Does Drinking Red Wine Give You a Headache?

It’s a perfect time of the year for staying in, pulling on your softest sweater, and uncorking a bottle of red wine. Unfortunately for many people, raising a glass of red wine to their lips can feel like a toast to their next headache, one that could come on in a matter of minutes.

Why can red wine cause headaches, even in people that usually don’t have alcohol-related headaches? A new study published today in Scientific Reports suggests it could be due to an antioxidant found naturally in red wines that interferes with the proper metabolism of alcohol.

Red Wine: The Drink Most Likely to Give You a Headache
Red wine is the type of alcohol most likely to cause a headache in people who have alcohol-triggered headaches, according to a meta-analysis on alcohol use disorders — more likely than spirits, white or sparkling wine, and nearly 3 times more likely than drinking beer.

And you don’t have to drink too much wine to get a headache; it can come on in 30 minutes or less after just one or two glasses, per the study.

How a Healthy Antioxidant Found in Red Wine Can Turn Toxic
To help answer the question of why red wines can cause headaches, researchers took to the laboratory to analyze how the antioxidant known as quercetin may play a role. Quercetin is a flavanol, a subclass of flavonoids, which are chemical compounds naturally present in all kinds of fruits and vegetables, including grapes. Flavonoids have many heart and brain health benefits, according to the American Heart Association.

Interestingly, quercetin is considered a healthy antioxidant, and is even available in supplement form, but investigators found that when metabolized with alcohol, it can be problematic.

“When it gets in your bloodstream, your body converts it to a different form called quercetin glucuronide,” said wine chemist and coauthor Andrew Waterhouse, PhD, a professor emeritus with the UC Davis department of viticulture and enology, in a press release. In that form, it blocks the metabolism of alcohol, he added.

When that happens, people can end up accumulating the toxin acetaldehyde in their systems, according to the authors. Acetaldehyde is a well-known toxin, irritant, and inflammatory compound, and high levels can cause facial flushing, headache, and nausea, said lead author Apramita Devi, PhD, a postdoctoral researcher with the UC Davis department of viticulture and enology, in the release.

Findings Could Provide Valuable Info for Red Wine Lovers
But why some people are more susceptible is still unclear, according to the authors. It could be that the enzymes of people who suffer from red wine headaches are more easily inhibited by quercetin, or they could be more easily affected by the buildup of toxic acetaldehyde than the average person, they wrote.

This is an intriguing hypothesis, says Katherine Donelan, RD, with Stanford Health Care in California. “Quercetin is a powerful antioxidant and has traditionally been thought to be one of the nutritional assets of red wine, but this study certainly throws a wrench into that thinking,” says Donelan, who was not involved in the study.

“While it's essential to remember that further research is needed to validate and generalize these findings, this initial insight could serve as a valuable guidepost for wine enthusiasts, particularly those prone to headaches,” she says.

Flavanol Levels Can Vary Substantially Between Red Wine Varieties
Levels of flavanol can vary dramatically in red wine — in part because quercetin is produced in response to sunlight, says Waterhouse. “If you grow grapes with the clusters exposed, such as they do in the Napa Valley for their cabernets, you get much higher levels of quercetin. In some cases, it can be four to five times higher,” he said.

Flavanol levels are also impacted by how the wine is made, including skin contact during fermentation, fining processes, and aging, according to the authors. In fining, an agent such as gelatin, egg whites or carbon are added to wine to flush out unwanted material from the wine.

Sulfates, Histamines, and Tannins Could Also Be Causing Your Red Wine Headache
“Historically, wine consumption has been linked to adverse effects such as headaches, flushed skin, and nasal congestion. These reactions are commonly ascribed to allergies or sensitivities to components like sulfites, histamines, tannins, and tyramine,” says Donelan.

Alcohol itself (and not just in red wine) hastens dehydration and creates damage throughout the digestive, cardiovascular, immune, and central nervous systems — and is a known carcinogen, she says. The less alcohol you drink, the lower your risk for cancer, according to the Centers for Disease Control and Prevention.

Next Steps: Clinical Trials Looking at People Drinking Red Wine
Researchers plan to test the theory on people who develop these headaches. A small clinical trial, funded by the Wine Spectator Scholarship Foundation and led by UCSF scientists, is in the works.

“If our hypothesis pans out, then we will have the tools to start addressing these important questions,” said Waterhouse.

Expert Advice on Avoiding Red Wine Headaches
To minimize the risk of a headache from red wine, Donelan suggests opting for varieties that are lower in potentially irritating elements. This includes wines with:

minimal or no sulfites, common in organic or biodynamic options
lower tannin content, like Zinfandel
reduced histamine levels, such as Pinot Noir or Merlot
lower alcohol content
Drinking plenty of water and consuming a meal rich in protein and fiber can play an important role in minimizing the chances of a headache later, she says. “This approach works by diluting the potentially problematic contents of wine and slowing their absorption in the gastrointestinal tract.”

When you try a new red wine, start with less than half a glass. If it's going to give you a headache, it'll do so within 15 minutes, according to Harvard Health Publishing.