Red wine headaches (RWH) have long been a perplexing issue for many wine enthusiasts. However, recent research has shed new light on the potential causes behind this common phenomenon. The findings suggest that a specific compound found in red wine, known as quercetin, may be the culprit behind the dreaded red wine headache.

The Role of Quercetin in Red Wine Headaches

According to a study published in the journal Scientific Reports, the researchers at the University of California, Davis have discovered that quercetin, a flavanol compound found in the skin of grapes, may interfere with the metabolism of alcohol, leading to the accumulation of a toxic substance called acetaldehyde.1 This buildup of acetaldehyde is believed to be the primary trigger for the headaches experienced by some individuals after consuming red wine.

The researchers explained that when quercetin enters the bloodstream, it is converted into a different form called quercetin glucuronide. In this form, it inhibits the activity of an enzyme known as ALDH2, which is responsible for the breakdown of acetaldehyde.23As a result, acetaldehyde, a well-known irritant and inflammatory substance, can accumulate in the body, causing the characteristic symptoms of a red wine headache, such as facial flushing, headache, and nausea.4

Differences in Quercetin Content Between Red and White Wines

The researchers noted that the quercetin content in red wines is significantly higher than in white wines. Studies have shown that the flavonol content, which includes quercetin, in white wines is approximately ten-fold lower than that found in red wines.4 This difference in quercetin levels between the two wine varieties helps explain why red wine is more commonly associated with headaches compared to white wine.

However, it’s important to note that the quercetin levels in red wine can also vary depending on factors such as grape variety, sun exposure during growth, and the winemaking process. Wines made from grapes that have been exposed to more sunlight tend to have higher quercetin levels, while less expensive red wines generally have lower quercetin concentrations.4

Susceptibility to Red Wine

The researchers suggest that individuals who are more susceptible to red wine headaches may have a preexisting condition, such as migraine or another primary headache disorder.4 For these individuals, the consumption of red wine containing even modest amounts of quercetin may be enough to trigger a headache. “We postulate that when susceptible people consume wine with even modest amounts of quercetin, they develop headaches, particularly if they have a preexisting migraine or another primary headache condition,” said co-author Morris Levin, a professor of neurology and director of the Headache Centre at the University of California, San Francisco.4

Ongoing Research and Future Clinical Trials

The researchers from the University of California, Davis are planning to conduct a small clinical trial to further investigate the role of quercetin in red wine headaches. This study, led by the University of California, San Francisco, will involve testing the effect of red wines with varying quercetin levels on people who are known to experience RWH.4

“We think we are finally on the right track toward explaining this millennia-old mystery. The next step is to test it scientifically on people who develop these headaches, so stay tuned,” said Andrew Waterhouse, one of the study authors and a professor emeritus with the University of California, Davis viticulture and oenology department.4

Other Potential Causes of Red Wine Headaches

While the quercetin theory provides a promising explanation for the cause of red wine headaches, it is important to note that other factors may also contribute to this common issue.

Histamines

Some researchers have previously suggested that histamines, compounds involved in the immune response, found in red wine could be a potential trigger for headaches.4Histamines are present in higher concentrations in red wines compared to white wines, which could help explain the higher incidence of headaches associated with red wine consumption.4

Tannins

Another compound found in red wine that has been linked to headaches is tannins. Tannins are plant-based polyphenols that can stimulate the release of certain neurotransmitters associated with pain.4 The higher tannin content in red wines compared to white wines may contribute to the increased likelihood of headaches experienced by some individuals.

Sulfites

Although sulfites have long been thought to be the culprit behind red wine headaches, research has shown that this is not the case. Sulfites are used as preservatives in many foods and drinks, including both red and white wines, and are not the primary cause of RWH.4

Dehydration

It’s also important to consider the dehydrating effects of alcohol, which can contribute to headaches. Consuming red wine, like any alcoholic beverage, can lead to dehydration, which can exacerbate or even cause headaches.4 Ensuring adequate hydration by drinking water before, during, and after consuming red wine may help mitigate this issue.

Strategies for Preventing and Treating Red Wine Headaches

Given the potential causes of red wine headaches, there are several strategies that individuals can employ to prevent or manage this condition:

Choosing Low-Quercetin Wines

For those who are susceptible to red wine headaches, selecting wines with lower quercetin levels may be beneficial. As mentioned, less expensive red wines and those made from grapes with less sun exposure tend to have lower quercetin concentrations.4 Experimenting with different red wine varieties and monitoring the headache response can help identify the wines that are less likely to trigger a headache.

Antihistamine Use

For individuals with a sensitivity to histamines, taking an over-the-counter antihistamine medication before consuming red wine may help prevent or alleviate the resulting headache.4 It’s important to follow the dosage instructions and be aware of any potential interactions with other medications.

Staying Hydrated

Maintaining proper hydration by drinking water before, during, and after consuming red wine can help mitigate the dehydrating effects of alcohol and potentially reduce the risk of headaches.4

Pain Medication

If a red wine headache does occur, over-the-counter pain medications, such as aspirin, ibuprofen, or acetaminophen, can be used to help alleviate the symptoms.4 It’s important to follow the recommended dosages and consult with a healthcare professional if the headache persists or worsens.

Conclusion

​The recent research findings provide valuable insights into the potential causes of red wine headaches, with quercetin emerging as a key culprit. By understanding the role of this compound in the metabolism of alcohol and the subsequent buildup of acetaldehyde, scientists are one step closer to unraveling the mystery behind this common wine-related affliction.

As the research continues, with plans for clinical trials to further investigate the relationship between quercetin and red wine headaches, individuals who experience this issue may find some relief in the strategies outlined for prevention and management. By being mindful of their individual sensitivities and experimenting with different wine varieties, as well as incorporating hydration and medication when necessary, wine enthusiasts can potentially enjoy their favorite red wines without the burden of persistent headaches.