Red wine headaches are a genuine and worrisome phenomenon, worrisome because any given patient will have a headache from certain red wines and not others. But there doesn’t seem to be a single individual cause. Red wine headaches range in severity from a mild migraine to a full-on migraine.

Just half a glass of wine can trigger an attack in fifteen minutes or so, and these attacks can last for several hours. Two medium-sized glasses of wine could even trigger a migraine in those who are prone to them.

Some experts question whether sulfites in wine are the source of red wine headaches (RWH), for these reasons:

• Respiratory problems (including asthma attacks), rather than headaches, are more likely to react to sulfites;
• Red wine is more likely to be the trigger, however many sweeter white wines contain considerably more sulfites than red wines, because they have a much higher sugar content;
• Numerous other foods contain sulfites, so these headaches shouldn’t be specific to any red wine.

Some allergy experts believe that tannins are responsible for severe headaches. The Harvard Health Letter noted:

“Some controlled experiments show that tannins cause the release of the neurotransmitter serotonin. Quite high levels of this serotonin can cause headaches, which may well be the cause of RWH in people who already suffer from migraines.”

Somehow, the experiments fail to explain why people who aren’t susceptible to migraines get headaches from red wine, or why people don’t similarly suffer from the high levels of tannins in tea and chocolate. .

Winemakers use sulfites during the winemaking process to prevent wine from oxidizing, helping to keep it clean and fresh for longer. When a wine is allowed to come into contact with oxygen for a long period of time, it will immediately oxidize and spoil, eventually becoming vinegar. Sulfites are unlikely to be the only culprit, but since many white wines contain larger amounts than reds, they generally don’t seem to cause a reaction.

Research from 30 years ago suggests that prostaglandins may be to blame for these headaches. Prostaglandins are substances that contribute to pain and are easily blocked by drugs that inhibit prostaglandin synthetase, ie aspirin, and even paracetamol and ibruprofen.

Most researchers believe that one or more of the remaining suspects is the cause of most red wine headaches. These include tannins, histamines, triamines, and prostaglandins. Histamines and triamines are byproducts of secondary fermentation in red wine, resulting in up to two hundred percent higher amounts of amines in red wine than white.

Excessive consumption of wine can give almost anyone a headache, but for some people, drinking just a small amount of wine will give them a nasty migraine, combined with nausea and hot flashes. To minimize the chance of getting a RWH, just try a glass of a certain red, and if you suffer within 15-20 minutes, obviously don’t drink that wine. If you suffer, reduce your risk by reducing your consumption first, and remember to choose the best quality red wine you can afford. Cheaper wines tend to be less stable, although this is not always the case, and therefore may contain more sulfur dioxide.

3 reasons why sulfur dioxide is used in wine

1. As prevention of bacterial growth.
2. As a protective agent for wine against oxygen.
3. To bind various unpleasant aromatic compounds, such as acetaldehyde.

If you’re trying to find sulfite-free wine when you shop, good luck! Sulfites are a natural byproduct of the winemaking process, so all wine contains at least trace amounts. Sulfur dioxide (SO2) is not a bad substance, but used incorrectly or in excess, it can be disastrous for a wine, and not good for your health. But without it, winemakers couldn’t make good wines and the wine wouldn’t age as well.

In the end, it all comes down to the usual add-on: drink in moderation to reap the full benefits; overdo it, and you can suffer in many ways.