The Grapes of Wrath:
Red Wine and the Migraine Connection
Many migraine sufferers will report that red wine is a major trigger for their migraines. Red wine seems to be constantly on offer during the Christmas party season and many of us like a glass of red wine no matter what the risks.
But does red wine cause migraines in every migraine sufferer and are some red wines better or less triggering than others?
In 2012 a small study was conducted by a Dr. Abouch V. Krymchantowsk of the Rio Headache Clinic. He asked 40 patients at his headache clinic to try an experiment. These patients had previously indicated their migraines were triggered by drinking red wine.
He gave them half-bottles of four different kinds of wine: a Malbec, a Tannat, a Cabernet Sauvignon and a Merlot. All the wines were from South America. The Malbec and the Tannat were high in tannins, while the Carbernet and the Merlot had lower tannin levels. He asked people to wait at least four days after drinking one of the half-bottles before they tried another.
Krymchantowski says the wines with the highest tannin content, the Tannat and the Malbec, were the most likely to have been the apparent triggers of those attacks and the Cabernet and Merlots triggered less attacks. So all wines, it seems, are not equal, with some being more likely to provoke a migraine attack than others. It is also clearly not the alcohol alone that triggers an attack as some people can’t drink red wine but can drink white wine, beer or sprits. So what is it in red wine specifically that triggers migraines?
The jury is out on this as some studies show evidence that wines high in sulfates cause migraines and other studies are contradictory. Sulfur dioxide is a preservative added to many other foods as well as wine. In wine, it prevents oxidization and retains freshness. Red wine often contains less sulfites than white or sweet wines. If you would like to try this approach look for the label “no added sulphur” as sulphur occurs naturally in the fermentation process (it’s been used since Roman times) anyhow so it’s impossible to have a completely sulphur free product.
Tannins have a drying effect in the mouth when consumed. The higher the tannin level, the more drying the effect. It’s thought that tannins also boost serotonin, a brain chemical that’s been associated with migraine in some people. In the Rio Headache Centre study, the migraine triggering effect was highlighted with wines with higher tannin levels triggering more migraines. You can test your reaction to tannins by drinking a cup of over-steeped black tea. By over-steeping the tea you’ll flood it with more tannins than you’d normally drink. If drinking this tannin-rich tea leaves you headache free, it’s unlikely to be the tannins in wine that cause your migraine reaction.
Histamines are thought to be more likely to cause headache and migraine than other ingredients in wine. They are part of a family of substances called biogenic amines, produced by otherwise harmless micro-organisms, often in the course of fermentation. They are found in many things we consume, including beer, cheese, sausages, bananas, chocolate, canned tuna and wine. Some people lack sufficient quantities of an enzyme that synthesizes dietary amines, leaving them susceptible to headaches or severe migraines. Some people anecdotally suggest taking a histamine blocker before wine consumption to reduce the triggering effect but check with your chemist or GP as there may be some contraindications with alcohol and other medications.
Tyramine is present in robust red wines as well as many other foods, such as figs, chocolate, avocados and cheese. One of the enzymes in the body that helps break down tyramine is monoamine oxidase (MOA). With some antidepressant drugs (often prescribed to help control migraine), MOA in the body is inhibited, so the body does not deal effectively with tyramine, which can raise blood pressure and cause headaches. People taking these drugs are often advised to limit their intake of foods containing tyramine.
Usually it’s a combination of two or more triggers that precipitates a migraine attack. A long stressful day with gaps between meals can cause you to reach for the glass of wine when you get through the door, whereas we may notice that another time we can drink the same wine with no effect. Many women find that drinking red wine, in fact any alcohol, during and prior to menstruation, can also trigger migraines. So an alcohol free period then may be a better choice for these women. For some people red wine or any wine will always be prohibited as they just cannot tolerate it. Some of our chronic patients indicate that the clearer the liquid the less triggering the effect so they stick to spirits.
There are many variables at play and keeping a migraine diary will help you identify a pattern and make more informed choices on your tipple of choice.
Green Man Wines in Terenure is a specialist wine shop which stocks a wide range of organically or biodynamically produced wines, many of which contain less sulfates and additives. Visit their online shop at https://greenmanwines.ie