Dit bericht is ook beschikbaar in: Nederlands (Dutch)
Headaches and Wine: Don’t Blame the Sulfites
Geschatte leestijd: 11 minutes
‘I get a headache from just one glass of wine, and I think it’s because of sulfite.’ One person complains of a headache from drinking red wine, and another gets it from white wine. Both contain sulfite, it’s true. So does rosé, for that matter. But scientists agree that sulfite in wine does not cause headaches.
So what is it? Because a number of people do get headaches from drinking one glass of wine, sometimes even after just a few sips. Could it be because of tannin, which is mostly found in red wine? Is it alcohol or is it other substances found in wines, such as the so-called biogenic amines; histamine and tyramine? I did some research.
It is a widespread idea that there is a link between headaches and sulfite in wine. This may be because every bottle of wine states that the wine contains sulfite. As a kind of warning; Attention! contient des sulfites, Watch out! contains sulfites, sometimes in as many as six languages.
Wine always naturally contains sulfite, it is in and on the grapes and is released during the fermentation of the must. Depending on the grape varieties, the soil, the yeasts used, there is a basic amount of sulfite of 5 to 30 milligrams per liter present in wine.
Winemakers add sulfite to stop the fermentation process in wine to keep fruity wines. In addition, sulfite protects wine from oxidation and unwanted growth of bacteria and fungi. When bottling wine, some sulfite is often added at the last minute to extend the shelf life in the bottle.
Because red wine contains tannin – a chemical compound that contributes to the shelf life of wine – less sulfite is needed. White wine and rosé contain little or no tannin by nature. Hence, some extra sulfite must be added to those wines to have a better shelf life.
Brussels has decided, because of food safety, that sulfite is allowed in wine, albeit in a limited way. The use of sulfite according to European legislation: red wine may contain up to 150 mg of sulfite per liter, white wine and rosé 200 mg per liter. For organic wines, the rules are even stricter; for example, a maximum of 100 mg of sulfite per liter for red wine.
Dutch Nutrition Center
Much has been published about sulfite, but nowhere has it been linked to headaches. For example, the Dutch Nutrition Center, het Voedingscentrum – a government-funded nutrition educator – writes on its website: ‘Sulfites (E numbers E220 to E228) are preservatives. Examples of ingredients and products that often contain sulfites are fruit, fruit juice, dried vegetables and potatoes (…), raisins, tomato paste, sugar, glucose syrup, sauerkraut, mushrooms, broth, gravy, soup and sauces.’
Further, the Dutch Nutrition Center mentions that most people are not hypersensitive to sulfite. But if they do, the reactions can vary, from very mild to severe. These may include heart palpitations, skin rashes or fluid retention. Headaches as an allergic reaction to sulfite are not mentioned by the Dutch Nutrition Center.
Sophie Parker-Thomson MW
In her graduate thesis on sulfite and biogenic amines in wine, Master of Wine Sophie Parker-Thomson describes that several clinical studies have shown that there is no link between headaches and sulfite. Sulfite does cause a respiratory reaction in 3 to 10% of people with asthma. According to Parker-Thomson, the more likely cause of the headache is a group of compounds called biogenic amines. Examples include histamine and tyramine. I will return to that below.
Ronald S. Jackson
Even in the impressive standard work on wine, Wine Science by Ronald S. Jackson, in which he cites hundreds of studies to describe the making and effects of wine, he makes no direct connection between sulfite in wine and headaches.
Jackson describes in detail the importance of sulfite in wine as an antioxidant, the relationship between sulfite and yeast during winemaking, and what the effects of SO2 may be on people with asthma. But a relationship between headaches and sulfite has not been found.
The National Headache Foundation of New Orleans (USA), founded in 1970, is even more outspoken about sulfites: ‘Headaches and Wine: Don’t Blame the Sulfites.’
The question of what causes some people to get headaches from wine is apparently not easily answered. From too much wine – meaning too much alcohol – you can get a headache, that’s for sure. But not after just one glass, you really need to drink a few. And usually, too much alcohol doesn’t give you a headache and a broke feeling until the next day; the well-known hangover.
In fact, alcohol stimulates fluid retention, causing the body, and therefore the brain, to become dehydrated. That’s what causes the headache. In addition, too much alcohol causes over-stimulation of the stomach lining (gastric mucosa) resulting in nausea and vomiting.
Tannin, also known as tannic acid, is found primarily in red wine and significantly less in rosé. There is basically no tannin in white wine. It is found in the skins, seeds and stems of grapes and is released during the winemaking process. It enhances the shelf life of wine. Hence, red wine usually has a (much) longer shelf life than white wine. The presence of tannin in wine can be recognized by a drying, stiff feeling in your mouth.
It is rare, but people can be hypersensitive to tannin. This can be easily tested by drinking a strong cup of black tea, as it contains a lot of tannin. Will you get a headache? Then in your particular case, tannin may be the cause of headaches after drinking wine. However, the most common symptoms with tannin intolerance are nausea and a stuffy nose; not headaches.
Other substances in wine are the so-called biogenic amines, such as histamine and tyramine. They are breakdown products of proteins created during winemaking. Histamine, in particular, is considered a possible cause of headaches.
