Migraines can be debilitatingly painful, and regular sufferers will do almost anything to prevent them, including giving up something they dearly enjoy, such as wine. But should they? New research from the Netherlands' Leiden University Medical Center shows that while many people report alcohol—and red wine in particular—as a trigger for migraines, the relationship between the two isn't so simple.
"Alcoholic beverages have been reported in top 10 trigger factors for migraine," Gisela Terwindt and Gerrit Onderwater, both researchers from the study, told Wine Spectator via email. "We aimed to investigate which particular beverages are frequently reported by patients as triggers for their attacks, and also estimate the triggering consistency and time to attack onset after consumption of these beverages. Furthermore, we wanted to investigate the effect this has in alcohol-consumption behavior in migraine patients."
Using the Leiden University Migraine Neuro-Analysis study population, the researchers conducted surveys of 2,197 Dutch adults, ages 18 to 80, who suffer from migraines and fulfilled the International Classification of Headache Disorders criteria. They asked questions about each patient's drinking habits, whether they believed alcohol was a trigger for migraines, and how often and in what timespan drinking brought on an attack.
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The results, published in the European Journal of Neurology, revealed that roughly 36 percent of the patients did consider alcohol as a migraine trigger. This belief affected many of their decisions around drinking: Among the 650 participants who said they had either stopped drinking or never drank, more than 25 percent said they did so because of alcohol's presumed triggering effects.
Of the 1,547 participants who were drinkers, nearly 45 percent did not report alcohol as a trigger, while roughly 43 percent did. (The remainder were unsure.)
When drinkers who considered alcohol a trigger were asked about a particular alcoholic beverage bringing on a migraine, red wine was mentioned most frequently (77.8 percent of the answers) and vodka least frequently (8.5 percent). Interestingly, though, only 8.8 percent of participants reported getting migraines after drinking red wine 100 percent of the time. "[This implicates that] other factors may also be involved," the researchers wrote. "Therefore suggesting total abstinence should not be a direct consequence taken by patients."
That finding is the primary takeaway of the study: "The association between trigger and attack is a complex one, likely influenced by other internal and external triggers and varying susceptibility," said the researchers. "It can be debated if alcohol is a factual or presumed trigger."
Even among those who do believe alcohol to be a trigger, there is no clear understanding of why. Is it the alcohol itself? Or, considering that so many believe red wine is a leading culprit, is there something in wine specifically?
"We currently do not know which compound(s) might be responsible for the presumed triggering effect, or whether other trigger factors may be in play," said Terwindt and Onderwater. "Testing various factors in an experimental, placebo-controlled fashion, one would be able to specifically investigate this." However, they note, these studies are difficult to carry out, and expensive, too.
Past studies have looked at whether specific compounds in wine, such as histamines or tannins, can trigger migraines, but the results have been inconclusive.
Keeping a record of when migraines occur, and the circumstances under which they are brought on, can lead to a better understanding of one's triggers, but migraine sufferers should continue working with their physician to best cope with the problem.