FAQ Episode 12: Migraines, red wine and the quercetin effect.

FAQs for Natural Migraine Relief for Women

Hi! Jeff Baker here again, as the physician host for Frequently Asked Questions about Natural Migraine Relief for Women. Today I’m going to answer another “question from the class” from one of my Natural Migraine Relief course members: “ I hear that red wine has its health benefits, but that it could also make migraines worse. Is this true?” To answer this, we have to target one of my favorite supplements as a potential villain in the infamous “red wine headache” syndrome.  Even those who do not enjoy this adult beverage should read on to understand the quercetin connection to migraines.

For some people, drinking red wine even in small amounts can trigger a migraine. Typically, this “red wine headache” can occur within 30 minutes to three hours after drinking as little as a small glass of wine.   What’s interesting is that this can hold true even for those who don’t get headaches when drinking small amounts of non-red wine alcoholic beverages.  A recent study at the University of California at Davis¹ explains in greater detail how this can happen.

You may have heard about the “French paradox”, where wine-drinking French folks had lower heart disease despite their relatively high-fat diet.   It is thought that polyphenols and flavonoids can be protective to offset arterial plaquing from oxidized fats.  One of those flavonoids is quercetin, which has multiple potential benefits and is readily available as a nutritional supplement.  It is naturally present in many fruits and vegetables, including grapes. However, when quercetin is metabolized in conjunction with alcohol, it can create some problematic side effects.  In the bloodstream, your body converts quercetin to a different form called quercetin glucuronide and, in that form, it can block the metabolism of alcohol. As a result, red wine tipplers can end up accumulating a toxin side product called acetaldehyde.  A buildup of acetaldehyde leads to flushing, nausea and headaches.  A related concern is that about 40% of the East Asian population has an enzyme that is less efficient in clearing acetaldehyde, which can allow it to build up in their system more readily.

“We postulate that when susceptible people consume wine with even modest amounts of quercetin, they develop headaches, particularly if they have a preexisting migraine or another primary headache condition,” said study co-author Morris Levin, professor of neurology and director of the Headache Center at the University of California, San Francisco.

Levels of quercetin can vary dramatically in red wine.

Dr. Waterhouse, another of the study’s authors noted that “if you grow grapes with the clusters exposed, such as they do in the Napa Valley for their cabernets, you get much higher levels of quercetin. In some cases, it can be four to five times higher.”  Also, in comparison, red wines have ~10 times more flavanols than white wines.  Levels of quercetin will differ depending on how the wine is made, including skin contact during fermentation, finishing processes, and aging.

Benefits and concerns about Quercetin as a supplement

Quercetin is a powerful antioxidant used as adjunct therapy in the treatment of cancer, allergic reactions, inflammation, arthritis, and cardiovascular disorders. It can reduce platelet aggregation, the peroxidation of lipids, enhance the biogenesis of mitochondria, and assist with blocking viral replication.

Specific to migraine, it can also help stabilize the cells that release histamine in the body, which can reduce a potential inflammatory root cause for migraines.  However, the bother could outweigh the benefits if it inhibits the metabolism of alcohol, with the resulting acetaldehyde promoting a migraine.

Bottom line:

1)  if you find that taking supplemental quercetin worsens your migraines, reduce the dose or discontinue entirely. This is unlikely to be a problem unless you also use alcohol in some form.

2) taking a supplemental dose of quercetin could add to your flavonoid total if you also drink red wine, or already are eating vegan.

3) if you enjoy a red wine where the effect of quercetin could be a factor, consider a varietal with lower flavonoid content.  This list of reds² starts with the highest relative levels:

-Shiraz

   -Cabernet Sauvignon

   -Petit Syrah

   -Pinot Noir

   -Merlot

   -Zinfandels

I did not find Malbecs listed, but most likely they are near the top of this list.

4) for class members, if you have excess histamine as a factor promoting your migraines, the Natural Migraine Relief course discusses common symptoms of histamine excess related to migraines and several measures to manage this. See Lesson 7 for more details.

Learn more about your migraine root cause factors and specific non-drug interventions.

The pros and cons of flavonoids as a factor in migraines is only one of over 90 potential non-drug interventions we discuss in the online course Natural Migraine Relief for Women. If you are not already a course subscriber, look to www.naturalmigrainerelief.online for more information on how you can find and personally triage the best non-drug therapies to relieve your migraine headaches.

Also, remember to subscribe to this Substack blog to get regular postings on Frequently Asked Questions about Natural Migraine Relief for Women.

Reference:

¹ Scientific Reports “Inhibition of ALDH2 by Quercetin Glucuronide Suggests a New Hypothesis to Explain Red Wine Headaches”  Devi, Apramita et. al. Published November 20, 2023

² The Phenol Explorer spreadsheet showing the content value of quercetin in red wines.  http://phenol-explorer.eu/contents/show/1/291/135