Biogenic amines are widespread in our diet and are formed mainly during food alteration processes such as through fermentation in wine, ripening of cheese, fermentation of sauerkraut and drying of fruit and sausages.
Wine is created by yeasts – single-celled fungi – converting the sugars in grape juice into alcohol and carbon dioxide (CO2). If the sugars are exhausted, then after some time a second process starts, the malolactic fermentation, or malo for short. Bacteria convert the sharp malic acid present in the wine into the softer lactic acid.
During this second process, the malo, the biogenic amines histamine and tyramine are formed.
Most red wines have had malo and some white wines too; like many white Burgundies. With white wines, however, the winemaker usually chooses not to let the malo take place because it is precisely the malic acid that is desired to give the wine freshness. As a result, the amounts of histamine and tyramine in white wine are very low.
Probably the best known and most researched biogenic amine is histamine. A hypersensitivity reaction to histamine usually produces symptoms such as gastrointestinal upset, palpitations, itching and … headaches. When there is an excess of histamine in our bodies, a reaction occurs immediately.
Histamine is an important body chemical that ensures proper functioning of respiration, blood circulation, wound healing and fat digestion, among other things. It also plays an active role in our immune system, helping to fight off invaders and pathogens.
Excess histamine is normally broken down in the body by the enzyme diamine oxidase (DAO). If the body takes in an additional dose from outside sources (the wine) on top of the histamine already present, the DAO enzyme may not be able to sufficiently break down the histamine. An intolerance reaction then develops, resulting in a headache.
The biogenic amine tyramine is also thought to be a direct cause of headaches. Researchers at the American Diamond Headache Clinic studied the relationship between headaches and red wine. This showed that especially young and unfiltered red wines (natural wine!) increase the risk of headaches, and that the substances histamine and tyramine play an important role in this.
Tyramine plays a role in the regulation of blood pressure. In the case of excess tyramine, the enzyme monoamine oxidase (MAO) causes degradation. If the enzyme cannot cope with the extra dose of tyramine – for example, by drinking wine and eating mature cheese that also contains tyramine – your blood pressure can rise rapidly, giving you a headache.
Based on the many studies on histamine and tyramine, the conclusion is that people who are hypersensitive to either biogenic amine may experience headaches after drinking just a small amount of (red) wine.
With respect to histamine, there is something special going on in our bodies. The histamine stored in our bodies can be released by so-called histamine liberators, substances we take in through our diet.
Naturally occurring histamine liberators are found in many of our foods such as pork, fish and seafood, strawberries, citrus fruits, egg whites, alcohol, nuts, chocolate, licorice and various spices such as curry, coriander and bay leaf.
Certain food additives to improve color, odor, taste, consistency and shelf life are also among the histamine liberators. Examples include nitrate and nitrite salts, sodium benzoate, glutamates and … sulfite!
When histamine is released into our bodies, it is normally broken down by the DAO enzyme, so we are not bothered by it. That’s the normal process.
However, histamine liberators not only cause additional histamine to be released, but also block histamine degradation by the DAO enzyme; so double up. A lot of histamine is released in our bodies as a result.
If people with histamine intolerance additionally ingest extra histamine via drinking wine, then together it can cause an intolerance reaction, such as headaches.
Histamine in wine can cause immediate headaches for people with histamine intolerance. Approximately 1% of the population (Maintz, Novak, 2007) has histamine intolerance. And so for that group, there is a real chance of getting a headache after drinking one glass of (red) wine.
Sulfite in wine does not give an immediate headache. This has been extensively researched. But sulfite is a histamine releaser and DOA blocker. Drinking wine with sulfite then releases histamine into the body, putting people with histamine intolerance at risk of developing headaches anyway.
So it is possible to get a headache from wine after drinking one glass: it does not matter if it is red or white wine or rosé. In any case, the trigger is histamine (direct), sulfite (indirect) or a combination of the two. The prerequisite is that the wine drinker has a histamine intolerance.
The effect of sulfite as a histamine releaser, resulting in (indirect) headaches, has not been widely studied. I have only been able to find one study in which “sulfite concentration in wine is related to the risk of developing headaches in individuals who are susceptible to wine induced headaches”. Sulfite concentration and the occurrence of headache in young adults: a prospective study – Miguel Silva et al,. 2019.
Want to drink wine despite an intolerance to histamine? The greatest chance of not getting a headache then is by drinking crisp, white wines or a light rosé. So no red wine and no white Burgundies, for example, because of their malo.
And drinking a glass of water before each glass of wine will reduce the effect of the allergic reaction through dilution. In addition, to be on the safe side, do not eat products high in biogenic amines such as aged cheeses, sauerkraut and dried sausages at the same time as histamine-rich wine.
Main sources consulted
- Ronald S. Jackson, Wine Science,5th edition
- David Bird MW, Understanding Wine Technology,3rd edition 2010;
- Sophie Parker-Thomson MW, What is the Relationship Between the Use of Sulphur Dioxide and Biogenic Amine Levels in Wine 2020;
- Jan W.M. Derksen et al. Het allergieboek, 1st edition 2010;