several hands holding drinks with the best and worst alcohols for migraine
Diet,  Migraine,  Triggers,  Wine

Best and Worst Types of Alcohol for People With Migraine

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Migraine attacks can be debilitating, and most people who experience them will do anything to find relief. Avoiding personally known triggers can be a useful way to reduce the number of potential attacks. Alcohol is a common trigger for migraine attacks, but some types may be less likely to cause problems than others. Let’s explore the best and worst types of alcohol for people with migraine.

Introduction to migraine and alcohol

Migraine is a neurological condition. Some common symptoms are a severe headache, vertigo attack or stroke like symptoms that can last for hours or even days. Migraine sufferers may also experience nausea, vomiting, and sensitivity to light and sound among other symptoms. To understand more about the symptoms experienced with migraine attacks, read our articles on vestibular migraine or different types of headaches.

**While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor

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What triggers migraine attacks?

There are many possible triggers for migraine attacks, including stress, bright lights, loud noises, weather changes, certain foods and drinks, and changes in sleep or hormone patterns to name a few.

Menstruation was found to increase the likelihood that food and drinks would be more likely to trigger an attack. This is linked to the threshold theory, or Bucket Theory, where a stacking of triggers will induce a migraine attack.

Why does alcohol trigger migraine attacks?

Understanding certain food components of some alcoholic beverages will help you understand your choices when it comes to selecting the best alcohol to avoid migraine.

Congeners role in hangovers

One of the reasons certain types of alcohol may be more likely to trigger migraine attacks is the presence of congeners. These are by-products of the fermentation process, and they’re found in higher concentrations in dark liquors. A congener is anything produced by yeast that isn’t ethanol. Congeners can also include chemicals like histamine, which can trigger migraine attacks and headaches.

Congeners in darker beverages have been linked to hangovers. The few experimental studies indicate that the highest congener beverage (bourbon) results in more severe hangover ratings than does the beverage with essentially no congeners (vodka). These congeners tend to affect how people feel the next day, including contributing to increased levels of hangover symptoms. The study also found that it was the ethanol consumption that was responsible for a majority of the hangover symptoms. 

Tannins and migraine

Tannins are another compound that can cause problems for people with migraine. They’re found in both red and white wine, but they’re more concentrated in reds. Tannins give wine its astringent taste, and they can also contribute to headaches. Tannins can be found in other drinks including, tea, coffee and chocolate. The astringency from the tannins is what causes the dry feeling in the mouth when you drink these beverages or eat food high in tannins like unripe fruit.

Ethanol and migraine

While both congeners and tannins play a role in migraine attacks, ethanol (a natural byproduct of plant fermentation) (https://www.chemicalsafetyfacts.org/ethanol/) is still the biggest trigger when it comes to migraine attacks appearing after alcohol consumption. Usually, the effects of an alcohol triggered migraine attack will happen within 30 minutes to 3 hours.

Another type of attack is called the delayed alcohol induced headache and will usually appear the next day. This is the hangover effect that appears in the morning following alcohol consumption when the alcohol in the blood has reached zero. People with migraine are more likely to have this type of reaction to migraine than those without.

Beer and migraine

Histamine, tannins, tyramine, flavonoid phenols, sulfites, and phenylethylamine are all found within alcoholic beverages and this also includes beer. These items have been linked to triggering migraine attacks.

How do you know if beer is one of the types of alcohol that can trigger an attack for you? Test to see if alcohol (beer, wine, clear liquors, bourbon etc.) is a trigger by consuming a modest amount and then waiting 30 minutes to 3 hours to see if a migraine attack ensues.

Also be aware of other types of triggers that could be present. Things like stress, lack of sleep (too much sleep as well), hormones and weather can play a huge part of triggering an attack. We tend to focus on the last things consumed as the most likely trigger. When we really keep track, sometimes we find that the food or drink was not to blame at all.

Now that you know about the possible impact of congeners, tannins and ethanol of migraine and delayed alcohol induced headache, you can chose the better alcohols for migraine control.

How alcohol can disrupt our sleep and trigger migraine

A change in sleep pattern can contribute to triggering migraine attacks. Alcohol is a known sleep disruptor. About 90 minutes into our sleep, we enter REM (rapid eye movement) sleep. This is the restorative stage of sleep and when it is disrupted, it can cause drowsiness during the day, and lead to other migraine symptoms. 

While alcohol can help you feel sleepy and induce sleep, it tends to interfere with sleep in the later stages of the evening. It can even induce sleep apnea.

Fermentation and alcohol

Different types of alcohol are made through a fermentation process. Alcohols like gin and vodka are fermented first from a mash of foods that contain starch and sugar. They are then distilled to increase the alcohol content and this process removes the congeners in the alcohol.

