Why Does Red Wine Cause a Headache?

People have been complaining about wine headaches since ancient Greece.

While all types of alcohol can cause headaches, especially in people who are prone to migraines, red wine appears to be particularly pernicious. But scientists still aren’t sure why it is a catalyst.

“This puzzle has been around for literally thousands of years,” said Dr. Morris Levin, director of the Headache Center at the University of California, San Francisco, Medical Center. “There are a lot of ingredients in wine that could conceivably cause a headache, not the least of which is just alcohol itself.”

A preliminary study published Monday in the journal Scientific Reports proposes a novel theory: An antioxidant found in grape skins affects how your body processes alcohol, leading to the buildup of a toxic byproduct that causes headaches.

Here’s what the science says about red wine headaches and how to stave them off before you sip.

The research on red wine

A wine headache, which happens in the first three hours after you have a drink, is not the same as a hangover, which kicks in later.

One idea is that allergies are to blame for that achy, throbbing feeling. Some people are sensitive to histamines, which are found in many fermented foods, including red wine. But studies testing the histamine hypothesis found no difference in people’s responses to pinot noirs with low and high levels of histamines, or when people were given an antihistamine before drinking a glass of Sangiovese.

An allergy to sulfites, a type of preservative found in wine, is another potential cause, though there are no studies actually proving that sulfites in red wine can bring on headaches. And other foods, like dried fruits and soy sauce, contain more sulfites and don’t have the same reputation.

The current leading theory among scientists points to a group of chemicals known as polyphenols, which includes the tannins and antioxidants that are present in red wines. Researchers have struggled to determine which specific compounds might be the culprit, or exactly how they cause headaches. What’s more, other foods — like tea, chocolate, onions and berries — also contain high levels of these chemicals but don’t have a strong link to headaches.

The new study suggests red wine headaches might be caused by a combination of alcohol and a certain polyphenol, an antioxidant called quercetin.

To arrive at their hypothesis, the researchers looked to another known cause of alcohol-induced headaches: a genetic variant that is common in people of East Asian descent and that leads to headaches, flushing and nausea if they drink alcohol. The variant interferes with how the body processes alcohol, leading to a buildup of a harmful compound called acetaldehyde.

“In small amounts, we can handle” acetaldehyde without feeling sick, said Lara Ray, a psychology professor at the University of California, Los Angeles, who specializes in alcohol use disorders and was not involved in the study. But when alcohol isn’t metabolized properly, “the body then shows this aversive response.”

The researchers set out to find a compound in red wine that might similarly impede this process. In lab tests, they found that was the case with quercetin, an antioxidant produced by grapes when they’re exposed to sunlight. “We refer to this as sunscreen for grapes,” said Andrew Waterhouse, a professor emeritus of oenology (wine chemistry) at the University of California, Davis, and an author of the study.

The idea that quercetin causes wine headaches is still just a theory, but “it’s a compelling argument,” Dr. Ray said.

However, Vasilis Vasiliou, the chair of the department of environmental health sciences at Yale University and a specialist in alcohol metabolism, cautioned that what happens in a petri dish doesn’t always translate to what happens in the human body. He added that other research has suggested that quercetin can actually help protect against damage caused by alcohol.

To test their hypothesis, the researchers will need to compare people’s responses to wines that are high and low in quercetin.

Preparing before you pour

If you’re prone to red wine headaches, you could try taking an over-the-counter painkiller before you have a glass; one small study suggested that doing so prevented them. But be careful about using acetaminophen or ibuprofen if you’re drinking more than a glass or two — taking them with alcohol can raise the risk of liver damage and gastrointestinal bleeding.

The simplest solution might be to switch wines. Both green and red grapes contain quercetin, but for white and rosé wines, the skins are removed immediately after the fruit is crushed. The skins are left in while red and orange wines ferment, so more quercetin leaches into the wine. There is some research into which red wines have lower quercetin levels, but there are no definitive answers yet.

For Dr. Levin, a co-author of the new study, the pursuit has become somewhat personal — he recently developed the unpleasant reaction to red wine and now seeks out varietals that he hopes won’t affect him. “I think I know which wines might be the more tolerable ones, but I’m not quite sure yet,” he said. “So it’s another experiment.”