“I can’t drink red wine: it gives me headaches.”
“I can’t drink white wine: it gives me headaches.”
“I can’t drink Champagne: it gives me headaches.”
You have probably heard this before. Some people just react badly to certain types of wine. The cynic would say it’s all psychosomatic, yet there exists a bona fide, though not well-understood, medical condition called “red wine headache.” What’s going on in wine that causes these headaches?
Sulfites
Sulfur dioxide and its forms in wine are generally referred to by the catch-all term “sulfites.” Lots of people have heard of them, but many do not understand why they are in wine in the first place. Sulfites have been added as an antioxidant and antimicrobial agent practically since wine was first made. Many consumers read bottles of wine that say “Contains sulfites” and assume that these chemicals are the cause of headaches.
They are not.
There is no evidence in any scientific literature that sulfites cause wine-related headaches. Sulfites do cause a trigeminal response (nasal irritation) if present in large amounts in wine. This stinging perception of molecular SO2, which smells like a struck match (a match head is basically sulfur and phosphorus) varies by the amount of total sulfites, pH, and other factors. A very small part of the population (about 1%, according to the FDA) is allergic to sulfites and can have respiratory difficulties with exposure, but headaches are not common.
The general mantra with sulfites is “harmless to many, annoying to some, dangerous to few.” Red wines generally have fewer sulfites than white wines (due to the antioxidant capacity of tannins and other polyphenolics found in reds).
Biogenic Amines
Less well-known in the wine world are another set of compounds, formed by the degradation of free amino acids by fermentation organisms. They’re collectively called biogenic amines, and they include histamine, tyramine, and the worst-sounding of the bunch, putrescine.
Their health effects in large doses include headaches, nausea, and other unpleasantness.
Many countries now have recommended (but not yet set in legal stone) limits on biogenic amines in wines. In spite of this, studies examining the safety of these compounds have found that their amounts in wine are below those which would cause such side effects. Biogenic amine concentrations in aged cheese are more likely to produce symptoms than in wine.
Also, anyone taking the prescription drugs known as MAO inhibitors (a much older generation of antidepressants, seldom used these days) should definitely avoid biogenic amines. MAO, or monoamine oxygenase, breaks down and eliminates detoxifies these compounds under normal conditions. In the presence of MAOis a person can go into a hypertensive crisis, which can actually be fatal. On that note, people with varying levels of MAO could have varying responses to histamine and tyramine.
Red wines are generally higher in biogenic amines than whites (practically all red, but significantly fewer white wines are go through malolactic fermentation [see inset] and more nutrients are extracted from the skins during fermentation of reds.)
Factors that increase biogenic amines in wine
- Spontaneous malolactic fermentation: Commercial malolactic bacteria have been selected for lower production of these biogenic amines. Spontaneous MLF can contain malolactic bacteria that are more prone to biogenic amine production.
- Yeast lees exposure: Exposure to yeast lees releases mannoproteins and amino acids in yeast, leading to BA production, so wines aged sur lie and in the methode champenoise will have higher BAs.
- Brettanomyces: in a recent study, fermentations containing Brettanomyces bruxellensis (aka Brett) produced a larger amount of BAs than Saccharomyces. Many Old World wines (particularly unfiltered, low-sulfite wines) are susceptible to spoilage by Brett.
- High nitrogen: high nitrogen in the must can lead to increased production of biogenic amines during fermentation and also contribute to BA production by spoilage organism in the bottle down the road. Diammonium phosphate (DAP) can be added to up nitrogen nutrients in must but is sometimes overused.
Tannins and other polyphenols
Since red wines contain tannins and white wines do not, these and other polyphenolic compounds are also a factor that is often targeted as a headache cause. Tannins do cause an astringent feeling in the mouth by interacting with mouth proteins (much more information on this topic can be found here at Palate Press.)
What does this have to do with headaches? Not much. One argument against tannin-related headaches is the fact that tannins are naturally found in all kinds of foods from tea to chocolate to nuts. In fact, many wines with added tannins (yes, you can do that in some places) contain tannins derived from nuts.
