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My Sulfite Headache

“I think I’m allergic to sulfites. This wine gave me a headache.”

“Well, how much did you drink?”

“… a bottle?”

It happened so many times during my time as a wine salesperson that it had become one of our most standard jokes, some of us even going so far as to just cut out the second line: “This wine gave me a headache.” ––“Well, you’re not supposed to drink the whole bottle!” Most of the customers grinned sheepishly at this and agreed that maybe they’d overdone it. Yet the next time they shopped for wine, they’d ask for the “sulfite-free wines,” and I had to adopt several meditative breathing practices to avoid barraging them with Well Actuallys. Once in awhile, I’d get one who was sure the headaches were coming from “tannins,” and I’d fight back a Nathan-Lane-in-The-Birdcage shriek: “TANNINS?!” It’s no wonder my manager referred to the topic as “the retailer’s headache.”

The second installment of my wine science series is dedicated to all those customers with headaches.

I’d like to focus this discussion on sulfites, the most commonly implicated culprit, though I’ll touch on other components of wine that have been studied as possible headache triggers. In the wine world, sulfites are commonly found as powder (potassium metabisulfite) and a gas (sulfur dioxide/SO2). By the time I started encountering the Sulfite Fear on a regular basis, I’d already worked for two years in wine cellars. That means, at least once a season, opening up a jar of potassium metabisulfite without remembering to exhale and hold it away, and getting a face full of the stuff as it rises in a cloud from the jar’s lid. What ensues is coughing and sputtering like you just took a sip of beer right before seeing your ex walk into the bar with your arch nemesis. It burns a little, makes you cough; I’m an asthmatic, and it reminds me of a mild, short-lived flare-up. It’s something you try to avoid, especially because it shouldn’t get in your eyes, but unlike many accidents that can happen in a cellar, it’s not a rush-off-to-the-hospital scenario. And the only headaches I’ve ever gotten from sulfites were due to frustration about their bad rap.

Sulfites act as a preservative in a wide variety of common foods, from raisins to shrimp. We add potassium metabisulfite (affectionately known as “meta” or “KMS”) repeatedly during fermentation is to kill off wild yeast strains, preserve color and freshness, and increase shelf life. I make small sulfite additions throughout my winemaking process; if I didn’t, my wine would be even more susceptible than homemade wine already is to spoilage and other annoying problems that ruin a wine’s flavor. I’m glad sulfites exist, to be honest. They’re insurance and protection against many flaws.

Sulfites are also––repeat after me––a natural byproduct of fermentation. We add KMS a few times throughout the winemaking process (about 50 parts per million), but even if we didn’t, SO2 would still be there in trace amounts––about 10 ppm––as a byproduct of yeast metabolism. When you see “no sulfites detected” on a wine label, it means no added sulfites, and the wine will probably have a much shorter shelf life than the average bottle. (That means approach with caution: unless a salesperson has tried it recently and can advise you, you have no way of knowing if it’s still good.)

That said, even mainstream wine doesn’t have a lot of sulfite in it compared to other things we encounter regularly.  While the maximum allowed in winemaking is 350 ppm, most commercial wineries, including everywhere I’ve ever worked, keep their additions at around 50 ppm; unless you’ve somehow neglected your wine to the extent that a wild yeast menagerie is setting up shop in your tank, there’s no reason to use anywhere near the upper limit. Dried fruit, by contrast, has over 100 ppm and sometimes as much as 1,000 ppm. The FDA requires that all food containing more than 10 ppm of sulfite must include sulfites on the label.

Now’s a good time to mention that you probably aren’t allergic to sulfites. The incidence of sulfite sensitivity among asthma sufferers is estimated at 3.9 percent, and very rare among the general populace. While a sulfite reaction is not a true allergy, the symptoms are similar: wheezing, shortness of breath, swelling, and/or a rash. So although sulfites create a reaction for a small number of people, they’re not specifically a cause of headaches.

However, if you are diagnosed with a sulfite sensitivity, keep in mind that white wine contains a much higher level of added sulfites than red (if you smell a glass of recently bottled white wine, you might get a little prickle in your nose from lingering sulfites, since there’s typically a final addition at bottling time), and preserved foods an even higher amount. No-added-sulfites wines vary in quality, but I’d like to save that discussion for a forthcoming post on the “natural wine” movement.

