Wine Headaches: Perplexing Pain

Currently, there is no agreement on causation of wine-induced headaches, or so-called “red wine headache syndrome.” There are a number of components of wine that have been considered. Sulfites, which are added to wine as an antioxidant and antimicrobial agent do not cause headaches. In high amounts, sulfites can irritate the nasal mucosa and cause an annoying odor of burnt match heads. Alcohol can produce headaches as part of a hangover due to dehydration, but does not cause headaches directly.

Linda Buson, a microbiologist at University of California at Davis feels that the cause is sensitivity to biogenic amines (histamine, tyramine, and phenylethylamine) produced by the degradation of amino acids as a byproduct of spontaneous malolactic fermentation. Natural bacterial strains produce more histamine than laboratory strains. Larger wineries often inoculate wine with laboratory strains so headaches may be less of a threat with a large production label. Wines that are aged sur lie and in the methode champenoise, and wines spoiled by Brettanomyces have higher levels of biogenic amines. Amines also occur naturally in a wide variety of aged, pickled and fermented foods, including chocolate, cheese, olives, nuts and cured meats. Many doctors warn headache sufferers away from foods rich in amines, which can also trigger sudden episodes of high blood pressure, heart palpitations, nausea and elevated adrenaline levels. I personally have noticed mild tachycardia a few hours after drinking two glasses of Aubert Chardonnay which is produced with natural bacterial strains and aged sur lie. I believe cheese heightens this effect in me. Interestingly, I have not noticed this reaction with any other California Chardonnay.

Frederick Freitag of the Diamond Headache Clinic in Chicago suspects the cause of wine-induced headaches is flavonoid compounds from the skins and seeds of grapes with some contribution by oak barrels. These flavonoid compounds are the same polyphenols that benefit the heart.

Other possible causes include residual sugar in combination with alcohol and psychological or suggestive factors in certain people. Also, those who are intolerant to wine may not be able to degrade histamine due to a deficiency of the enzyme diamine oxidase.

Ingesting ibuprofen or acetaminophen before drinking wine can block the “red wine headache syndrome” in some people.

A study carried out at Bordeaux University and reported in decanter.com (July 16, 2009), found that adding selected lactic bacteria to wine must could reduce biogenic amines in the finished wines. These bacteria, which don’t generate biogenic amines, could compete and overwhelm indigenous bacteria that are producing biogenic amines.

University of Berkeley chemistry professor Richard Mathies, who has suffered from wine-induced headaches, has developed a sensor-filled chip that can measure the amount of amines in a wine. The device, based on portable microchip capillary electrophoresis, was first reported in the journal Analytical Chemistry, November 1, 2007. The aim is to produce a small device engineered into a PD that people can use to easily test wines in five minutes. It could also be used to put amine levels on wine labels and to test a wide range of food products such as cheese, chocolate, and fish.

Migraine headaches can be triggered by polyphenols in wine that release a chemical, 5-Hydroxytryptamine or 5-HT, and by tyramine and tannins in wine. Grape varietals with thinner skins and lighter tannins, such as Gamay and Pinot Noir may be less risky for the migraine sufferer.

85% of the Asian population have a deficiency of aldehyde dehydrogenase (ALDH). Alcohol is broken down in the liver by two competing enzymes: alcohol dehydrogenase degrades alcohol to the toxic acetaldehyde and aldehyde dehydrogenase converts alcohol to the harmless acetic acid. High levels of acetaldehyde in people with ALDH deficiency cause an unpleasant flushing response along with headaches after drinking wine.