Audio blog 14: Red Wine Headaches

Red Wine Headaches: Ideas On Causes and Remedies (but sadly not real solutions…)

Nearly every time I do a speaking event, a familiar scenario transpires. After the wine class, a person who seemed very interested in what I had to say approaches me with a sad look on his or her face and says, “I love the taste of wine. I’m so fascinated by the subject but I just can’t drink that often. I get a horrible headache every time I drink, especially with red wine. Is there anything I can do?”

My heart always breaks a little for that person and I hope that despite my obvious lack of expertise in health matters (here’s my caveat, I’m an MBA, not an MD so I am only offering this article second hand) that I can solve the problem and get the person back on track to enjoy wine, headache-free.

Before I go down this path, I want to be really clear about the information that’s widely available and that’s repeated over and over again in major wine outlets and news publications. I scoured scientific journals and I found an even better source – a scientist who scoured scientific journals[1] – to see what conclusive evidence there is on this topic. What I and they found was a lot of half studies without a statistically significant result in most cases. The bottom line is that no one has funded a large-scale study on this topic. (And I get it: really, who is going to fund something like this, which is what it comes down to? Wine companies have other priorities and they would be the most likely cash source…).  So as I share this info, I want to tell you now that except for two of these solutions, one which I can vouch for and another which has scientific proof behind it, the rest is pure conjecture.

Still, we’re not operating in the dark. There are some strong contenders for what is causing that nasty pounding after drinking wine or more specifically, red wine. And, better yet, if you’re not averse to taking an over-the-counter medicine, you could solve the problem fairly easily in many cases.

Let’s run through the different potential causes and give ideas on how to tackle them.

The first thing that is killing most heads…

I’m not going to hold you in suspense. I want to tell you the number one thing that is probably causing your headache: alcohol. It dehydrates the body, or to quote the UK National Health Service:

“Dehydration can also occur as a result of drinking too much alcohol. Alcohol is a diuretic, which means it makes you wee more.” (insert immature chuckle here).

And what a lot of us fail to realize is that most wine is somewhere between 12.5% and 14.5% alcohol by volume. That means that for a 5 ounce glass of wine, 12.5% to 14.5%, more or less, is made up of alcohol. Contrast that with beer, which is more like 3-4% alcohol by volume and you see that wine is not as innocuous as it seems.

So if you happen to have one or two glasses of wine, especially red, which tends to be higher in alcohol (because the grapes are riper and picked later, thus upping the sugar), AND you have no water in between and no food or nibbles, you are robbing your body of water. Dehydration gives you a headache, so there you go!  

The Solution?

First, try wines with lower alcohol content. If you can drink around 10% or 11% ABV versus 14%, that could help. Look on the bottle for the percentage – it’s required by law in most countries. Lower alcohol means more bang for your buck – 1 glass of this stuff won’t wallop you like one glass of a 14%’er will.

Alternately you can take a page out of the professional drinkers’ book people in the wine industry’s book. We’re usually downing water in between glasses or eating food to mitigate the effect of the high alcohol. It seems like our tolerances are off the charts (and they probably are to some extent) but a lot of that comes from experience and lots and lots of water.

Ok, that’s the number one cause of headaches. But there are several others, so don’t think I’m about to dismiss you if you’ve tried to drink water and it doesn’t work!

Next are the mean amines. Wines that go through malolactic fermentation release amines in the process, and have levels that can be 200% higher than in wines that don’t go through malo. There’s been some research done on the effect of the “amines” but nothing super conclusive. [2]

The second thing we’re pretty sure is causing pain: Histamines[3]

Histamines are compounds that exist in wine at varying levels. Red wine and bubbly tend to be higher in these pesky enzymes. That means if you have a sensitivity, you may have a terrible allergic reaction, e.g., a headache, rash, even sneezing. This is especially true for people with a diamine oxidase deficiency (you can take a probiotic to help that problem, incidentally). The National Institute of Health in the US has shown that high levels of histamine in blood plasma can create bad allergic reactions, including allergy headaches. Since alcohol increases histamine in blood plasma, you could wind up suffering with a headache.

The Solution?

Pop the anti-histamine of your choice about an hour before you drink wine. Still drink the water to prevent dehydration, but see if this helps you out. Again, no conclusive studies on this one, but it has some research behind it, so I’d give it a try (just check the interactions with alcohol before you take anything).

And the less proven amine…

Some doctors posit that high levels of the amino acid tyramine, which can cause migraines, is the main cause of headache pain from wines. If stuff like processed meats (think pepperoni or hot dogs), tofu, soy sauce, miso, and cheeses like blue, brie, cheddar, Swiss, or Roquefort give you a headache, you may have an issue with tyramine. Although the levels are lower in red wine than in these foods, they go hand in hand. You’ll need to skip the wine and cheese pairings and stick to one small glass of wine if you think this may be your issue. That said, apart from a few doctors saying they think this is the problem, I couldn’t find any studies to back it up.

Tannins often take heat for causing headaches. And they do change serotonin levels, which can cause migraines. They ARE more prominent in reds than in whites, so that could explain the issue for people who have problems with red and not white. Tannins also can release fatty acids (prostaglandins) that can cause headaches and pain.

But again, this is all conjecture. We don’t have much to back this up. Still, it’s a theory posited by headache specialists, so if you think this is your problem, take some kind of headache medicine – ibuprofen, Tylenol, aspirin, whatever. Again, watch out for the interaction between the wine and the drug.

What is probably NOT causing your headache? Sulfites

Sulfites/sulfur dioxide/sulphites are a naturally occurring byproduct of fermentation and are added to wine to prevent spoilage and browning. They are also in dried fruit jam, molasses, bottled lime and lemon juice, sauerkraut, lunchmeat, and gravy. Although wine is singled out as a product that has sulfites, plenty of others have equal or higher levels.

Unless you are part of the 1-5% of the population that has a sulfite allergy, this isn’t your problem. If you have severe asthma or allergies, this could be a huge issue and you’ll know it’s a problem because the result is not a headache, but an asthma attack or something worse. If you don’t have these issues, dismiss this one.  It’s better you move on and try to find the real cause.

The Wrap

After all this, I will repeat what I said at the beginning: the issue with a red wine headache or any wine headache is most likely dehydration or histamine issues or a combo of a few of these things. Try a few solutions and see if they work. And make sure you chug water. If it’s still an epic fail, I guess you’ll have to wait until I report back with some new, exciting finding that solves this really annoying problem!