 Other possible headache causes

Tannin is a compound that comes from grape skins and seeds. When you’re making a red wine, you ferment it with the skins included, rather than pressing the juice out and discarding the skins, so that your wine will have both color and tannin. On the palate, tannin coats your lips and tongue, stains your teeth and lips purple (widely advertising your previous night’s excesses to the world), and leaves a drying, gritty texture in your mouth. When they’re not overdone, tannins give wine heft and “structure” (a wine term for the frame or “muscle” of your red wine), and, to some extent, contribute to a wine’s ability to age. Big tannins (you’ll see them described as anywhere from “supple” to “face ripping”) are your wine’s way of letting you know that it totally blasted its pecs today.

If you’ve ever blamed a headache on tannins, I’d like you to ask yourself if you’ve ever gotten a similar headache from chocolate, walnuts, or tea. All have tannins, yet it’s rare to hear people complain of a “chocolate headache” or “walnut headache.” However, the way tannins bind starches may inhibit serotonin, so if you’re very sensitive to serotonin deficiency, you may get a headache from anything with tannin.

Ultimately, there’s no proven link between any individual component of wine and headaches.

Yet the search isn’t over. Also naturally present in wine, histamines and tyramine have recently been studied as possible headache triggers. If you’re sensitive to tyramine, a chemical compound that can raise blood pressure, then aged cheeses, smoked or cured meats, and citrus fruits would also give you a headache. Histamines have not been shown to cause headaches in the general populace––again, unless you’re histamine-sensitive, in which case your doctor may recommend taking an antihistamine to avoid headaches. Histamines are found in many fermented foods, so if you get headaches from tofu and tempeh as well wine, that could be the culprit.

Migraines, of course, are much more serious than the typical hangover headache. If you get migraines, you know that trying to eliminate variables and figure out your triggers can be challenging. Scientists continue to study the incidence of migraines in conjunction with alcohol and food to try to determine triggers. A 2007 study led by Alessandro Panconesi, the full text of which is available for free, noted, “Recent studies show that alcohol acts as a trigger at least occasionally in a percentage similar to that of the previous studies (37%), but as a frequent/consistent trigger in only 10% of the patients,” adding that variations by country may indicate that cultural drinking habits play a role. Stress drinking, too, has been indicated to relate to an increased frequency of migraines. If you get migraines, it’s possible certain types of alcohol could be a trigger for you, and this is a special medical case on which I as a non-doctor won’t try to advise.

For the rest of us, I hate to be Captain Obvious, but it might just be the alcohol. It’s not necessarily common knowledge that red wine is higher in alcohol, generally speaking, than white. When I drink Australian shiraz, I get flushed and usually experience a headache, but I know it’s not sulfites or tannins due to the rest of my habits. Instead, I suspect it’s the super-ripe, fairly high alcohol content style common among these wines: for someone who typically drinks delicate, cool-climate reds that are 12.5 to 14% alcohol by volume, 16% is a lot, and the jammy sweetness goes to my head pretty fast.

My advice for avoiding a wine headache? Have your wine with food (it’s more fun that way… stay tuned for the next post in this series!) and chug a glass of water with every drink to avoid a hangover. And let’s be clear: if you have more than four or five drinks in a sitting, you’re meeting the standards for a binge drinking session, and I’m not judging you, but your body might. All the no-sulfites-detected wine in the world isn’t going to make your drinking habits more responsible.

 

 

Julia Burke

Julia is a wine educator with an interest in labor and politics in the wine industry. She has also written about fitness and exercise science, mental health, beer, and a variety of other topics for Skepchick. She has been known to drink Amaro Montenegro with PB&J.

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23 Comments

  1. My nitric oxide research seems to indicate that headache after drinking is a compensatory response. I am pretty sure it is not a bug, it is a feature.

    It is rather complicated, and I am leaving out a lot of the details because I don’t want to go on for hours.

    Migraine seems to be due to ischemic preconditioning in the brain, that is a state that the brain can get into where it shuts down processes (like healing) so as to preserve viability. The brain requires a continuous supply of ATP. If that is compromised, the brain responds by making more and/or using less (or both). Ischemic preconditioning is the name given to that (very complex state with many different degrees). You can induce that state by short periods of ischemia, the state then persists for some time (24 hours or so), and during that time, the tissue compartment (all tissue compartments can do this) is more resistant to ATP deprivation that without the ischemic preconditioning. The signaling that triggers ischemic preconditioning is low ATP, low NO, or high superoxide. These are all coupled and activating any one will cause the others to go in the same direction.

