Red Wine and Migraine Headaches
Her headache was ripening. She was subject to occasional abrupt onsets of migraine and even now a thing like a starburst pulsed in one corner of her field of vision and her temple had begun to throb. -- Ngaio Marsh, Clutch of Constables.
Migraine headaches can be caused by a variety of things, most of them rather poorly understood. For about a quarter of the sufferers, specific foods seem to trigger the attacks of throbbing headache, sensitivity to light, and nausea. Alcoholic drinks, and in particular red wines, are among the commonest items named by victims as possible triggers of migraine episodes. Doctors have generally tended to blame the alcohol in wine, but a new study in London suggests that the cause may indeed be specific to the redness of wine.
The test was carried out by dividing migraine sufferers whose attacks seemed to be triggered by red wine into two groups. Eleven were given a drink of red wine, while nine had a mixture of vodka and lemonade with the same amount of alcohol. The drinks were served very cold, out of dark bottles and drunk through dark straws, and while the people were told that the beverages might contain alcohol, none could guess successfully what they were drinking. (One person thought it was cough syrup!) Nine of the eleven people who drank the red wine developed migraine headaches, most within three hours, but none of the vodka-lemonade drinkers did. No one in another, control, group of people who did not normally have migraine headaches after drinking red wine had any problem (except inebriation) after drinking a similar amount of the wine.
What made the difference? If people had known what they were drinking, the headaches might have come because they were expected -- which is why the drinks were disguised as much as possible. A chemical called tyramine, which is sometimes blamed for migraine attacks, was present in very low amounts in the red wine used, but the amounts were so low that tyramine was also believed to be an unlikely source.
Red wines are red because of a group of chemicals, called phenolic flavanoids, which are leached out of the skins and pips of the grapes into the wine during fermentation. White wines, which have the skins and pips strained out before fermentation, have only about a twentieth as much of these chemicals as do reds. Exactly how the phenolic flavanoids would produce a migraine headache has not yet been fully explained, though it is known that people whose migraines seem to be related to their diets often have a deficiency in an enzyme that helps inactivate phenols. Another question that needs to be addressed is the role of the alcohol interacting with the phenolic flavanoids in the wine. Would the skins of fresh red grapes produce migraine headaches in those people susceptible to red wine?
One account of the experiment suggested that some of the phenolic flavanoids in red wines become part of the sediment that forms as the wine ages, and that migraine sufferers might be able to tolerate well-aged and carefully decanted red wines even though they could not safely drink young, rough, red wines with all of their flavanoids intact. Again, this idea has not really been tested.
All of this, of course, applies only to those food-sensitive migraine sufferers who are subject to migraines after drinking red wine. But at least it is now recognized that in this particular case, the alcohol itself does not seem to be causing the problem.
