Feel like the initial joy of sipping red wine always ends in a migraine attack? While you might be kicking yourself for drinking that glass of pinot noir, the exact cause of red wine-induced headache and migraine is unknown.

Great. So, what’s the deal with your throbbin’ noggin? Before you cut out cab sav and merlot for good, here’s what we do know.

Why does red wine cause headaches and migraine?

Science hasn’t been able to prove the exact cause of red wine-induced migraine, but alcohol in general and certain compounds in red wine are linked to causing migraine attacks and headaches.

Like other alcohols, red wine can dilate blood vessels in your brain, which can provoke a headache. Alcohol can also lead to dehydration, which you guessed it, can also lead to a pounding head.

The level of histamines, tannins, and sulfites in red wine may also cause headaches and migraine.

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According to the American Migraine Foundation, all alcoholic drinks can provoke either an immediate or delayed headache. But red wine has an especially bad rap as a headache trigger (even when compared to other alcoholic bevvies).

In a 2019 survey of 2,197 folks with migraine, nearly 80 percent of folks reporting alcohol-induced migraine actually blamed red wine. Research from 2014 also concluded that wine — especially red wine — is a very common migraine trigger compared to other alcohols.

But the exact cause of a migraine after a few glasses of red wine is likely multifaceted and may be due to a combo of the following causes.

Dehydration and vasodilation

Any alcoholic bevvy can do a number on your body. The ethanol in alcohol is a vasodilator, meaning it causes blood vessels to widen, including those in your brain. Vasodilation can fire up certain nerves in your brain that produce a pain response.

Alcohol is also a diuretic and causes your kidneys to amp up their response (i.e., having to pee mere minutes after you get back to the barstool). Before you know it, you’re tipsy *and* super dehydrated.

While these effects aren’t wine-specific, they may play a role in intensifying that dang petite sirah headache.

Histamine sensitivity

Grape skins contain histamine, which are compounds involved in immune responses that are released during allergic reactions.

Since white wine is made without grape skin, it has lower histamine content than red wine (which contains the whole grape). So, it’s possible that a histamine sensitivity could make you more susceptible to a headache when sipping on the red stuff.

That’s not what the (admittedly limited) research shows, though.

A small study from 2001 found that 16 people with wine intolerance who took antihistamines (anti-allergy meds) before drinking red wine had no notable improvements from the treatment. The researchers concluded that there’s no correlation between wine sensitivity/intolerance and the drink’s histamine content.

Still, this study is really small and dated, so we can’t rule out histamines as a migraine culprit for sure.

Other histamine-laden foods may also be triggers

Foods that have more histamine than red wine include:

Tannins

Thanks to grape skins, red wine also has more tannins. These plant chemicals give your body the green light to produce serotonin (aka the happy hormone), which can also (sadly) cause headaches in some people.

Since red wine has more tannins than white wine, tannins are a commonly called-out culprit for those fateful migraine episodes.

But while there is some older research from 2009 that shows a link between drinking alcohol with more tannins and gnarlier hangovers, there isn’t really any evidence that they can cause migraine after just a couple of glasses.

Tannins are also found in lots of other foods

If you’re tannin-sensitive, the above foods will also likely trigger you.

Sulfites

Sulfites are chemicals that occur naturally during fermentation and are also cited as a headache culprit. Sometimes more sulfites are added during the wine-making process to help preserve the drink.

But if you’re sulfite-sensitive, you’re more likely to experience breathing probs or congestion than headaches. Red and white wine typically have the same amount of sulfites, too.

Other high sulfite foods may be to blame

If you’re sensitive to sulfites, these foods will also likely trigger a reaction:

Other red wine headache triggers

Whether you get a headache from drinking red wine may depend on several other factors outside of just drinking wine. These may include:

  • other ingredients in the drink
  • what else you’ve eaten
  • whether you drank on an empty/full stomach
  • your stress level
  • your fatigue level

If you’ve called out red wine as a common headache trigger, it may be best to eliminate vin rouge from your drink cabinet altogether.

