Red wine triggers may lead to better understanding of migraine headache. A narrative review

Migraine headache is a prevalent condition that places a substantial burden on the healthcare system. It is known that certain foods, food additives, alcohol, caffeine, stress, sensory stimuli, disruptions in sleep-wake patterns, hormonal changes, and many other things may trigger migraines. Red wine is a frequently reported trigger for migraines and other headaches but it is unclear what substance(s) in red wine triggers headache and why red wine is more associated with headache than white wine, sparkling wines, or spirits. Implicated as headache triggers are biogenic amines (histamine, phenylethylamine, tyramine, and others), phenols, polyphenols, and sulfites. Enzymatic action in the metabolism of phenols and polyphenols may cause fluctuations in dopamine and serotonin levels which, in turn, have been implicated as headache triggers. The role of sulfotransferase enzymes and dopamine appears to offer a promising explanation of the red wine headache. The investigation of potential red wine triggers may better elucidate headache pathogenesis.