Everyday Q&A: What causes the red wine headache?

People have probably been complaining about the notorious Red Wine Headache (RWH) ever since red wine first emerged in 6000 BC in western Asia. As of yet, however, researchers have not been able to pinpoint a single etiology. In all likelihood, RWH is caused by multiple factors that affect different people to different degrees. Still, a few culprits have been tossed around.

Sulfites are naturally-occurring com­pounds found in virtually all wine, but for the vast majority of wine-drinkers, these are not the cause of RWH. People with sulfite allergies comprise less than 1% of the population, and their most common reaction tends to be breathing difficulties, not headaches. Much higher sulfite levels can be found in foods like dried fruit and processed lunchmeat. In fact, many sweet white wines contain more sulfites than reds. However, some winemakers point to the fact that the combination of sulfites and dehydration can deplete B vitamins and set off a migraine.

Many researchers believe that biogenic amines like histamine and tyramine may trigger an inflammatory response leading to RWH. Amine levels can be as much as 200% higher in red wines because most reds undergo malolactic fermentation, a process that converts malic acid into lactic acid while releasing amines. Though a 2001 study was unable to find a connection between amines and RWH, a recent study found that avoiding high-amine wines can prevent headaches.

Tannins, pucker-inducing flavonoids found in the skins and seeds of wine grapes, are more present in red wines because of a longer maceration time during fermenta­tion. Research has shown that tannins trig­ger changes in serotonin levels, which can lead to migraines. Tannins also lead to the release of prostaglandins, lipids which have been shown to induce headaches.

The best cure for RWH is to cover your bases. Staying hydrated while drinking will prevent sulfites from depleting your B vita­mins. Taking a non-drowsy antihistamine will inhibit an inflammatory response to amines. Taking an analgesic like aspirin will inhibit the release of prostaglandins. If all else fails, drinking younger reds like Beaujolais Nouveau will spare you most of the tannins and histamines, but bring you none of the glory. Cheers.