Alcohol’s exact role in triggering a migraine isn’t fully known.
Many things are probably at play. For instance, alcohol by-products called congeners have been linked to headaches. Dark-colored alcohols like red wine, brandy, and whiskey may contain more of them. Learn more about the effects of alcohol on the brain.
Alcohol not only contains a chemical called histamine, but it also spurs your immune system to make more. This boosts inflammation throughout your body. A chemical called ethanol is alcohol’s main ingredient. Once it gets into your system, it is converted into a chemical that triggers migraine.
Ethanol is also a natural diuretic. That means it makes you pee more than normal. All of these things can set you up for a migraine. You might have heard that red wine is most likely to cause problems. But other drinks like sparkling wine, beer, and hard liquor may be just as likely, if not more, to cause problems.
Alcohol can cause two different types of migraine headaches. You could get a headache within 30 minutes to 3 hours of drinking. You don’t have to chug a large amount for this to happen. Some people only sip a glass or two of wine before their head starts to throb. Or you might be fine until after your blood alcohol level returns to normal. This is called a delayed alcohol-induced headache (DAIH). It may not show up until the morning after you drink. This type of headache can happen to anyone, but people with migraines are more likely to get one. It can happen even if you drink less than people who don’t get migraine headaches.
Drinking a small amount of alcohol may be good for you. It can lower your odds of heart disease and strokes. But if you’re prone to migraine headaches, you’ll need to be careful about how much you drink. A 5-ounce glass of wine (or 12 ounces of beer or a 1.5-fluid-ounce shot) may be OK every now and then, so long as it doesn’t bring on a headache. If it does, you’ll need to drink less or stay away from all alcohol.
If you aren’t sure that alcohol is to blame for your headaches, try keeping a diary. Each time you drink, write down the type of alcohol you have, the amount, and if and when you had a migraine. Include how you felt the prior 48 hours as well as any stress or anxiety you were under at the time. Over time, you should be able to see a pattern. A migraine should be a good reason to abstain each time you have a night out.
You can also try to:
- Have alcohol with a meal. This may lower the chance of bringing on a migraine.
- Don’t drink when you’re stressed. It’s linked to a higher number of migraine headaches.
- Skip home hangover remedies. There’s no proof that drinking raw eggs or downing hot sauce will get rid of your morning-after migraine faster. Downing more alcohol (the “hair of the dog” theory) won’t help either.
- Try triptans. Ask your doctor if this medicine might help. It can’t prevent a migraine, but it can help stop one after it starts. Triptans work best when you take them at the early signs of a migraine. Still, they can cause serious health risks for many people.
Most studies point to red wine as a common headache culprit, particularly in people with migraine. These individuals commonly cite wine, especially red wine, as a migraine trigger. However, a 2012 study contradicts this association. This prospective study looked at migraine diaries spanning up to 90 days. Wine, beer, and spirits did not elevate the risk of migraine with aura, but sparkling wine did. People who get hangovers that trigger a migraine may wish to avoid alcohol with high levels of congeners. These are substances that the alcohol manufacturing process produces. Some research suggests that congeners play a role in hangovers, although factors such as inflammation also contribute. Brandy, red wine, and rum have the highest levels of congeners, while gin and vodka contain fewer of these chemicals. However, a 2019 study found higher rates of vodka consumption among drinkers with frequent migraine attacks. The response to alcohol varies from person to person, and there is no alcohol that absolutely will not cause a migraine or other headache.
Can I still drink alcohol if I live with migraine? There’s no one-size-fits-all answer to this question, as everyone is unique and experiences migraine differently. Many people find that only certain drinks trigger their attacks, so they only need to avoid specific beverages. However, what applies to one person with a migraine might be quite different for another.
Keeping a headache diary will help you determine whether alcohol is definitely triggering your attacks. What is and isn’t a trigger can be tricky to untangle; it might be that you tend to drink when you’re very stressed, and it’s actually the stress that’s the trigger, or perhaps you only drink at the weekend and your weekend sleep habits are to blame.
Keeping note of things like stress, what you’ve eaten, caffeine consumption, menstrual cycle, and sleep pattern over a few months will help you identify your migraine triggers. You should also record how much alcohol you drink, what types of drinks you’ve consumed, and how much. You can take your diary to your doctor, who will help you determine what might be triggering your attacks.
Whether or not alcohol is a migraine headache trigger is debatable. While some people do experience migraine headaches after drinking alcohol, not everyone does. In many cases, researchers say it’s more a matter of individual triggers or other factors that coincide with your alcohol consumption, like stress.
If you experience migraine headaches after drinking alcohol, it may be best to avoid alcohol. Talk with a doctor about ways to identify your migraine triggers and what to do if you develop these headaches.