Histamine In Wine: What Are The Signs And Symptoms Of Intolerance?

DIFFERENCE BETWEEN WINE ALLERGY AND WINE INTOLERANCE

Before we dive into histamines, it's important to distinguish between wine allergy and wine intolerance. A wine allergy involves an immediate immune response to specific allergens in wine, such as the proteins from grapes, yeasts, or additives like sulfites (used as preservatives). This can result in symptoms like hives, swelling, and even anaphylaxis. 

On the other hand, wine intolerance may or may not involve the immune system. It often stems from enzyme deficiencies or sensitivity to compounds like sulfites or histamines, leading to delayed reactions such as headaches, flushing, and digestive issues. Understanding this difference is crucial to effectively addressing your specific response to wine.

WHY DOES WINE CONTAIN HISTAMINE?

Why are there histamines in wine?

Food and drink made through fermentation naturally contain histamine. Wine is made by fermenting grapes, and the bacteria used to kickstart this process are responsible for producing histamine. 

Cheese, sauerkraut, and processed meat can also contain exceptionally high levels of histamine. (1)

WHAT DOES HISTAMINE DO?

Histamine is a chemical message produced by specific cell types, including mast cells (white blood cells), platelets, and Enterochromaffin cells (in your stomach lining).

When histamine is released, it binds to one of four histamine receptors. It causes smooth muscle contraction, dilation of blood vessels, mucous secretion in the stomach lining, and a drop in blood pressure, to name a few.

In normal circumstances, once histamine has done what it needs to do, your body breaks it down.

However, some people may be unable to help break down histamine as efficiently or are particularly sensitive to small amounts. In this case, they may develop symptoms of wine histamine intolerance. (2)

Therefore, drinking wine that contains histamine can cause a reaction that can mimic an allergy.

OTHER COMMON WINE ALLERGENS

Histamine isn't the only compound in wine that can cause reactions. Other common wine allergens include sulfites, tannins (polyphenols that give the wine its structure), proteins from grapes and yeasts, egg whites, milk proteins, and fish derivatives. 

These allergens can trigger symptoms ranging from mild discomfort, such as headaches or rashes, to severe allergic responses like anaphylaxis. If you experience symptoms like these, it may be due to one of these other compounds, not just histamine.

WHAT ARE THE SYMPTOMS OF WINE HISTAMINE INTOLERANCE?

The symptoms of wine histamine intolerance include:

• Diarrhea
• Headache
• Blocked nose
• Wheeze
• Low blood pressure
• Hives / itchy skin
• Flushing (going red in the cheeks)

If you're someone who gets these symptoms after drinking a small amount of wine, it could be a sign of intolerance.

Diagnosing histamine intolerance can be challenging. It often involves an elimination diet, where you avoid high-histamine foods and beverages to see if your symptoms improve. 

Keeping a food diary can also help you identify triggers. Sometimes, your doctor may suggest testing you for DAO (diamine oxidase) enzyme levels or performing a histamine skin prick test to confirm the diagnosis. 

Speaking to your doctor is essential because these symptoms are not specific to wine histamine intolerance — several other conditions can cause similar symptoms.

CAN YOU BE ALLERGIC TO HISTAMINES IN WINE?

Technically, an allergy is an inappropriate immune response to an otherwise innocuous substance. For example pollen or nut protein. These are “foreign” molecules that are not produced by your body. molecules like pollen and nut protein are called “allergens”.

On the other hand, histamine is an essential chemical messenger every human being in the world produces. Therefore, it can’t be an allergen, and you can’t be "allergic" to it per se.

Rather, some people are particularly sensitive to the effects of histamine. Small amounts can trigger a big response. And it’s in those individuals, histamine in wine can be a problem. It's an "intolerance" rather than an "allergy".

ALCOHOL INTOLERANCE VS. HISTAMINE INTOLERANCE

It's also essential to distinguish between alcohol intolerance and histamine intolerance. Alcohol intolerance, which is often genetic, occurs when your body can't properly break down alcohol, leading to symptoms like facial flushing, nausea, and rapid heart rate. The presence of histamines in alcoholic beverages can exacerbate these symptoms. 

