The answer to this age-old dilemma is rather complicated.
Lettie Teague, a wine columnist for the Wall Street Journal, has built a career covering the best new wines, and what makes them great. Yet, like many others, Teague admits that she occasionally suffers headaches after a glass or two.
In her most recent column, Teague explores whether or not Red Wine Headache—a phenomena experienced by so many people that it has its very own Wikipedia page—could be explained by health professionals, and whether or not casual drinkers should be concerned.
Teague spoke with Dr. Alexander Mauskop, the director and founder of the New York Headache Center located in Manhattan, about the subject: Mauskop said wine-related headaches is actually one of the center's topmost cases, but clarified that his knowledge is limited, and then proceeded to catalogue a number of possible explanations: The type of oak casket used in fermentation may play a role, but it's not clear which oak is worse. He then noted that some of those who experience wine-related headaches wonder if they are actually allergic to sulfites. This is rare, he says (and there are more sulfites in white wine, suggesting it isn't that).
Wine drinkers could be suffering from dehydration, given that alcohol acts as a diuretic (this is true for all alcoholic drinks), which Mauskop says is the root of the problem for many of his clients. Another explanation may be a depletion of magnesium: "Alcohol is a major depleter of magnesium," Mauskop told WSJ. He recommends that chronic headache sufferers seek out 400mg of magnesium supplements per day, and see if that doesn't help.
But despite Mauskop's musings, there's not much published research on wine headaches: Teague unearthed a 1988 Lancet study, titled "Red Wine as a Cause of Migraine," where two groups of drinkers were asked to drink either red wine or a substitute (diluted vodka disguised as wine) to see if migraines came exclusively from one or the other. The participants chugged down 300 milliliters, around two glasses, and waited to see if they were affected.
The results, however, weren't clear: some participants developed headaches, while others did not. One possible lead suggested that tyramine, a naturally occurring compound found in both food and wine, has previously been found to trigger migraine headaches—but the amount of tyramine in both red and white wine is less than 2 milligrams per meter.
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Teague asked another expert, Cornell University's Chris Gerling, an associate within the Viticulture and Enology program, about histamines naturally produced in most wines, another possible culprit. Gerling didn't believe there was much evidence for the theory.
But another expert explained why histamines could be an issue. Dr. Sami Bahna, a professor with the Allergy & Immunology department of the Louisiana State University Health Sciences Center, told Food & Wine that genetics could play a part in how you digest and metabolize wine. In the case of histamines, certain genetic dispositions (or medications) could mean you're not metabolizing histamines effectively, which means that symptoms like facial flushing and headaches would be much more common after even just a few sips of wine.
But maybe the simplest explanation is the possibility that—hear us out—you may be hung over.
You should consider your case serious if you notice an immediate reaction to the first glass of wine you've tasted, according to Lawrence Newman, a neurologist and the director of headache medicine at NYU's Langone Medical Center. “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,” Newman told SELF magazine.
The bottom line: Unfortunately, Teague explains, she failed to discover a single solution to the dilemma. Magnesium supplements may help if you're experiencing a deficiency, but not if your levels are normal.
More research is needed to pinpoint the cause of wine-induced headaches, but identifying the issue may help you minimize it as much as possible: talk with your healthcare provider if you feel that histamines may be the issue, or if you experience a magnesium deficiency. And make sure you're properly hydrated before enjoying a bottle with friends.