Why Red Wine Might Cause Those Nasty Headaches

In a 2017 literature review published in Current Pain and Headache Reports, 28% of the studies considered noted that red wine was a key trigger for primary headache — meaning the headache occurs soon after drinking and cannot be caused by a hangover. It also doesn't seem to be impacted by the actual volume of wine consumed or whether the wine is expensive or cheap, like the bottles from Trader Joe's. In comparison, only about 10% of studies found primary headaches came from other wines or beer, and 14% from more potent spirits. A 2023 study published in Scientific Reports further backs up these findings. The facts are clear: red wine has the potential to wreck our night before it's even started. But why?

A lot of myths have long swirled around the topic of red wine headaches, with frequent finger-pointing at both tannins (what are tannins in wine?) and sulfites. Sulfites have been especially demonized. These compounds contain a sulfur ion and are used as a preservative. The science falls apart, however, when you consider that there are just as many sulfites in white wines as red ones and that the human body naturally produces a certain amount of sulfites through everyday metabolism. 

Lately, scientists have found a new potential culprit: quercetin, a plant flavanol. Quercetin inhibits enzymes that break down acetaldehyde, a byproduct of drinking alcohol. A buildup of that can lead to hangover symptoms like a red face, queasiness, and nasty headaches. Quercetin levels tend to be much higher in red wine than white wine, explaining why that particular vino packs such a punch. 

Okay, so we know that quercetin might be the substance to blame for our pounding heads after drinking red wine. Does this mean that we need to lock up the Cab and swear off Kalimotxos, the Spanish cocktails made with Coke and red wine? Not so fast. We may not be able to completely eliminate the issues with quercetin in red wine, but we may also be able to lessen them.

Quercetin content varies greatly between red wine varieties, as its presence has to do with how the grapes were grown and processed. Therefore, trial and error is probably the best way to learn which wines treat you well. When sampling a new wine, start with just half a glass so that you can see how it makes you feel. If you are doing great afterwards, you might want to seek out that specific wine in the future. Also, never drink on an empty stomach. That's good wisdom for any alcohol, but especially for red wine, given that dehydration can drastically worsen headaches. While drinking wine, sip a couple of glasses of water.

If you do fall prey to a red wine headache, you can safely treat it with a lot of the same methods you'd use for a regular headache: rest, a cool compress, and possibly a caffeinated beverage. Ask your doctor if OTC pain relievers are okay, but take extreme caution mixing ibuprofen or acetaminophen with large amounts of alcohol, as that can potentially damage your liver or other internal organs. Always consult a doctor if you get frequent headaches.