According to Beyond Celiac, distilled gin and vodka are gluten free. It’s important to make sure that no gluten was added after the distillation process, especially if celiac disease is a factor for you. Generally, these clear alcohols are highly distilled and have almost no leftover congeners from the beginning fermentation process. 

Bourbon and whiskey both have more congeners because they are less heavily distilled which preserves the congeners from the fermented mash. This lends to their distinctive flavor profiles. This could be a reason why they may not be the best choice for the migraine-prone.

Wine is made by fermenting grapes. The type of grape, as well as the length of fermentation, will affect the final product. 

Why clear liquors are thought to be the best alcohol for migraine?

Vodka and gin are both clear liquors that are made through the distilling process discussed above. This process removes congeners, which means that these drinks are less likely to trigger migraine attacks. However, they can still contain other triggers like histamine or tannins. 

Does alcohol trigger every person with migraine?

The informal poll of our Migraine Strong community members indicated that 53% are triggered by alcohol. This percentage is very similar to the amount reported in a study on migraine and triggers. Clear liquors (gin, vodka and clear tequila) were found to be tolerated best.

Those who are triggered by alcohol usually feel the attack coming on within a few hours, although some reported that the next day was when they felt it. 

Of course, everyone is different and will have different triggers. Some people may be able to drink red wine or whiskey without any problems, while others may find that even clear liquors are problematic.

To summarize, for people with migraine, the best alcoholic choices are clear liquors like vodka, gin, or dry white wine. The alcohols more likely to trigger a migraine attack are dark liquors like bourbon, whiskey or red wine. If you do drink alcohol, it’s important to be mindful of your consumption and to experiment to see what works best for you.

Best alcohol for migraine

Vodka, gin or clear tequila

These clear liquors are less likely to trigger migraines than their darker counterparts. If you do drink vodka or gin, be sure to avoid any sugary mixers as they can also trigger headaches.

Best wine for migraine

Look for white wine that is not too sweet and a little on the dry side. Pinot Grigio, chardonnay or sauvignon blanc would be a good place to start and are generally easy to find.

Worst alcohol for migraine

Bourbon, whiskey or red wine

Whiskey and red wine are two of the most common migraine triggers. If you’re going to drink either of these, be sure to do so in moderation and stay well hydrated. White wine may be a safer choice than red.

Why does Champagne and sparkling wine give me a headache?

The carbon dioxide gas bubbles in Champagne help your body to absorb the alcohol faster. The bubbles increase the pressure in your stomach, which forces alcohol out through your stomach’s lining and into your bloodstream for faster absorption.

Other Considerations

If you’re prone to migraine attacks, it’s wise to avoid alcoholic beverages altogether. However, if you do drink, be sure to do so in moderation and stay hydrated.

Drinking plenty of water will help to prevent a hangover and will also help to keep your migraine attacks at bay.

Be aware that if you are already teetering on the edge of a migraine attack, have had a stressful day, are menstruating or slept poorly the night before…all of these triggers can make it more likely that alcohol will overflow you trigger bucket and an attack will ensue.

If you want to test to see if alcohol is a trigger, test one of these best alcohols for migraine and headaches on a day when you feel good and other triggers are low. 

The Pure Wine Wands have been very helpful for me. While white wine isn’t an issue for me, the big reds that I prefer can be an issue. I use the Pure Wine Wands to help me enjoy wine without the headache or migraine attack. Our review of the Pure Wine Wands details out how they work for us!

Non-alcoholic spirits

In recent years, manufacturers have started producing non-alcoholic versions of our favorites. I wanted to test one of these for this article and I chose Lyre’s Agave Blanco Spirit. It is a take on clear tequila. This non-alcoholic spirit worked well in a traditional Margarita as well as a Bloody Maria. Don’t expect the same ‘burn’ that you get with tequila, but it really does make a nice drink that taste like a grownup drink without a ton of sugar. They have some great recipes on their website and their products are available on Amazon for easy shipping!

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Best and Worst Types of Alcohol for People With Migraine

I began having migraine attacks when I was a teenager, but was never properly diagnosed until I was an adult. This began 18 years where I was chronic and mostly intractable, resulting in a migrainous stroke in the summer of 2014. By implementing the protocols from the Heal Your Headache book by Dr. David Buchholz and the Migraine Strong Treatment Pie, I have been able to reduce my migraine frequency to episodic and maintain that since 2015. The end result of continuing to practice these tools is being able to actively participate in my life as a wife, mother, family member and friend. My goal as a migraine advocate, educator, and wellness coach is to help others gain more control over migraine. Let us know how we can help.

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