multivitamins, these types of herbal Eastern medicines are not widely understood here," Lee said in a phone interview. "These are plants that for thousands of years Asian cultures have recognized."

Blowfish combines aspirin and caffeine into a water-soluble tablet.  Washington Post photo by Marvin Joseph
Blowfish combines aspirin and caffeine into a water-soluble tablet. Washington Post photo by Marvin Joseph

Like several of the new remedies, Morning Recovery uses dihydromyricetin, which is made from the seeds of Hovenia dulcis, more commonly known as the Japanese raisin tree.

"The first medical encyclopedia in China cited DHM [dihydromyricetin] as a hangover remedy," Lee says.

Morning Recovery is a 3.4-ounce lemon-flavored liquid in a small blue bottle that combines raisin tree extract with extracts of prickly pear, Korean pear, milk thistle and red ginseng. There were problems dissolving the white powders in liquid and making it "bioavailable"; the researchers tinkered and filed their own patent for solubility. When it debuted in April 2017, it was ranked No. 3 out of start-ups on Product Hunt, a website that lets users share and discover new products. It was, Lee says, a good fit for Silicon Valley.

"It was biohacking the alcohol-induced hangover," he says. "You want to go after early adopters with high disposable incomes and open minds to try new things."

He says his company is targeting parents, mostly with white-collar jobs that demand mental productivity, who want to wake up the next morning and be able to take care of their children.

For John Mansour, the idea for his B4 "precovery vitamin supplement" carbonated beverage in an 8.4-ounce can began on a golf course in Florida, partnering with a friend in the wine and spirits business to solve an age-old problem. The pharmacist and chemist brought the product to market in December 2016, selling via Amazon but largely in retail wine and liquor stores in Florida such as ABC, Total Wine and Publix.

"Where's everybody thinking about feeling better the next day? Probably while they are buying alcohol," Mansour said in a phone interview. "The science really says the best way to protect the body is to give it what it needs ahead of time, before it goes through this battle."

Mansour says B4 has three parts to its formula: one for hydration, a second part that is a B-vitamin complex for metabolic energy and a third that is a liver-protecting antioxidant mix.

Rehan Khan, founder of Omni Global Labs, which manufactures the Rebound patch, focuses largely on vitamin B-12, with smaller amounts of other B vitamins and natural ingredients including acai berry extract, prickly pear leaf and turmeric extract. Khan was initially selling topicals and patches for energy, appetite suppression, weight loss and sleep but pivoted to hangover relief when he and his team fine-tuned a slow-release-patch system. It came to market in 2017, selling largely on Amazon, eBay and Walmart.com. Khan now has 15 employees and will enter retail stores in the next six months.

The label makes claims on its front such as "revolutionary hangover patch" and "24-hour hangover defense," assertions the FDA might think are overly bold.

Still, Khan says, "the FDA is not with a hammer behind my back."

This article was written by Laura Reiley, a reporter for The Washington Post.