But if avoiding your beloved malbec is off the table, these lifestyle changes might help you prevent red wine migraine attacks:

  • Choose high quality wines in small quantities.
  • Avoid drinking wine on an empty stomach.
  • Drink plenty of water before and after you drink.
  • Wait an hour before your second glass.
  • Sip your wine slowly.
  • Don’t mix wine with other drinks.
  • Stop drinking wine as soon as you notice any head pain.

It may also be helpful to keep a food journal to help narrow the list down of food and drink triggers. Since wines are made from a variety of grapes, preservatives, and other ingredients, there are many potential culprits. Talking to a doctor and allergist may also help you pinpoint the food or drink giving you a headache.

Remember that any type of alcohol can lead to a headache, especially if you go a little overboard. According to 2015–2020 U.S. Department of Health and Human Services guidelines, the recommended daily max alcohol consumption is 1 drink per day for women and 2 drinks per day for men.

In a small 2014 study, high tannin red wines like tannats and malbecs were most likely to trigger migraine attacks in participants. But drinking cabs and merlot was associated with fewer migraine attacks.

While this theory still remains essentially unproven, the idea is that drinking wine with less tannins = less headaches.

So, in addition to drinking (lighter tannin) white wine, you may also want to try red wines with fewer tannins like:

  • pinot noir
  • cabernet franc
  • zinfandel
  • merlot

As soon as you notice the onset of a wine headache, it’s a smart idea to put the glass (… or mug or red Solo Cup) down and try one or all of the following:

If you take OTC or prescription headache medication, follow the label instructions and warnings carefully

Mixing OTC pain relievers with alcohol can be dangerous in some cases, especially if you:

  • take a higher dose than recommended by the bottle
  • have 3+ drinks a day while taking the medicine
  • have stomach ulcers or another bleeding disorder
  • take blood thinners

If you have a pounding headache the next morning, it’s likely a hangover and not a migraine caused by red wine.

Naturally, drinking wine or any type of alcohol can lead to a hangover headache, but that’s more reliant on how much you drink as opposed to what you drink.

Hangovers are mostly caused by alcohol’s dehydrating properties. Hangover headaches also happen due to the buildup of acetaldehyde, a toxic byproduct your body makes when it metabolizes ethanol. This buildup also leads to a throbbing head and flip-flopping stomach.

Bad news if you overindulge with wine: some limited research shows a wine hangover may actually be more intense.

Research from 2013 found wine’s higher concentrations of fermentation byproducts called congeners may linger in the body longer. This may make your body work harder to break down the ethanol and congeners = feeling more crappy and rundown.

Since headaches that onset the day after a night of drinking are likely due to hangover symptoms, try the following hangover fixes:

  • Eat up. Get your blood sugar levels back up by fueling up with some carbs. A glass of orange juice and some eggs and toast should get the job done.
  • Get hydrated. Yes, chugging Gatorade post drinking sesh really could help heal your headache. (Though the National Institute on Alcohol Abuse and Alcoholism notes that the research on this just isn’t there yet.) Losing lots of fluids from alcohol depletes electrolyte levels, but foods like bananas, spinach, kale, or avocados can help bring them back up to par.
  • Try some ginseng. Ginseng is an antioxidant and anti-inflammatory that just might help your bod break down alcohol more effectively. This may help fend off those next-day aches and pains. In a small 2014 study, men who drank a red ginseng hangover remedy after having a glass of whiskey had lower blood alcohol levels and fewer hangover symptoms.
  • Pain management. Similar to treating any headaches, try using a cool compress and lying down in a dark room. Taking an OTC pain medicine like ibuprofen may help too.

Even though your pain is legit, there’s no concrete scientific link between migraine and red wine. Compared to other types of alcohol, red wine’s relatively high tannin and histamine content may play a role in headaches and migraine.

Drinking wine varieties with lower tannin content (like merlot or pinot noir) in smaller quantities may help combat symptoms or do nothing at all.

If you think red wine is causing your headaches, try keeping a food journal to help you pinpoint your unique triggers.

And if your red wine headache is sudden, intense, or accompanied by symptoms you’ve never experienced before like fainting, fever, or stiff neck, see a doctor ASAP.