After “What’s your favorite?” and “Why do some cost more than others?” the questions about wine I most frequently get asked concern headaches. Why do I get them, and what can I do to avoid them?

Actually, more often these questions are framed as assertions: I can only drink wines without sulfites because sulfites give me headaches. Red wine gives me headaches. The only wines I can drink without getting headaches are certified organic.

With rare exceptions, such lone-factor claims are erroneous. There is no single reason a particular person might experience headaches after drinking wine, unless there was a distinct whack on the skull or some other obvious cause. A headache is usually a complicated nexus of factors unique to the headache-holder. We can investigate possible factors, but a static conclusion is likely to remain out of reach.

I personally do not get headaches from drinking wine. Therefore, everything I say here remains in the realm of the theoretical. But with a decent combination of information, experimentation and self-study, those who do get headaches might find ways to reduce their likelihood.

The self-study part is especially important. Self-study, self-curiosity, self-questioning are all not only crucial to a lasting appreciation of wine – or of anything important – they are ultimately why trying to appreciate wine holds any value whatsoever.

If you get headaches from drinking wine, I’m very, very sorry. And I hope even a tiny bit of what you find in the rest of this column can help. Perhaps the spirit of self-study, since it animates the deepening of love for wine just as it might animate a better understanding of how to consume it salubriously, can unite us all.

So here’s where I’ll start: Wine ought to be drunk with an intention of maintaining health. Health exists on physical, physiological, neurological, psychological, emotional, social and cultural levels. Wine can contribute to health along all these planes. It can also damage health along all of them.

I’m aware of a handful of factors that might be responsible for causing headaches, but I’m more familiar with the ways one can promote health and thereby prevent or minimize headaches. Building health ought to go hand in hand with preventing illness.

Of course, headaches aren’t the only, or the worst, ill effects of wine consumption. Besides the debilitating consequences of alcoholism itself, some people experience allergies and intolerances, even some forms of cancer.

On the positive side, moderate alcohol consumption is – or is hypothesized to be – beneficial to physiological health, through less coronary heart disease, kidney and prostate cancer, fewer ulcers and improved cognitive health, including reducing the development of dementia. Add to these topics the emotional, social and cultural health pros and cons, and we could talk all night – but they are beyond the capacity for today’s column to explore.

So let’s return to headaches, and dispense with a couple of false culprits. Sulfites are not causing your headaches. There are far more sulfites, by factors in the dozens, in everything from canned tuna to orange juice to dried fruit and potato chips than in the most over-sulfited wine ever made. Sulfites occur naturally during fermentation, but are also added as an anti-oxidative to most wines, either during fermentation or just before bottling, or both.

Sulfites are a complex topic unto themselves, but I like to stick with wines where they are added just once, just before bottling, in minimal amounts (under 20 milligrams per liter).

Nor are tannins responsible for headaches. Tannins are found in the skins, stems and seeds of grapes, and in the wood used to age some wines. Tannins, at levels comparable to or above those in wine, are found in nuts, chocolate, tea, beans, berries and more. Unless your diet is extremely restricted or you get headaches every day, tannins are not to blame.

The most obvious headache-causing factor in wine, for everyone, is alcohol. Sorry, but there’s no way around this. The more alcohol you consume, the greater your risk of a headache. As alcohol breaks down in the body, it produces acetaldehyde, which along with the alcohol travels from your blood to your brain and spinal cord fluids. There, they irritate the brain tissues, which you experience as a headache.

Reduce the effects by drinking less wine, drinking wine with less alcohol (even half a percentage point is significant), drinking more water alongside the wine, eating food as you drink. Obvious.

What’s less obvious, indeed what is often purposefully hidden, is what can be – and often is – added to wine as it is produced. The overall image of wine is that it is crushed grapes, whose juice naturally ferments into wine. Some wines are made this way. Indeed, most of the wines I write about in this space every week are made this way. But the majority of wines are not.

The majority of wines are industrialized product, manufactured cheaply and artificially just like overly processed foods. The main difference is that there are at least some labeling laws in place concerning what has gone into the food you buy. If you can afford it and have been moderately well educated about food production, you probably steer clear of foods listing ingredients you can’t pronounce, coloring agents, preservatives and other extraneous items.

No such luck with wine, unless you ask hard questions. An incomplete list of wine additives allowed by the USDA and bearing no obligation to be listed anywhere includes gelatin, dimethylpolysiloxane, various carbohydrases, sugar, polyoxyethyline 40 monostearate, acidifiers such as tartaric and fumaric acid, silica gel, bentonite. These and other additives are used to color, stabilize and adjust the flavors of wines.

Most cheap wines are cheap because corners have been cut, in part by using those additives. They are approved by the U.S. government as well as, in many cases, the European Union. Wines can be made with “organically grown grapes” and still be subject to rather aggressive chemical and physical manipulation after harvest.

I don’t want to consume these beverages, which I don’t really consider wine. I’m not sure what their relationship is to headaches, but I do know that when I drink wines made outside the industrialized model (honestly, at this point that’s almost all the time, and I drink plenty of inexpensive wine), I can drink quite a bit of it – white, pink, yellow, orange or red – and feel fine.

I’m guessing that the reason at least some people get headaches from wine is that they’re drinking the wrong wines.

Experiment for yourself. If you experience headaches from drinking wine, isolate the possible causes and dispense with each, for equal, controlled periods of time.

A recap of possible causes and suggested remedies:

 Too much wine; drink less.

 Too much alcohol; start by drinking only wines with 13 percent alcohol or lower.

 Not enough water; drink at least 12 ounces for every glass of wine.

 Failure to take two or three ibuprofen tablets before bed after you’ve had more than two glasses of wine; I haven’t yet mentioned this, but seriously, it’s my fail-safe hangover-prevention technique. Don’t make it a regular practice since ibuprofen, aspirin and other NSAIDs are blood-thinners, but drinking more than two glasses of wine a night shouldn’t be regular practice either.

 Wines produced with hidden chemicals and other additives; ask your retailer or restaurant server to confirm that a wine contains only grapes, native yeasts and minimal amounts of sulfur added at bottling; if they don’t know or can’t convincingly steer you in the right direction, shop and dine elsewhere.

Next week, I’ll delve into how particular wines complement diets that are designed to improve physical and physiological health.

Joe Appel is the Wine Buyer at Rosemont Market. He can be reached at:

[email protected]

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