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Health Q&A: Wine and Headaches

Jennifer Fiedler

Posted: Wednesday, April 02, 2008

Q: I have enjoyed wine for many years but, lately, when I drink certain wines, I get a terrible headache that can last for days. I have been told it could be histamines, or the way the wine is aged in oak. Is there something to look for that I can avoid?

A: Fred Freitag, associate director of the Diamond Headache Clinic, says there are distinct types of headaches that some people experience when they drink wine: "There is a unique headache associated with red wines, which is different from the headache some people get from drinking wine of any sort, which is different still than the migraines some patients experience related to wine ingestion." As such, identifying the specific triggers that cause these headaches can be tricky, however, Freitag says that there are some "myths" that can be ruled out.

Freitag believes histamines, which are found in higher amounts in red wine, are an unlikely source for the causation of headaches, as they are found at greater levels in other frequently consumed foods: "there is more histamine in 4 ounces of fish or a serving of eggplant than in 4 ounces of red wine." In addition, he reports that a more common allergic reaction to histamines is a stuffy nose, rather than headaches.

Sulfites, small amounts of which are found in wines, also are mistakenly identified as a headache-causing agent, says Freitag. They too are found in many food sources, like dried fruit, baked goods and pickled vegetables. An allergic reaction to sulfites usually encompasses breathing and rashes, not headaches.

Headaches could be triggered by alcohol, says Freitag, which would explain why red wine, which is generally higher in alcohol, seems to pose more problems for certain people.

According to Freitag, other elements in wine that could trigger headaches include tyramine (an amino acid derivative that is formed during fermentation), which has been linked to migraines, or one of the many chemical compounds created during the winemaking or aging process, called congeners. Some of these compounds are found on grape skins, and it would follow that wines that are fermented on their grape skins, like red wines, would have more of this compound. Other compounds are extracted from the woods used in fermentation and aging, so to determine if these are problematic triggers, you would want to compare your reaction wines that are fermented in stainless steel and wines fermented in oak.

Alessandro Panconesi, an internal specialist in Florence, Italy, recently published a review of migraine studies that followed wine intake in the Journal of Headache and Pain. He reports that headache triggers could be many things, and even come from "stress or emotions that concur with [the consumption] of alcoholic drinks."

The best plan of action is to consult with your doctor, as migraines can be ameliorated with special treatment. In addition, carefully monitor your intake of wine to try and determine which specific types of wines, or occasions when you drink wine, are causing you problems to see if there is a pattern that would help you avoid the offending agent.

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