This Is Why Red Wine Gives You Headaches

Why one glass at dinner can equal hours of pain.
illustration of two people cheers with wine
Illustration by Jocelyn Runice

There are those of us who can throw back a bottle of red wine, no problemo (not that we're saying you should). And there are those of us who will end up with a red wine headache, even if we have only the smallest glass of cab sauv. But why are only some of us vulnerable to the dastardly effects of red wine, while the rest of the world can go on guzzling it like there’s no tomorrow? (Well, until tomorrow does come and the hangover hits.)

For starters, red wine headaches are different from hangover headaches.

If you’ve ever suffered through a brutal hangover headache, you know it typically comes after a night of heavy drinking. Hangover headaches aren’t directly caused by the alcohol itself, but instead come courtesy of the resulting dehydration and buildup of acetaldehyde, a byproduct your body creates when it metabolizes ethanol, the type of alcohol found in all drinks.

Yes, you can totally get a hangover from too much red wine. But for those of you who feel the pain after drinking only a glass or two, your headache is probably a migraine. “One drink of red wine can trigger a migraine if you’re sensitive to it, but one glass of red wine probably isn’t going to give you a hangover,” Lawrence Newman, neurologist and director of the division of headache medicine at NYU Langone Medical Center, tells SELF.

If you get a headache after just one glass but have never been diagnosed with migraines before, it’s worth seeing a doctor to figure out what’s going on.

Scientists haven’t pinpointed a direct link between red wine and migraines, but there are a few potential culprits.

Many red wines contain a high volume of sulfites, a chemical that occurs naturally during fermentation and is also added by producers to prevent oxidation and maintain freshness. Though a lot of people are quick to blame headaches on sulfites—the suggested correlation even launched a sulfite-free wine market—Patricia Scripko, a neurologist at the Salinas Valley Memorial Hospital, tells SELF that there isn’t enough conclusive evidence to back up that claim. And, in many cases, white wine can contain the same amount of sulfites or more.

Tyramine, a product of fermentation, and histamines, compounds that are involved in immune responses and are released during allergic reactions, are two other components of red wine that might be guilty of triggering migraines, Mark Green, M.D., professor of neurology, anesthesiology, and rehabilitation medicine and director of headache and pain medicine for The Mount Sinai Hospital, tells SELF. But, according to Dr. Newman, many other alcohols contain similar amounts of both these chemicals and aren’t known to cause migraines as frequently as red wine. There was even a study in which 16 subjects with wine intolerance took antihistamines (allergy medication) before consuming red wine to counteract the effects of the histamines, but the treatment had no significant impact on the negative outcomes they experienced.

Tannins, which come from a grape’s skin, seeds, and stems, are the most probable culprit. Overall, red wine contains more of these substances than do other liquors, but they’re also present in the wood barrels used to age wine and spirits like bourbon. In fact, migraine sufferers tend to have more trouble with those darker spirits as well, Dr. Newman notes. But while some studies have shown a connection between drinking alcohol with more tannins and worse hangovers, there isn’t a lot of evidence to prove that they cause migraines after just one or two glasses of vino.

Even if you are a migraine sufferer, red wine won’t necessarily be one of your triggers.

There are many things that can bring on migraines—most famously, alcohol. Dr. Newman explains that red wine is more frequently noted as a migraine trigger than other alcohols. Experts note this is largely anecdotal: Patients just seem to report more problems with red wine than with other types of booze. If you experience migraines but red wine has never brought one on, then it’s probably not a trigger for you.

If red wine is one of your triggers, it may not always cause a migraine. “Some people notice that red wine does it sometimes and other times it doesn’t, even if they’re drinking the same bottle each time,” says Dr. Newman. “That probably means wine alone isn’t sufficient to be your lone trigger.” Other factors, including stress, your monthly cycle, or even your sleep habits, might determine if that one glass makes an impact or not.

Luckily, if you know you’re going to be drinking red wine, there are a few steps you can take to limit any migraine-related side effects.

If you're considering having some red wine, but know another one of your migraine triggers is at play (such as stress or your period), skipping a glass with dinner may be what you need to do to avoid a debilitating headache. Otherwise, if you make sure to eat before you start drinking and stay really well hydrated while you do, you’ll be less likely to get a migraine. It’s worth a try. After all, it’s hard to imagine life without the occasional sip of pinot noir.

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