The basis of the argument stems from studies that suggest that tannins in cotton can induce the release of serotonin, a neurotransmitter which constricts blood vessels, leading to headaches. However, a recent study found that red wine is actually a vasodilator, and it is likely that the mechanism of vasodilation is related to the polyphenols in wine. So if anything, the polyphenolic content of a red wine should work to alleviate headaches. Thus, the evidence of tannin as the culprit seems a bit weak.
Glutamate
Another suspect one might think of as a cause of wine headache is glutamate, the amino acid responsible for the umami flavor found in many wines. After all, many people report headaches and other symptoms after eating Chinese food, typically a hotbed of MSG (monosodium glutamate). Again, though, recent reviews of decades of literature have shown no clear connection between MSG and such symptoms. Thus, a connection between the glutamate naturally found in elevated levels in some wines and headaches is not likely.
Alcohol
Normally, the alcohol by volume in table wine can range from 7% in crisp, light Mosel Rieslings and Vinho Verdes to 16% in Zinfandels and some Alsace Gewürztraminers. So a night of drinking wine will leave one far more dehydrated than a night of light beer. Indeed, I am sure that many wine headaches have a simple explanation: hangovers.
Though the hangover itself is not very well-understood scientifically (despite the money to be made with a cure!), many of its symptoms are similar to those of dehydration. Alcohol inhibits proteins called aquaporins, which concentrate urine, conserving the body’s water supply. Thus, you might make several trips to the bathroom during a night of drinking, then wake up parched. Dehydration and many of the other adverse effects of alcohol can add up to a killer headache… for which my favorite cure is a Bloody Mary.
Psychology
Allow me to present another possibility. Our perception of wine is highly influenced by psychology and context. This explains how hilariously inaccurate results can come from blind tastings, even with professionals. Some studies involving red wine and headaches have indeed been discounted due to the researchers’ inability to properly blind participants, suggesting that a placebo effect may have influenced the participants’ claims of headaches caused by red wine. If a person really believes that red wine can give him headaches, then ingestion of red wine may work him up into a headache regardless of the contents of the wine in question.
I’m not trivializing what is widely recognized as a genuine medical phenomenon. I’m simply suggesting that not as many people actually suffer from headaches triggered solely by ingestion of red wine as we might think. Headaches are very common and medically mystifying, so sometimes it is hard to tell the true causes of many headaches.
Avoiding headaches
So far, there is no conclusive determination on what component of red wine causes the dreaded “red wine headache”. This is likely due to the fact that funding for the detailed studies needed to isolate the cause(s) is hard to come by.
Wine is such a complex chemical mixture that we may never understand the complicated combinations of factors that cause headaches in certain people. Each of us is unique and likely possesses different sensitivity to the thousands upon thousands of different molecules in wine. Migraine sufferers, in particular, can have an array of environmental triggers, from certain foods to bright lights.
In general, though, given the factors that influence biogenic amine production, if you are susceptible to “red wine headache”, it may be wise to avoid wines prone to Brett, spontaneous MLF, and long yeast exposure. Keeping meticulous tabs on the wines we drink (and our reactions) can be helpful, too. I guess when it comes to avoiding headaches, we can always rely on the old Henny Youngman gag: “Doctor, it hurts when I do this!” “…Then don’t do it!”
For now, though, all this medical research is giving me a headache. Time to pop open some wine.
Further Reading:
- Review of Adverse Reactions to Food Additives (featuring sulfites) (subscription required, sorry)
- Details on biogenic amine production and table of recommended limits for biogenic amines in wine
- Meta-analysis of effects of biogenic amines in food and wine
- Study linking red wine polyphenols to vasodilation
Tom Mansell is a PhD candidate in chemical engineering at Cornell University in Ithaca, NY. He is borderline obsessed with the science of wine and winemaking. His blog, Ithacork, focuses on Finger Lakes wines and always includes a “Science!” section, which gets down to technical details for the hardcore wine geek. Follow him on Twitter @mrmansell.