Betty's Wine Musings
Wine Sensitivities
Red Wine Headaches (RWH)

Since I lead wine tastings for a living, I get a lot of people telling me about their red wine headaches (RWH), which they attribute to sulfite or tannin sensitivities. Because I hear these complaints so often, I did a little research and will share with you what I learned about possible causes of, and solutions for, RWH. Thank you to for some great information for this article.

The long and short of it ~ there is a real phenomenon called RWH, and there is no consensus on causes or cures.

There is also no consensus on when it shows up. Some people, for example, can drink French red wines but not American red wines. Some people can drink American but not French. Some people are okay with certain red varietals. Some people are sensitive to all red varietals.

Causes of RWH

There are four factors that are considered to be the most likely contributors to RWH.

  • Sulfites
  • Tannins
  • Histamines
  • Tyramine
  • Prostaglandins

In all likelihood, several of these can be a factor for most RWH sufferers. I’ll explain each of the contributors below.


Suflites are a natural byproduct of yeast. In limited quantity, sulfites are an integral part of wine chemistry. Without them, most wine would spoil from bacteria, and their shelf life would be dramatically reduced.

Many people assume that they are allregic to sulfites, because sulfites have gotten a lot of bad press over the last 10 to 20 years. Truth be told, less than 1% of the population suffer from sulfite allergies, and most of these people experience breathing problems, not headaches. The only people known to get headaches on a regular basis from sulfites are asthmatics.

Also, it turns out that white wine typically has more sulfites than red wine. Yet few people get white wine headaches. Furthermore, dried fruit has more sulfites than white wine, and I don’t think I’ve ever heard of anybody getting a dried fruit headache. Have you?


Tannins are the flavonoids in wine that make your mouth pucker. Tannins are more prevalent in red wines than in whites, because they come from the grape skins, which play a much more important role in red wine than white.

Some studies show that tannins cause the release of serotonin, a neurotransmitter that, at high levels, can cause headaches in people who suffer from migraines.

But non-migraine sufferers get RWH too. And other foods with tannins, including tea and chocolate, don’t cause headaches. So without doing serious research, it’s hard to fully understand what role tannins play with RWH.


These are compounds found in grape skins (and other plants). They are more prevalent in red wines than in whites.

Some experts believe that the combination of alcohol and a histamine deficiency can cause headaches.


Tyramine (an amino acid) is one of the many natural by-products of the fermentation process, so it’s present in both wine and cheese. Tyramine affects blood pressure and can be problematic for people whose bodies have difficulty breaking it down.

There is no known fix for people with tyramine sensitivity other than a strong recommendation to have wine or cheese, not wine and cheese, since combining the two will make the situation worse.


Prostaglandins, hormone-like lipid compounds, are in the tissue of pretty much all animals and are also found in wine. They are linked to pain and inflammation, both of which can contribute to headaches. Drinking wine might temporarily change the balance of prostaglandins in your body, resulting in a headache.

Solutions for RWH

There is not a single solution that will work for every RWH sufferer. But here are a few possible solutions:

  • Take ibuprofin, acetaminophen or aspirin one hour before drinking red wine.
  • Take an antihistamine one hour before drinking red wine.
  • Drink black tea before drinking red wine.
  • Try a small amount of red wine and wait 15 minutes. If you don’t feel a headache coming on, the wine you’re drinking is probably fine for you.
  • Stay away from really cheap wine.

If you suffer from RWH, try each of these remedies at different times and keep a journal to track your reactions.

I would love to hear from you about your experiences with RWH.

As an independent wine consultant with WineShop At Home, I absolutely enjoy bringing a taste of the Napa wine country home to you one sip at a time. Whether you simply love to drink wine, seek a special personalized wine gift, or are in search of a new wine jobs opportunity as a wine consultant, feel free to contact me for a truly unique wine tasting experience!

Cheers, Betty Kaufman
WineShop At Home

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  1. I am lucky that I alost never get headaches. Like maybe 5 my whole life. But, I have learned that I have a CHEAP wine aversion. When I drink super cheap red wines, I feel like hell. Even if I drink lots of water in between and before and after. I find, that even though my palette does not necessarily appreciate all of the differences between the GOOD STUFF and the cheap stuff – my body sure does. (Though, thanks to Betty, I am learning to appreciate all of the good stuff in good wine!)

    1. On the headache front, I feel very lucky too.

      I wonder why people seem to be more sensitive to the cheap stuff. Rob, if you are reading these comments, can you add any insight?

  2. I don’t know the answer. But that won’t stop me from answering. 🙂

    Here is my guess: Most of the “cheap” wine we drink in the US is grown in very hot climate areas (particularly, California’s Central Valley) and from unpruned vines. Grapes grown in hot areas end up low in acid. So to make the wine more palatable, the vintners add commercially produced acid to balance out the tannins and alcohol. (This is perfectly legal in the US. Ironically, adding acid is illegal in France, although sugar can be added there to bolster the alcohol levels – but adding sugar is illegal in the US! Go figure.)

    My hunch is that this acid addition might tend to cause headaches.

    The only other theory I can think of is that it is really just the lack of any barrel/bottle aging of cheap wines. Aging allows some of the short-chain tannins (the ones which make the mouth feel itchy or raw) combine into long-chain tannins. As wine drinkers, we think of wine as “smooth” when there are a lot more long-chains than short-chains. Perhaps the tendency to push cheap bulk wine out the winery door as soon as possible plays a role in the great headache mystery?

  3. Interesting stuff! I don’t suffer from headaches, but with some red wines my nose gets stuffed up and I feel as though I am having an allergic reaction. I haven’t documented when it happens and with which wines, but I should do that. Didn’t have any problems with that while drinking the wine in Italy!

  4. I usually get headaches from red wine too so haven’t had it in years. I am going to try again following your suggestions!

  5. Hi Betty,
    How are you these days? Thanks for sharing this. I was reading your post about sparkling wine and came across this one. I also suffer from wine related symptoms and have also done a lot of research on the causes. So I am always interested when I find more information about wine related sensitivities. Thanks for the helpful post. Wine related sensitivities can be frustrating since it’s like playing detective to figure out which wine or type of wine causes symptoms. After more than 1 year of playing detective, I am a little closer to understanding my situation. I know that when I have more than 8 oz in one evening, I experience symptoms such as: fluid build up in my left inner ear which feels like swimmer’s ear which then causes white noise ringing in my ear; and/or sometimes like seasonal allergies (phlegm and coughing). I have also found that my symptoms have nothing to do with price of the wine or the color of the wine.

    1. Hi Melinda. Thank you so much for commenting. I had no idea that you struggled with wine issues. Wow. I guess it happens to the best of us. Interesting that your sensitivity is not price or color related. I hope that you are able to get to the bottom of this, so you can enjoy wine more often. Happy New Year!

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