On the other hand, histamine intolerance involves explicitly a sensitivity to histamines in foods and drinks, regardless of their alcohol content. 

Both can cause discomfort, but they stem from different underlying causes.

WINE HISTAMINE AND HANGOVERS

You may have noticed that many of the symptoms of histamine intolerance mentioned above overlap with typical hangover symptoms.

This is because histamine exacerbates wine hangovers. Wine also contains several other compounds, such as sulfites, esters, and tannins, which give it its distinctive aroma and taste.

These compounds are collectively called congeners.

Research has shown that congeners in alcohol are a significant contributing factor to hangover symptoms. (2)

In addition, several studies have shown that histamine, in particular, is one of the possible causes of wine headaches and migraine. (3)

The theory is that histamine dilates blood vessels in the brain, causing increased pressure and triggering a cascade of events that ultimately lead to inflammation and pain.

One thing's for sure: histamine doesn't help with hangover symptoms. It is likely one of the reasons why some feel that wine hangovers are worse than other drinks.

WHAT WINE HAS THE MOST HISTAMINE?

A research group in Australia looked at 100 different types of red wine to test the varying amounts of histamine and find out which drink had the most. (4)

Interestingly, they found that histamine concentrations varied significantly between each wine type. However, they showed no consistent way of showing a particular type had more histamine than another. For example, one bottle of Shiraz red wine may have wildly different levels of histamine compared to another Shiraz type.

Ultimately, they concluded that factors such as crop health, fermenting yeasts, and bacterial strains involved in the fermentation process have much more influence on the histamine content in the wine than the "type of wine."

White and rose wine will naturally contain less histamine than red wine because they are produced differently and don't undergo the same aging process.

LOW HISTAMINE WINE

You may have noticed that some wine producers test the histamine level in their wine and showcase it on their labels. But generally speaking, it's not commonplace.

No set definition makes certain wines "low histamine," and there is no predefined concentration currently.

Red wine, in particular, will naturally contain high levels of histamine compared to other alcoholic beverages and should, therefore, be avoided if you experience adverse reactions from drinking it.

CAN YOU REMOVE HISTAMINE FROM WINE?

You may have encountered wine filters that are said to remove impurities from wine. These include sulfites and other larger sediments that can be filtered easily.

Histamine, on the other hand, is much smaller, and wine filters cannot remove it.

Some products use finer filters and claim to remove histamine. However, at the time of writing, no published research studies show that any of these work.

WILL ANTIHISTAMINES HELP?

Antihistamines like Zyrtec and Pepcid work by blocking certain types of histamine receptors. Taking antihistamines if you have an intolerance could potentially help. However, it's not advisable as it could mask some of your symptoms and make you feel more unwell in the long run.

It's also worth noting that certain medications, such as muscle relaxants, opioids, anti-inflammatory drugs, and some antibiotics, can interfere with your body's process for breaking down histamines or can even directly increase histamine levels. This can exacerbate any symptoms of histamine intolerance you're experiencing and make it even more challenging to manage your symptoms. 

While antihistamines might provide temporary relief, they are not a long-term solution, and avoiding wine is often the best course of action if you have a histamine intolerance.

The best way to avoid symptoms of wine histamine intolerance is to avoid drinking wine in the first place. Trying to medicate it could cause more long-term damage.

WHEN TO SEEK MEDICAL ADVICE

In rare cases, experiencing severe pain after drinking alcohol can be a sign you have a more serious underlying condition, such as Hodgkin's lymphoma. Additionally, migraines triggered by alcohol may indicate an immune system reaction involving histamines. Suppose you experience intense or unusual symptoms after drinking alcohol. In that case, seeking medical advice to rule out more severe conditions is crucial.

HISTAMINE IN WINE – FINAL WORDS

This concludes our discussion of histamines in wine and their potential problems for some people.

We've explained why wine contains histamine and the signs and symptoms of histamine intolerance. It's a well-known reaction to wine, and if you suffer from adverse symptoms from small amounts of wine, it's advisable to avoid it.

Red wines generally have a much higher concentration of histamine. They are more likely to give you symptoms if you're sensitive. Therefore, switching to white wine or rose might help. 

To reduce a wine hangover, check our article on wine hangover cures.