Does Wine Drunk Make You Sick? Understanding the Root Causes

October 21, 2025 •

4 min read

Studies indicate that compounds in wine, particularly darker varieties, can intensify hangover symptoms like nausea and headaches. So, does wine drunk make you sick in a uniquely potent way compared to other types of alcohol? Several distinct factors explain this common, unpleasant phenomenon.

Quick Summary

Several compounds in wine, including congeners, histamines, and sulfites, along with factors like dehydration, contribute to nausea and other hangover symptoms.

Key Points

Congeners: Darker wines like red wine contain higher levels of these chemical byproducts, which can lead to more severe hangovers and general malaise.
Histamine and Sulfites: These natural wine compounds can trigger allergy-like reactions, including headaches, flushing, and digestive upset, in sensitive individuals.
Dehydration: All alcohol is a diuretic, leading to dehydration which is a primary driver of common hangover symptoms like headaches and fatigue.
Genetic Intolerance: Some people, especially those of Asian descent, have a genetic variation that hinders their ability to process alcohol's toxic byproduct, acetaldehyde, causing rapid flushing and nausea.
Prevention Strategies: Drinking in moderation, staying hydrated with water, eating before and during drinking, and choosing lighter-colored wines are effective ways to reduce sickness.
Allergy vs. Intolerance: A true wine allergy is a rare immune response, while an intolerance is a more common digestive issue related to wine's specific compounds.

Why Wine Can Make You Feel So Sick

While the primary cause of any alcohol-related sickness is the ethanol itself, specific components in wine can exacerbate unpleasant effects, leading to a more intense hangover or immediate adverse reactions. It's not just the amount of alcohol consumed but the cocktail of compounds unique to wine that can trigger nausea, headaches, and other digestive issues. This section explores the key culprits behind wine-induced sickness.

The Role of Congeners

Congeners are complex chemical byproducts of the fermentation process that give alcoholic beverages their distinctive flavor and aroma. While present in all fermented drinks, they are found in higher concentrations in darker beverages like red wine, whiskey, and brandy. Experts believe that the body's effort to break down these extra substances alongside the alcohol may contribute to more severe hangovers and a heightened sense of malaise. If you find yourself feeling sicker after red wine than, say, white wine or clear spirits, congeners are a very likely suspect.

Histamines and Sulfites: Triggers for Intolerance

For some individuals, sensitivity to histamines and sulfites is the primary reason wine makes them sick.

Histamines: A naturally occurring compound found in high levels in red wine, histamine can cause allergy-like reactions in sensitive people. Symptoms include headaches, flushing, itching, and digestive issues. Some people lack sufficient levels of the enzyme diamine oxidase (DAO), which breaks down histamine, leading to its accumulation and these adverse effects.
Sulfites: Used as a preservative in winemaking, sulfites can trigger asthma-like symptoms, wheezing, and coughing in those with a sensitivity. While often blamed for headaches, this is a misconception for most, with respiratory issues being the more common reaction.

Dehydration and Acetaldehyde Accumulation

Regardless of the type, alcohol acts as a diuretic, causing the body to lose fluids and leading to dehydration. Dehydration is a major contributor to classic hangover symptoms such as thirst, headache, and fatigue. Additionally, when the liver metabolizes ethanol, it produces acetaldehyde, a toxic substance. For some, a genetic variant (especially common in people of Asian descent) means they produce less of the enzyme needed to break down acetaldehyde, leading to a rapid buildup of this toxin and subsequent nausea, flushing, and rapid heartbeat.

The Difference Between Wine Intolerance and Allergy

It's important to understand the distinction between a true wine allergy and a more common intolerance.

Wine Intolerance: A non-immune system reaction where your digestive system simply struggles to process certain compounds in wine, like sulfites or histamines. Symptoms are generally digestive, like nausea, gas, and abdominal pain, but can also include flushing and headaches.
Wine Allergy: A much rarer immune system response to a specific ingredient, such as grape proteins, yeast, or clearing agents used in the winemaking process. True allergies can trigger severe symptoms, including hives, swelling, and in rare cases, anaphylaxis.

