Medical Solutions for the 21st Century . . .
Meeting Tomorrow's Challenges Today
[Back to Newsletter Page]
[Go to Main Page]
New Answer to Old Questions       


There has been much discussion about wine and health issues. Much research has been published on wine and heart issues. What has not been discussed are some of the old issues that donít get a lot of press and where misunderstanding still exists.

The other day in the tasting room I heard the topic of Red Wine Headaches come up. I added my old answers of the cause and effect of this syndrome and then began to wonder about any research in this area. I contacted a good friend of mine, noted local vintner and physician, Wells Shoemaker. Over a glass of wine we had an in-depth discussion of new research into two of the most misunderstood issues concerning wine and health-red wine headache and sulfites.


The pretentious gentleman fixes the gaze of his adoring companion, swirls his glass, sniffs and pronounces, "Iím picking up a little sulfur hereÖ"

There are three sulfur compounds involved with wine: sulfites, hydrogen sulfide, and sulfur. While all of these contain the same element (sulfur), these substances are as different from one another as table salt, PVC pipe, and nerve gas, all of which contain chlorine of some form

Elemental sulfur itself, a yellow powder, is a soil and plant nutrient which happens to retard mold growth. It has long been used in Europe and the New World as a spray on grapevines to avoid mildew damage. While sulfur is being used less these days, many vineyards will see a spray of sulfur early in the growing season. Little sulfur will be found on the harvested grapes, and practically none of it remains after fermentation.

All proteins contain sulfur, and human beings require sulfur as a regular nutritional component. The amount of sulfur in wine is too minimal to serve a nutrient value for us; but then again, thatís why we recommend enjoying wine with a meal.


Nearly all wines now sport the label "Contain Sulfites;" a mandated warning statement. Potassium metabisulfite and sulfite for short, is added to wine and other foods to protect against oxidation, discoloration, and microbial spoilage. Without sulfites, few wines would last much more than a year in the bottle.

Two critical points---First, fermentation yeasts make some sulfite all by themselves, as do almost all living creatures, humans included. All wines have some sulfites in them. Second, addition of sulfites is not some new 20th century invention. Winemakers have used sulfites in wine for eons. In ancient times, sulfur was burned in the storage vessels, producing sulfites, which dissolved into the wine with the same advantageous effects we seek now.

Sulfites are used in much higher concentrations in many food items than you would find in wine. Dried fruits are especially high in sulfites. Sneezing, burning, runny eyes are sensations some people get when eating too many dried apricots. Too many sulfites give wine an unpleasant, bitter taste making it undrinkable.

People sensitive to sulfites will have ill effects form the much higher quantities of sulfite used in dried fruit and golden raisins. If these foods donít give someone problems, it is highly unlikely that they would suffer ill effects from sulfites in wine.

Sulfites have always been a part of wine, and are necessary to produce wines which are pleasant to drink. The amount of sulfites in wine is so small that adverse reactions would be exceedingly rare. Nevertheless, if a consumer has bad asthma or severe lung disease, it would be wise to stay away from very young, sweet, white wines. Aged red wines have very little residual free sulfite, and dry whites 2 to 3 years after bottling will likely cause no problems.

Hydrogen Sulfide

Hydrogen Sulfide, or H2S, is an acrid gas that smells of rotten eggs. Itís produced in nature by microbes acting chemically upon organic matter in the absence of oxygen. H2S can attach to organic molecules to make even smellier materials called mercaptans. The human nose can detect these sulfides at minute levels-parts per billion. Utility companies intentionally add sulfides to natural gas so that people can sniff out a gas leak long before any harm can come. H2S (lethal if concentrated) had almost deadly consequences in a fraternity prank while I was attending college.

Tiny amounts of sulfides (remember, sulfites are a different substance) may be produced during fermentation. Thatís a winemakerís challenge to get rid of these before bottling, since the odor will detract from the enjoyment of the wine.

Despite the best efforts, some wine will develop a sulfide odor after bottling. Thatís an embarrassing economic problem for the winery, not to mention an ego blow; but there is no health hazard from this tiny amount of hydrogen sulfide.

Red Wine Headache (RWH)

God created fleas, mosquitoes, poison oak, acne, corns, colic and Red Wine Headache just to be certain of Adamís on going contrition.

Lots of people will mention in the tasting room that they are "allergic" to red wine. What they describe is a pounding, symmetrical headache, associated with nausea and sometimes a flushing or "hot flashes" sensation. Itís not pleasant. It occurs relatively soon after drinking red wine-within an hour- and it usually doesnít take much more than a glass to trigger the effect.

Other beverages with considerably more alcohol do not trigger the headache, and white wine usually can be taken moderately with no ill effects. RWH is definitely different from the "hangover," which occurs 6 to 12 hours after drinking and only after imprudent amounts of consumption. Perhaps the most striking part of RWH is its resemblance to migraine headache, with its throbbing, severe pain and queasy stomach and quirks to circulation. Migraine is a common disorder, still of unknown cause, in which the blood vessels in the head constrict and then dilate. Indeed, red wine has been shown to be able to set off headaches in known migraine sufferers; but not all migraine patients experience this effect, and plenty of people without migraines do get RWH.

There is not a lot of scientific literature on RWH, since it isnít rare, novel, or sexually transmitted. However, some new information has come to light. It may be easiest to describe what it is not.

It is not an allergic reaction to alcohol, sulfites, or additives. Amines (histamine and tyramine) were thought for a long time to be the culprit. While small amounts are present in grape skins they are not present in high enough levels to be problematic. Tannins or pigments in red grapes can set off a reaction in the blood system that resembles a migraine, but this seems to affect only a small portion of sufferers.

The most recent studies lean toward a grape skin derived material that may be absorbed, then converted by the body after lag time into an active agent.

That can in turn trigger the blood vessel disturbance. One such material is prostaglandin, which is a remarkably potent substance. Prostaglandin inhibitor medicines, such as aspirin or the more potent Advil or Nuprin, have been found to block the development of RWH in some people. Some people with RWH have found it worthwhile to test their own headache physiology by taking one of the medications (such as Advil), then drinking a small amount of red wine. Some find successful prevention. Others may simply need to stay with white wine.

People who claim that they canít handle red wine are probably telling the honest truth. Be assured that it is not impurities or chemical additives or insecticide residues that cause RWH but rather a natural part of the grape as modified through natural fermentation. People respond differently to any natural substance. The key word to red wine headache is sensitivity.

[Back to Newsletter Page]
[Go to Main Page]