    The data on migraine seems to indicate that it is a state of ischemic preconditioning, and a state of low NO (and not high NO causing vasodilatation).

    I suspect that a lot of neuroinflammation is a “feature” to protect the CNS from too high a NO level during sepsis. During sepsis, the NO level is made very high so that bacteria don’t attach to the vasculature. As bad as bacteria in the blood stream are, bacteria forming a biofilm on the inside of the vasculature is easily 100 times worse. In an evolutionary sense, it is “worth” responding very strongly to the presence of bacteria in the blood stream with a response that all by itself can be fatal (i.e. sepsis). What evolution has done is configured the immune response to minimize the sum of deaths from too weak a response (death from infection) and from too strong a response (death from sepsis). To minimize the sum, you have to have some deaths in all categories. I think that much neuroinflammation is to protect the CNS from the very high NO levels which would otherwise shut down ATP production by mitochondria. Neurons only make ATP with mitochondria, neurons can’t afford to have mitochondria shut down, so neurons have to generate sufficient superoxide to lower the NO level in the vicinity of neuronal mitochondria.

    In some ways alcohol mimics the effects of high NO; increased fluidity of membranes. I think that alcohol triggers some of the same high-NO pathways that are triggered in early infection, so the immune system then triggers pro-inflammatory response to compensate. The pro-inflammatory response proceeds with the time constant of the immune response which is slower than the alcohol clearance by the liver.

    1. Interesting! This is specifically relevant to migraines, or to the common “red wine headache” that non-migraine-sufferers claim to experience?

    1. It’s higher than average––hence my reaction, I suspect––but I’ve seen it in mainstream Australian wines, though they’re starting to pull back in reaction to customer preference. California and Chilean reds, too, saw a rise in average alcohol content that was starting to become really apparent when I was working in wine retail. Wine writer Jancis Robinson’s thoughts on the trend: http://www.jancisrobinson.com/articles/a201201133.html

      1. Thanks for that link, very interesting. It suggests the labels are understating alcohol compared to actual measurement, which could explain things.
        I have never to my knowledge drunk a shiraz of 16%, but then, I drink a lot less these days and I’m conservative in my choices so may have missed the trend.

          1. Begone temptress! – ooo – McLaren Vale you say? I used to prune vines myself in a vineyard down there, we have friends there and it’s basically home so must try! Thanks for the tip!

          2. Julia, I keep meaning to give you feedback on this.

            First, if you ask around, people tend to roll their eyes a bit and grumble about “Made for the American market” and “overpriced for what it is”.

            However, I bought a bottle of the Merlot first. That was so heavy it was like a port, I could not finish it in one go (this, you may guess, is unusual!).

            Undaunted, I bought a bottle of the Two Left Feet and took it to dinner at a friend’s place to see what he thought. With plenty of time to breathe and with a barbecued steak dinner, we all thought it was majic!

            I was going to attempt the “double blind crossover “experiment, where I got “blind” one night on the sixteen percenter, and the next night on a 12 percenter, then try it again in reverse order to see if the hangover was worse.
            Perhaps fortunately, things have not panned out that way.

            Anyway, thanks for the tip, it was all an interesting experience!

          3. Thanks for getting back to me! I would definitely agree with both criticisms of Mollydooker; I’ve found them quite overpriced, but they’re a textbook example of plush, super-ripe, high-alcohol Aussie wines. I did enjoy the vintages of Two Left Feet I’ve tried.

            I suspect if you were to put a 16% and a 12% ABV wine next to each other you would be able to detect a boozy character or at least a greater body in the former, unless its alcohol was remarkably well concealed or the 12% was remarkably ripe for the grape variety. BYDHTTMWFI.

  2. A question: I can drink white wine with little ill effect. But even small quantities of red gives me a banging headache. Fast.

