The Mystery of the Red Wine Headache: What’s Really in Your Glass?

Last summer, I went on a European adventure with one of my college roommates. We spent three weeks traveling around Europe.

Our last hotell (which my friend booked) was extra fancy — complimentary wine in the lobby — something I had never experienced before.

With this news, I was all for staying put and enjoying the hotel’s amenities, but my friend couldn’t even finish her first glass of red wine.

She confided in me that even the smallest amounts of red wine would give her a headache—not a hangover headache when she woke up the next morning—but an instant throbbing in her brain.

Luckily, the good friend that I am, I finished her glass for her.

But, this unfortunate truth piqued my interest.

What was it about red wine, famed for its rich flavors and deep color, that allowed it to swiftly unleash a pounding headache?

A Different Type of Headache

I was surprised to find that there are?two?different types of alcohol-induced headaches:

1. Immediate?or?primary?headaches begin within 30 minutes-3 hours of alcohol ingestion.
2. Secondary?or?delayed?headaches developed within 5–12 hours of alcohol ingestion.

Most of us are familiar with the latter — a classic hangover after a night of overindulgence.

My friend’s struggle seems to be an example of a primary headache, commonly referred to as a “red wine headache.”

It isn’t about excessive drinking; it’s a rapid and specific response to red wine.

What’s even more interesting is people who are susceptible to red wine headaches usually have no issues drinking the same quantity of beer or white wine.

There seems to be something special about red wine and not in a good way.

The Culprit Uncovered: Quercetin

Luckily, I don’t seem to be the only one intrigued by red wine headaches.

Researchers at UC-Davis?have honed in on a specific flavanol present in red wine called quercetin that seems to be the troublemaker.

Quercetin?is a natural antioxidant found in grapes as well as other fruits and vegetables. It’s even available as a?supplement.

However, when quercetin interacts with alcohol in the bloodstream — say, after consuming a glass of red wine — it transforms into quercetin glucuronide.

This altered compound disrupts alcohol metabolism, leading to the accumulation of?acetaldehyde?— the infamous toxin known for facial flushing, headaches, and nausea.

It’s basically an uninvited guest crashing the party.

Nerds Only

I know the science dorks out there are probably craving more details on just how exactly quercetin glucuronide leads to an accumulation of toxins.

If this isn’t you, feel free to skip this section.

Alcohol is metabolized in the liver via a two-step process. First, the alcohol is converted to acetaldehyde by the enzyme?alcohol dehydrogenase.

Next, the acetaldehyde is transformed into acetate by a second enzyme called?aldehyde dehydrogenase.

The problem with quercetin glucuronide is that it inhibits the?aldehyde dehydrogenase?from doing its job by up to?80%.

The result?

The acetaldehyde concentration quickly builds up in our body instead of being converted to the innocuous acetate.

This is exactly what the?new study?explains in even more detail.

Toxin Buildup & Unpleasant Symptoms

What’s not new is that high levels of acetaldehyde leads to severe discomfort.

Disulfiram, a medication aiding alcoholics in recovery by dissuading further consumption, induces a similar acetaldehyde buildup to discourage drinking.

Many people of East Asian descent also?struggle with acetaldehyde?but in a slightly different way.

They are more likely to have an enzyme that's slow to break down acetaldehyde, resulting in its accumulation and subsequent adverse effects even when drinking small amounts of alcohol.

It seems like my college roommate isn’t alone with her problems of red wine headaches, and in fact, it seems to be quite common.

Quercetin Levels in Red Wine

If quercetin is the problem, why not just make red wine without it?

Well, it’s not that simple.

Grapes produce quercetin in response to sunlight meaning that a whole slew of different cultivation practices can influence the final concentration of the molecule.

This unpredictability complicates the selection of a wine for those prone to red wine headaches. Some varieties of red wine may be okay to drink while others will trigger that pesky headache.

One thing we do know is that?grapes grown in regions like Napa Valley?for cabernets tend to have notably high quercetin levels due to specific winemaking techniques.

Definitely avoid those bottles.

But, it’s not just about the sunlight. A long list of other factors, including skin contact during fermentation, fining methods, and aging, can also increase quercetin levels.

The Journey Ahead: Unanswered Questions

Despite identifying quercetin as the headache culprit, researchers still have more questions than answers.

For example, is susceptibility to red wine headaches determined by an individual’s enzyme responsible for acetaldehyde breakdown? Or are certain populations inherently more sensitive to acetaldehyde accumulation?

There’s room for experiments too — comparing wines with different phenolic levels — although this is hampered by the lack of a quick and easy method to quantify quercetin.

This could be circumvented by conducting tests instead with quercetin supplements or placebos alongside standard alcohol.

I even know someone who I’m sure would volunteer to be a subject.

For the wine enthusiasts (and my dear friend) who yearn to one day enjoy their favorite red wines without the looming threat of throbbing discomfort, have no fear, the scientists are on it.

But for now, maybe opt for a glass of white wine or beer.