What’s a Wine Headache?

Sure, you may expect a hangover the next day after one too many drinks. But for some people, even a single glass of wine — or just a few sips — can cause what’s known as a “wine headache.” And you may start to notice this type of headache sooner rather than later, thanks to a certain compound that decreases how quickly your body metabolizes alcohol.

So, why do wine headaches happen? And is there anything you can do to prevent them? Neurologist MaryAnn Mays, MD, has the answers.

What’s in wine that causes headaches?

There are a few possible culprits. The amount of histamines, tannins, sulfites and flavonoids that naturally occur in wine (particularly red wine) may cause headaches in some people.

Here’s how they can impact your health:

• Histamines: Wine typically contains histamines, which the fermentation process naturally produces. Histamines can cause inflammation that can trigger a headache, as well as a stuffy nose, sneezing and itching. Red wine tends to have a higher amount of histamines than white wine.
• Tannins: Tannins — which come from the seeds, skin and stems of grapes — are known to give wine depth and character (think a smooth or dry feel). Some people may be sensitive to the tannins found in wine, which can narrow blood vessels and result in a headache.
• Sulfites: Sulfites also occur during the fermentation process and work as a preservative to keep bacteria at bay. Some people may have a sulfite sensitivity that can trigger asthma or hives, but there’s debate as to whether sulfites can cause a headache.
• Flavonoids: A recent study shows that a certain flavonoid called quercetin may contribute to wine headaches. Quercetin is an antioxidant naturally found in grape skins. When combined with alcohol, it may produce negative side effects, like a headache.

Quercetin is also found in other foods, like citrus fruits, broccoli, onions and berries. But it doesn’t cause negative side effects in these other foods. So, why wine?

“Normally, your body breaks down alcohol into a toxic enzyme called acetaldehyde, and then it breaks down that acetaldehyde, too,” Dr. Mays explains. “But the thinking is that quercetin, when combined with alcohol, turns into quercetin glucuronide — a compound that makes it harder for your body to break down acetaldehyde. That buildup is thought to cause headaches in some people.”

Certain gene modifications (like a variant of an enzyme known as ALDH2) may also contribute to wine headaches. Research shows that certain demographics are more likely to be affected.

“We believe that about 40% of people with Eastern Asian heritage have this variant,” says Dr. Mays.

How to prevent a wine headache

Dr. Mays offers the following tips to help you avoid a wine headache:

• Drink water. In general, staying hydrated can help counteract some of the side effects of alcohol. Another reason why having a glass of water nearby is a good idea? “If you drink water, you’re less likely to drink as much alcohol,” states Dr. Mays.
• Don’t drink on an empty stomach. Eating food can help delay how your body absorbs alcohol. “Food may also help minimize the effects histamines can have,” Dr. Mays notes.
• Choose high-quality wine. When possible, look for premium wines that have fewer sulfites and other preservatives. Premium wine also tends to have less sugar — another possible headache trigger.
• Prep in advance. If you know you tend to get a headache while drinking wine, you can try to nip it in the bud. This may mean taking an over-the-counter NSAID or your migraine medicine before you even take a sip. “Treating it earlier may be effective at preventing a full-blown headache from occurring,” suggests Dr. Mays.
• Consider drinking white wine. White wines tend to have about a tenth of the amount of quercetin that red wines have. So, if you plan on having a glass or two, then it might be a good idea to switch to white wine.

Key takeaways

You may enjoy drinking a glass of wine to help you unwind after a stressful day, or you may want to sip some vino during a celebratory night out. But if that glass of Cabernet spurs a wine headache, there are some steps you can take to minimize its effects.

Drinking water, eating food and choosing specific wines can help. And if your headaches start to affect your daily life, it’s a good idea to talk to your healthcare provider.