Why do some people get headaches from wines?

When you drink wine, your body has to process the alcohol in it. This mostly happens in your liver in two stages:

First stage

Alcohol (ethanol) is converted into acetaldehyde. This is a toxic substance that can cause unpleasant symptoms if it builds up.

Second stage

Another enzyme quickly breaks acetaldehyde down into harmless components that your body can flush out through water and carbon dioxide.

The tricky part?

Not everyone’s body does this job equally well. If your system is slower or less efficient, acetaldehyde can pile up, leading to headaches, flushing, or nausea.

Some people even have genetic variations, especially common in East Asian populations, that make it harder for their bodies to process acetaldehyde. This is often referred to as the “Asian flush”, and it’s a big reason why wine (and alcohol in general) can hit some people harder than others.

For years, people assumed sulfites were the main cause of wine headaches. But new research suggests another player is just as important: quercetin.

Quercetin is a natural antioxidant found in fruits and vegetables, including grapes. It gives colour to red wines and is usually seen as a healthy compound. But when alcohol enters the mix, quercetin can get in the way of your body’s ability to break down acetaldehyde. This means that if you drink red wine with higher quercetin levels, your body struggles more with alcohol’s toxic byproducts, leading to those throbbing headaches.

Interestingly, quercetin levels aren’t the same in every bottle. Grapes that get more sunshine tend to produce more quercetin. That means wines from sunnier regions or wines where growers deliberately expose grapes to more sunlight may pack in higher levels. So ironically, your “premium” Cabernet might be more likely to give you a headache than a cheaper bottle of Gamay.

Wine is a complex drink, with dozens of natural compounds that affect people differently. Beyond alcohol and quercetin, here are some other headache triggers:

Histamines

These occur naturally during fermentation, especially in red wines. They widen blood vessels, which can contribute to headaches. Normally, your body can break them down, but alcohol makes that harder.

Tannins

These are the compounds that give red wine its dry, mouth-puckering feel. They can cause your brain to release serotonin, which at high levels can trigger headaches, particularly in migraine sufferers.

Sulfites

While often blamed, sulfites rarely cause headaches. They’re more likely to cause breathing problems in sensitive individuals (especially those with asthma).

Fun fact: Many white wines actually contain more sulfites than reds.

Other natural compounds

Things like tyramine or putrescine, which form during fermentation, can also play a role in triggering migraines for sensitive people.

Not everyone gets headaches from wine. Sensitivity depends on a mix of biology, genetics, and lifestyle factors.

Genetics

If your body doesn’t process alcohol efficiently, you’re more likely to get headaches.

Migraines

Roughly one-third of migraine patients identify alcohol as a trigger. Interestingly, those sensitive to wine typically react to multiple food triggers. Some individuals tolerate certain alcoholic drinks intermittently, suggesting environmental factors like stress might compound sensitivity.

Gender

Women generally reach higher blood alcohol levels than men after drinking the same amount, partly because of body composition and enzyme differences.

Other triggers

Stress, dehydration, and even the type of meal you eat with wine can make symptoms worse.

True wine allergies, by the way, are extremely rare. Most people experiencing reactions actually have an intolerance, not a full-blown allergy.

The good news is that if you love wine but dread the headache, there are a few strategies you can try. While none of these are guaranteed cures, many people find they help reduce the risk:

1. Choose Your Wine Carefully

• Opt for white wines or lighter reds, which often contain lower levels of tannins, histamines, and quercetin.
• Try wines from cooler regions (like Germany, Northern France, or New Zealand), where grapes get less intense sunlight and therefore may contain lower quercetin levels.
• If certain wines consistently trigger headaches, avoid them.

2. Stay Hydrated

Alcohol dehydrates you, which can make headaches worse. A good rule of thumb: drink a glass of water for every glass of wine. This helps your body flush out toxins more efficiently.

3. Don’t Drink on an Empty Stomach

Food slows down alcohol absorption and gives your body more time to process it. Pair wine with a meal rather than drinking it alone.

4. Know Your Limits

If you’re sensitive, even small amounts of wine may be enough to cause discomfort. Learn your threshold and stick to it. Sometimes, one small glass enjoyed slowly is better than pushing your luck with two or three.

5. Watch Out for Other Triggers

If you already have a history of migraines, wine might interact with other triggers like stress, lack of sleep, or certain foods. Managing these factors can sometimes make wine more tolerable.

6. Keep a Wine Journal

Track what types of wines give you headaches and what doesn’t. Over time, patterns often emerge—certain grape varieties, regions, or winemaking styles might be your personal triggers.

The bottom line…