By Mark Force
You may know it as wine allergy, wine intolerance, wine sensitivity, red wine headache, white wine headache, asian flush – what is the origin of this problem? There are a lot of opinions, and there is some controversy about the issue. Sulfite comes up frequently, but very few people are sulfite sensitive enough for this to be an issue. Tannins and histamine have been blamed. Biogenic amines, too. Who is right? What are the triggers for this problem of wine intolerance?
Wine intolerance is a much different issue than hangover – the suffering we experience from being indiscrete about the amount of ethanol we consume! Wine intolerance reactions can be severe for some people consuming as little as a couple of ounces of wine.
Coming to Understand Wine Intolerance
Over ten years ago a patient asked me if I could help her be able to drink wine again.
She loved drinking wine, especially whites, but had given up on it. A few years prior she started experiencing a piercing headache, foggy-headedness and fatigue after a glass of wine – or less. And, she would wake up exhausted and sore and achy the next morning.
This seemed such an interesting puzzle and sent me studying about how wine is metabolized.
After a few weeks of research I suggested a four week clinical trial of very precisely targeted vitamin and mineral formula to determine if that would improve her wine tolerance. After a few weeks she was able to joyously savor her Gewürztraminer and “buttery” Chardonnays!
The next time the issue of wine intolerance came up in a new patient history I was excited to see this patient see the same wonderful results. But, when she used the same vitamin and mineral formula…nothing – no relief – at all!
Eventually I was able to figure out the puzzle of this patients’ wine triggers, too. Over time the triggers for wine intolerance became apparent. And, the results kept getting more predictable as I kept fine-tuning the formula.
These triggers as it turns out are naturally occurring compounds in wine that come from the grape itself or are produced during fermentation and aging – sulfites, phenolic compounds (tannins), aldehydes, prostaglandins, histamines, tyramine, and miscellaneous congeners (fusel oils, methanol, acetone).
I observed the unique pattern of symptoms each person who has wine intolerance experiences depends on the combination and degree of sensitivity to these compounds of that individual.
The Wine Intolerance-Food and Environmental Sensitivity Connection
As I was treating people for their wine sensitivity they would tell me that they weren’t getting a headache for the rest of the day after riding the elevator at work with someone wearing too much perfume, that having to do laundry in their “moldy” basement wasn’t making them feel exhausted and achy all over, that they weren’t getting headaches after being around an air freshener, or new carpet or paint, that they could eat food that had MSG or other food additives and they wouldn’t get foggy-headed or spacey, that they could “eat that food that would always give them trouble” and not have trouble.
It turns out that the triggering compounds in wine that can make you suffer are in the food you eat and the air you breathe! It doesn’t matter if you drink, eat, or breathe these compounds – if you don’t metabolize them effectively, you’ll suffer.
If you’re sensitive to histamine you will react to histamine whether you drink wine or eat foods that are high in histamine. And, the “gut” problems from histamine intolerance are commonly diagnosed as Irritable Bowel Syndrome. The problem can trigger headaches, anxiety, hives, rashes, eczema, insomnia, extreme fatigue, dizziness…
If you’re sensitive to phenols – the family of compounds that include tannins – you’ll experience a number of reactions that are often misdiagnosed as fibromyalgia or chronic fatigue syndrome.
It’s Not A Mystery – It’s Genetics!
You will be sensitive to histamine if you don’t have enough of the enzymes that break down histamine – diamine oxidase (DAO) and/or histamine N-methyltransferase (HNMT).
You will be sensitive to phenolic compounds if you don’t have enough phenol-sulfotransferase (PST) to break them down.
The same is true for all of these compounds – not having enough of the enzymes to break them down and render them harmless means trouble for you. Level and activity of enzymes responsible for metabolizing and making these compounds innocuous is influenced by genetics. The genetic predispositions to being sensitive to these compounds can be tested and the nutritional biochemistry of these enzyme systems is known.
Targeted clinical nutrition can support these systems, up level enzyme activity, and improve wine tolerance. A small clinical observational study of people who had quit drinking wine altogether due to the severity of their reactions was quite promising. Eighty-five percent of participants were able to drink two 5 oz glasses of wine without headache (the primary inclusionary criterion) after six weeks of targeted clinical nutrition.
How Common Is Wine Intolerance?
A German study from 2012 concluded that approximately 9% of women and 5% of men have this problem.1 In my opinion, the problem appears to be more common in the US – probably somewhere around 12% in women and 8% in men – due to the higher baseline exposure to man-made chemicals from food and the environment in the US.
1 Wigand, P., Blettner, M., Saloga, J. & Decker, H., 2012, Prevalence of wine intolerance: results of a survey from Mainz, Germany, Deutsches Ärzteblatt international, 109(25), pp. 437-44.