Comparison of Potential Sickness Factors: Red vs. White Wine


Factor	Red Wine	White Wine	Potential for Sickness
Congeners	Higher concentration due to fermentation with grape skins.	Lower concentration, as skins are removed during fermentation.	Higher potential for more intense hangovers.
Histamines	Higher levels naturally present, a key trigger for headaches and other intolerance symptoms.	Lower levels compared to red wine.	Higher risk of histamine-related symptoms like flushing and headaches.
Sulfites	Usually added in lower concentrations than white wines, though still present.	Often has higher sulfite levels to preserve freshness and prevent browning.	White wine may be a greater trigger for sulfite-sensitive individuals.
Tannins	Derived from grape skins, seeds, and stems; can trigger headaches in some.	Found in much lower concentrations, if at all.	A specific trigger for certain individuals sensitive to tannins.
Acetaldehyde	The body's metabolism of ethanol produces this toxic compound in all alcohol.	Same metabolic process applies, though lower congener load may feel less taxing.	Equal potential, but other factors in red wine may amplify the effect.

Prevention and Mitigation Strategies

For those who experience sickness from wine, several strategies can help minimize adverse effects:

Moderation: The most effective way to avoid all alcohol-related sickness is to drink less.
Hydrate Effectively: Alternate each glass of wine with a full glass of water to combat dehydration.
Eat Food: Consuming food, especially before and during drinking, slows down alcohol absorption and can lessen stomach irritation.
Choose Wisely: If red wine is a consistent trigger, consider switching to white wine or clear spirits, which generally contain fewer congeners and histamines.
Pace Yourself: Limiting consumption to one drink per hour allows your liver more time to process the alcohol and other compounds.

Conclusion

In short, the sensation of feeling sick from wine is not just a myth but a complex reaction influenced by several key compounds. While the ethanol is the core intoxicant, specific compounds like congeners, histamines, and sulfites—particularly in red wine—can trigger more intense hangovers or intolerance symptoms. Factors such as dehydration and genetic variations in alcohol metabolism also play significant roles. The key to mitigating wine-induced sickness lies in understanding your personal sensitivities and practicing moderation and mindful drinking habits. For those with severe or consistent reactions, avoiding wine or consulting a healthcare provider may be the best course of action.

For more information on the causes and symptoms of hangovers, you can visit the Mayo Clinic website.

Frequently Asked Questions

Wine, especially red wine, contains higher levels of congeners, histamines, and tannins, which can irritate the stomach lining and cause more intense nausea and digestive issues for some people compared to lighter spirits.

An intolerance is a digestive issue where your body struggles to process certain wine components, leading to symptoms like nausea. An allergy is a rarer immune system response that can cause more severe reactions, including swelling and hives.

While sulfites are often blamed for headaches, this is a common myth. For sulfite-sensitive people, the more common reactions are respiratory, like wheezing or coughing. Headaches are more often linked to other compounds like histamines or tannins.

Yes, it is possible to develop or notice an intolerance later in life. This can be due to changes in your body's enzyme activity or increased sensitivity to compounds like histamines, which can be exacerbated by certain medications.

Key prevention methods include drinking in moderation, consuming a glass of water between each glass of wine, eating a meal beforehand, and choosing lighter-colored wines that have fewer congeners.

For many, red wine is more likely to cause more severe sickness due to its higher concentration of congeners, histamines, and tannins. However, white wine may contain higher sulfites, which can be an issue for those with a sulfite sensitivity.

Alcohol is a diuretic, meaning it increases urination and can cause dehydration. This dehydration is a major contributor to hangover symptoms like headaches, fatigue, and intense thirst, which can be particularly noticeable with wine.

Asian flush syndrome is caused by a genetic deficiency in the ALDH2 enzyme, which is needed to break down a toxic alcohol byproduct called acetaldehyde. This leads to a rapid buildup of the toxin, causing flushing, nausea, and rapid heartbeat.