Does Alcohol Trigger Headaches and Migraines?

Understanding the Headache and Alcohol Connection

Is Alcohol a Headache Trigger?. Alexandra Steedman/Getty Images

Alcohol has commonly been reported as a headache trigger, especially for sufferers of migraines and cluster headaches. So it's natural that many headache sufferers abstain from alcohol or consume less than the general population. But the questions remains, is alcohol truly a headache trigger? Is it worth abstaining from alcohol out of concern it will trigger a headache?

What is an Alcohol-Related Headache?

This is a little tricky to define, as there are a few different types of alcohol-related headaches.

According to criteria from the International Classification of Headache Disorders, there is an immediate alcohol induced headache and a delayed alcohol-induced headache. An immediate alcohol induced headache is also known as a cocktail headache while a delayed alcohol-induced headache is classically known as a hangover headache. Both types of headaches tend to be bilateral and have a pulsating or throbbing quality.

That being said, when migraineurs or sufferers of cluster headaches develop a headache after alcohol consumption, their headaches tend to resemble their usual migraines or cluster headaches.

How Does Alcohol Trigger Headaches?

Scientists don't fully understand the mechanism behind alcohol consumption and headache formation. An older hypothesis centered around alcohol causing vasodilation or widening of blood vessels — but scientists are really leaning away from this theory. Another hypothesis is that the chemicals in alcohol — like sulfites, histamine, tyramines, and tannins — contribute to headache formation.

Lastly, another hypothesis that pertains more to migraineurs is that alcohol triggers an inflammatory response which then leads to a migraine.

Which Types of Alcohol Seem to Cause Headaches the Most?

The type of alcohol that triggers headaches is variable. For instance, while red wine has commonly been thought of as a classic migraine trigger, some migraineurs note that white wine and not red wine triggers their migraines.

On the other hand, some migraineurs are okay with red and white wine but note that beer, champagne, or spirits trigger their headaches. Cluster headache sufferers in the United States report beer as their predominant alcoholic headache trigger.

Bottom Line

All in all, alcohol does not seem to be a slam dunk headache trigger. In other words, it seems that a small amount of alcohol here and there is reasonable, even if you are prone to headaches. Moderation appears to be the key answer here.

Of course, if drinking alcohol appears to be a potent headache trigger for you, then by all means abstain from it. But, if a cocktail with friends once in awhile or a glass of wine with your dinner on Saturday night does not seem to trigger a bad headache, then it's probably okay. You have to weigh the reward-risk ratio here.

It's also important to discuss your alcohol intake with your doctor to make sure it's safe for you. For instance, alcohol should be avoided in certain medical conditions, like  liver disease.

Alcohol can also interact with certain medications.

Aside

As an aside, it's important to note that this article does not focus on alcohol use disorder. Please see your doctor if you are concerned about your alcohol use and consider visiting the website www.niaaa.nih.gov from the National Institute on Alcohol Abuse and Alcoholism.

Sources

Dueland, A.N. (2015). Headache and Alcohol. Headache, 55 (7): 1045-9.

Headache Classification Committee of the International Headache Society. (2013). "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia, 33(9):629-808.

Panconesi, A. (2008). Alcohol and migraine: trigger factor, consumption, mechanisms. A review. The Journal of Headache and Pain, 9:19-27.

Panconesi, A., Bartolozzi, M.L., & Guidi, L. (2011). Alcohol and migraine: what should we tell patients? Current Pain and Headache Reports, Jun;15(3):177-84.

Panconesi, A., Bartolozzi, M.L., Mugnai, S., Guidi, L. (2012). Alcohol as a dietary trigger of primary headaches: what triggering site could be compatible? Neurological Sciences, 33 Suppl1:S203-S205.

Rozen, T.D. & Fishman, R.S. (2012). Cluster headache in the United States of America: Demographics, clinical characteristics, triggers, suicidality, and personal burden. Headache, Jan;52(1):99-113.

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