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Thread: In Vino Veritas

  1. #1
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    Post In Vino Veritas

    In Vino Veritas: The Link Between Migraine and Wine
    Medscape Medical News
    Andrew N. Wilner, MD
    November 19, 2014

    Introduction
    As a writer, I've often wondered whether my career was hampered by my lifelong intolerance to alcohol. Usually, but not always, the taste of wine on my tongue or the waft of its aroma to my nose initiates a distinct bitemporal throbbing that increases with each sip and reliably obliterates any joy of the moment. Consequently, I have been forced to look askance at any vinous offering—red, white, or rosé. Unlike Hemingway, Fitzgerald, or Parker, my writing muse has been relegated to a daily struggle with sobriety. On the other hand, as a neurologist, I have the gift of first-hand experience with one of my patients' most common neurologic afflictions, migraine.

    A Historical Perspective
    A recent review published in the journal Headache and (on Medscape) investigated the ancient relationship between wine and headache.1 It seems that Celsus (25 BC-50 AD) and centuries later Paul of Aegina (625-690 AD) were aware of wine as a headache trigger. Of all alcoholic beverages, wine is the most common initiator of headache, particularly red wine. (Note: We are not talking about "hangovers," which result from quantity rather than quality. Wine-induced headaches may occur, mysteriously, independent of dosage.)

    The Underlying Science
    Krymchantowski and Jevoux 1 review the possible substances contained within wine that might provoke headache, including histamine, tyramine, phenylethylamine, sulfites, flavonoid phenolic compounds, and 5-hydroxytryptamine. Although sulfites were long believed to be responsible for wine-induced headaches, the authors suggest that this link is "speculative or in fact wrong" because sulfites are present in much higher concentrations in foods that fail to produce headaches. Their review suggests that phenolic flavonoid radicals, with their potential to interfere with central serotonin metabolism, are probably responsible for the unfortunate relationship between wine and headache.

    Clinical Studies
    Susceptibility to wine-induced migraine is quite variable. In one of the authors' studies, 2 11/33 (33%) of migraine patients reported headaches in all four of four challenges with a half bottle of various wines, while the remainder of the group had only three, two, one, or no attacks. In another study,3 even wine from the same grapes but grown in different countries (French vs South American Cabernet Sauvignon) produced different rates of migraine.

    Future Research
    People with migraine who wish to drink wine do so at their own peril. However, the aforementioned findings suggests that diligent research may reveal regional varietals that may be better tolerated.

    Conclusions
    I've never credited alcohol as a key ingredient to creative success. Hard work, inspiration, talent, and financial desperation are probably more important. Surely it was not alcohol that inspired the pens of Dylan Thomas, James Joyce, and F. Scott Fitzgerald (although drinking most certainly hastened their demise). On the other hand, alcohol might lubricate one's pen and dim the glare of that as yet unsullied white page, every writer's Brobdingnagian fear. For migraineurs, the scintillating scotomas that efface visual fields followed by hammering headaches and constitutional malaise are an unlikely formula for award-winning prose. Just the thought is a sufficient deterrent to put the corkscrew away.

    Tea, anyone?



    References
    1) Krymchantowski AV, Jevoux CC. Wine and headache. Headache. 2014;54:967-975. Abstract

    2) Krymchantowski AV, Jevoux CC. Red wine-type and triggering of migraine: An open prospective study. Abstract. Headache. 2012;52:884.

    3) Krymchantowski AV, Jevoux CC. Cabernet Sauvignons from France do trigger migraine more often than those from South America: An open prospective study. Cephalalgia. 2013;33(Suppl 8):90.
    Steve

    Dum spiro spero....While I breathe, I hope

  2. #2
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    Re: In Vino Veritas

    I can't drink wine because it gives me a headache and makes my skin hurt. It never fails to ruin my dinner so I stick to water!

  3. #3
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    Re: In Vino Veritas

    I have a few food sensitivities as well, so, like you, using that knowledge helps us avoid the discomfort those sensitivities cause.

    Then there are the practical things to avoid, IMO...onions and garlic, which I consider as being KISS REPELLENT..
    Steve

    Dum spiro spero....While I breathe, I hope

  4. #4

    Re: In Vino Veritas

    I would be interested to access more details about this study-design and reliability. I expect a lot of flaws and "mights". I do not think it is likely he has enough evidence that these chemicals are responsible for headaches.
    I do not believe a glass of wine will lead anyone to migraines, but I might be wrong. I believe a glass of bad wine or a glass of good wine in a bad company can lead to migraine.
    And I also believe some people have allergies and sensitivities, including to wine. Sorry, Steve, it was still interesting material

  5. #5
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    Re: In Vino Veritas

    I do not believe a glass of wine will lead anyone to migraines
    That has not been my experience. Red wine is an automatic trigger for a migraine along with some other very specific triggers. Years ago I worked with my neurologist to maintain a log over a two year period to identify my triggers, and red wine is a guarantee, while most white wines, with a few exceptions will trigger a migraine for me.
    Steve

    Dum spiro spero....While I breathe, I hope

  6. #6

    Re: In Vino Veritas

    Thanks Steve for the clarification. It was hard for me to believe, because a glass or two of red wine makes me feel better and sleep better for sure.

  7. #7

    Re: In Vino Veritas

    I have never been able to drink wine.It goes straight to my head,just one glass will make me very tipsy,which is strange to me because it takes a few mixed drinks before I even start to feel them.

    Wine also makes the top of my head feel weird,I don't know how to describe it other than a crackling feeling,I feel it physically, and then I always get an instant migraine.

    I know to stay away from it.

  8. #8

    Re: In Vino Veritas

    But I have been! Just met an amazing 90 yrs old who has a glass every day!

    ---------- Post Merged on November 28th, 2014 at 09:20 AM ---------- Previous Post was on November 27th, 2014 at 09:52 PM ----------

    Okay, I realize, I might have sounded a bit confrontational, but my truth here is that wine does not give me or my husband headaches. However, I did read another article, that was exploring a possible connection between hystamine sensitivity and wine. The article, which was scholarly and experimental in design, concluded that a proportion of the participants in the study could connect their migraine with wine ( Something like 19 out of 45).
    What I found frustrating here is that without access to MedScape, one has no way to know how valid and reliable the here cited study was and whether findings could be generalized to the public. I have read literature reviews with poor quality, using low quality evidence and studies with poor design as a basis for making statements. I have also encountered people, who did major pioneer work in particuar areas of health/medicine and were initially turned back by all peer-reviewed journals. I have also had a professor who was publishing two experimental design research studies almost every week. Two per week! How does one do that? What kind of quality is that? Anyway, as in everything, not all the information out there can be immediately taken for true and trusted without a deeper look at the evidence.

  9. #9

    Re: In Vino Veritas

    And at least some migraine sufferers have found that they don't have a problem with sulfite free wines. It takes time and trial and error to find your own allergic triggers.

  10. #10
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    Re: In Vino Veritas

    Steve

    Dum spiro spero....While I breathe, I hope

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