    Many years ago before I acquired a more skeptical approach to information purported to come from “science” I read that people with strong adverse reactions to MSG also often had bad reactions to sulfites (I’m afraid that I believed it at the time, given that a red-wine-headache hits me much sooner than an MSG one). I have since learned that the connection to sulfites is unproven. That said, any info on a connection between MSG sensitivity and red-wine-headache? Again, in my case we can eliminate higher alcohol content because the RWH starts in most cases before I’ve have drunk even half a glass.

    1. Hmm, I haven’t found anything, but I’ll ask around.

      Do you get reactions to anything else that has tannin, histamines, or tyramine? Or anything else with MSG (many sauces and other prepared foods)?

      1. Do you get reactions to anything else that has tannin, histamines, or tyramine? Or anything else with MSG (many sauces and other prepared foods)?

        No, only MSG and red wine. I carefully avoid anything with MSG in it, read food labels, ask in restaurants before I order, etc. As for tannins, I drink lots of black tea and eat smoked foods. I don’t know what has histamines or tyramine in it, so I can not answer that one.

  3. Maybe it’s the flavonoids. Red wine has a lot of them and during the body’s process of eliminating them there is a temporary up tick of blood flow and increase in uric acid production.

  4. Even tiny amounts of white or red wine give me massive migraines. My in-laws live in the wine country of the Okanagan Valley in B.C. (Like the Napa Valley in California). They are big wine drinkers, and tell me I should experiment and find wines that don’t give me a headache. I told them that I don’t like wine enough to go through the headaches to find one wine (maybe) that does not incapacitate me from one sip. I have no such problems with beer or hard liqour. When visiting them or in gatherings where wine is consumed, I usually drink a beer, a gin and tonic, or rye and coke when they are having wine. No headaches!

    1. Migraines are especially tricky; I don’t get them personally but I know triggers vary widely from one person to another. If you’re fine with beer or liquor it wouldn’t be the sulfites, yeast, or alcohol content; maybe you’re one of the select few with a tannins as a trigger?

      I love Okanagan wines! One of my favorite winemakers, Ann Sperling, makes wine in both the Okanagan and in Niagara, Ontario, about 20 minutes from where I used to live and work.

  5. I get red-wine triggered migraines as well – I’m not a science person, so I don’t claim to be an expert in the cause of them, but it’s usually after a few sips, and the onset is almost immediate. I can drink most white wine and hard alcohol without a similar issue (that’s not to say I don’t get a hangover if I drink too much of these, but a dehydration headache a fundamentally different experience than a hardcore migraine). I’ve also experienced this onset with one or two “darker” whites (Gruet from New Mexico, a fairly “earthy” dark white sparkling wine, had the same effect – half a glass in, I couldn’t feel my left hand).

    Given that the biggest issue this has created for me is the funny looks I get when ordering white wine with a steak, or not being able to split a bottle of red with a table of friends, it’s not really a major hardship, but it’s still quite annoying.

  6. When you see “no sulfites detected” on a wine label, it means no added sulfites

    I think my brother’s reaction to sulfites is genuine–he is asthmatic, for one thing, which you article implies makes it more plausible. Anyway, he claims that there is a big difference between “no sulfites added” and “contains no detectable sulfites”. He can drink the latter without any problems.

  7. Damn, I wish the site allowed one to preview a post before submitting it. I had attempted to lead that with blockquote from the article:

    When you see “no sulfites detected” on a wine label, it means no added sulfites

  8. Good post. I’m wondering about this though:

    > Histamines are found in many fermented foods, so if you get headaches from tofu and tempeh as well wine, that could be the culprit.

    Tofu isn’t fermented, it’s coagulated with gypsum. Does this section about histamines still apply?

    I’ve generally assumed that headaches related to alcohol are because of dehydration: You drink a bunch of diuretics (alcohol), and then when you get thirsty.. you drink more diuretics, and then you go to bed and don’t drink anything else for 8+ hours. Drinking a giant bottle of water between drinking and going to bed has completely stopped day-after-drinking headaches for me and my old roommate, but we also don’t drink nearly as much as we used to..

    1. Interesting question about the tofu! The famed “Chinese restaurant syndrome” (MSG reaction? Fried food overdose by mall-goers?) has yielded some research into the presence of histamines in foods used at American Chinese restaurants, and especially in soy foods. “Soy foods” as a category have been pointed to as having a high amount of tyramine, but I haven’t found a distinction between “fermented soy foods” and “foods made from soy.” I’ll keep digging around. Thanks for bringing it up!

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