Red Wine and Headache – What’s the Connection?
By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD
The United States produced over 773 million gallons of wine in 2021 [1]. Cabernet Sauvignon, a type of red wine, was the top sold variety in the United States in 2019 [2]. Many people report that after drinking red wine, they experience a migraine attack [3]. However, science has not been able to pinpoint the exact connection between red wine and headache. Today we will deep dive into what we know.
Alcohol has been a reported trigger for people living with migraine [4]. There are two different types of headache that may occur when alcohol is consumed – migraine and delayed alcohol-induced headache (DAIH). Alcohol can trigger a migraine attack within 30 minutes to three hours of consumption, which is also referred to as an alcohol-induced headache. DAIH, known as a “hangover” headache, is felt the morning after consumption [4]. There may be a misconception that drinks containing alcohol cause migraine, as a 2007 study illustrated that after observing alcohol and nutritional factors the day before the onset of a headache, they found limited importance of nutrition, including alcohol intake, as triggers of migraine [5].
A 2019 cross-sectional questionnaire study among 2197 patients with migraine investigated whether alcoholic beverages were a trigger factor, and how this affected alcohol consumption patterns in patients living with migraine [6]. In this study, alcoholic beverages were reported as a trigger by 35.6% of participants with migraine. Over 25% of patients had stopped consuming or never consumed alcoholic beverages because of the potential trigger effects. 77.8% of participants identified red wine as the most common trigger among alcoholic beverages. However, the study reported that only 8.8% of participants identified that red wine consistently led to their migraine attack [6].
Alcohol can dilate blood vessels in your brain, which can trigger a headache, and red wine is a known migraine trigger [7]. Grape skin contains histamine, which is a compound released by cells in response to injury and during allergic or inflammatory reactions. When histamine is released, it causes smooth muscle to contract, and the dilation of capillaries, which are the smallest type of blood vessel. White wine is made without grape skin, which is why it has a lower histamine content than red wine. Red wine, on the other hand, is made from the entire grape. It is possible that this increased amount of histamine in red wine can make the consumer more susceptible to a migraine attack. Some other foods that contain more histamine than alcoholic drinks include aged cheese, eggplant, sauerkraut, spinach, fish, sausage, and salami [7].
Grape skins also contain tannins, which are extracted from grape skins, seeds, and stems [8]. Tannins are the reason why you get a mouth-coating feeling when biting into an unripe pear or plum. Red wines have more tannins than white wines [7]. Tannins also cause your body to release serotonin, which can bring on a headache in some patients. Sulfites are another component found in red and white wine, and are used as a preservative. These substances are often blamed for wine related headaches, and foods that are high in sulfites include chips, pickles, raisins, and soy sauce [7].
So, if you enjoy red wine, what do you do? Cutting back on your red wine intake may help; however, it may depend on the red wine that you are drinking. Some patients may find that a merlot red wine triggers a migraine, whereas a pinot noir does not [9]. It may be helpful to keep track in a headache diary which wines or alcoholic beverages are triggering attacks, and if the quantity or brand is contributing. The bottom line though is that migraine is a disease and oftentimes it’s the perfect storm of lifestyle factors and triggers that cause an attack. For this reason, managing the disease with guidance from a physician and starting appropriate treatments are most helpful!
We look forward to helping you at the Westport Headache Institute! – Dr. K
References:
- Jan Conway Topic: Wine Market. In: Statista. https://www.statista.com/topics/1541/wine-market/. Accessed 10 May 2023
- 10 Popular Wine Varietals of the USA in Terms of Sales. In: USA Wine Ratings. https://usawineratings.com/en/blog/insights-1/top-wine-varietals-of-the-usa-in-terms-of-sales-208.htm. Accessed 10 May 2023
- Hullett A (2022) Why Does Red Wine Cause Headache and Migraine? In: Greatist. https://greatist.com/health/red-wine-migraine. Accessed 10 May 2023
- Alcohol and Migraine. In: American Migraine Foundation. https://americanmigrainefoundation.org/resource-library/alcohol-and-migraine/. Accessed 10 May 2023
- Wöber C, Brannath W, Schmidt K, et al (2007) Prospective analysis of factors related to migraine attacks: the PAMINA study. Cephalalgia 27:304–314. https://doi.org/10.1111/j.1468-2982.2007.01279.x
- Onderwater GLJ, van Oosterhout WPJ, Schoonman GG, et al (2019) Alcoholic beverages as trigger factor and the effect on alcohol consumption behavior in patients with migraine. Eur J Neurol 26:588–595. https://doi.org/10.1111/ene.13861
- Pietrangelo A (2020) Wine Headache: Causes, Treatment, Prevention Tips. In: Healthline. https://www.healthline.com/health/wine-headache. Accessed 10 May 2023
- Masterclass Learn About Tannins in Wine: Definition, Origins, and 7 Ways Tannins Affect Wine
- Red Wine Headaches: What You Need to Know. https://www.excedrin.com/amp/red-wine-headaches.html. Accessed 10 May 2023