Understanding Wine Sensitivities: Allergies & Intolerances
Since there’s been so much discussion lately around wine and health, I decided to kick off the New Year—and Dry January—with a few posts on the intersection of wine and wellness.
Source: Coppiera Archives
Sensitive to wine?
From Asian flush and sulfites to fun phrases like biogenic amines, here’s what might be going on.
In recent years, I’ve found myself having more conversations about sensitivities to wine—perhaps because I’m getting older, or perhaps because the no- and low-alcohol movement is gaining steam. Many people attribute their growing intolerance to certain styles of wine to the much-maligned (and often misunderstood) sulfites. But it turns out sulfites are only one of several possible culprits.
In fact, roughly 10% of the general population reports some kind of sensitivity to wine. In the medical community, these reactions are divided into two categories: true allergies, which involve an immunologic response, and intolerances, where no allergen-specific immune reaction can be detected.
Let’s break down the most common wine-related allergies and intolerances. At the end, we’ll talk about what—if anything—you can do to mitigate them. One important note before we begin: I am neither a scientist, nor a medical researcher, nor a doctor—just a humble, aging wine lover. Any questions about your personal situation should be directed to a medical professional.
A. ALLERGENS
The most common allergens in wine include proteins from the grape itself and substances used during winemaking known as fining agents (listed in the chart below). True allergies to wine are actually quite rare. By definition, an allergy must provoke a measurable immune response.
For example, if you are allergic to grapes, you would almost certainly experience obvious symptoms when drinking wine—hives, swelling, itching, or in rare cases, anaphylaxis. While it is possible to develop food allergies later in life as the immune system changes with age, if you can eat table grapes without issue, you’re likely not allergic to grapes themselves.
Another potential allergen comes from processing aids, particularly fining agents. These substances are added after fermentation to remove suspended particles and improve clarity, stability, color, and aroma. Common fining agents include egg whites, milk proteins, isinglass, and gelatin.
Allergies to fining agents are also rare, as these substances are typically removed completely—especially if the wine is filtered. However, in unfiltered wines, if processing aids are used, trace amounts may remain and could affect individuals with severe sensitivities.
While there is no strict legal definition governing what can or cannot be used in organic or natural wine, most animal-derived fining agents are generally avoided. Many producers favor plant- or mineral-based alternatives like bentonite (clay) or fungal chitosan, though practices vary widely by winery.
If fining agents are a concern, ask producers directly what they use and whether the wine is filtered. Natural wines may avoid animal-based agents, but they’re also often unfiltered—so it’s worth asking specific questions.
Chart 1: Common Allergens used in Winemaking
Sources: AWRI, Allergologie select
B. INTOLERANCES
This is where most wine-related issues tend to live.
Unlike allergies, intolerances don’t trigger an immune response, but they can still cause very real and uncomfortable symptoms. This list isn’t exhaustive, but it should help narrow down why someone might say, “I sometimes get a headache after drinking wine.”
Asian Flush
Flush syndrome results from two genetically determined enzyme deficiencies that impair alcohol metabolism. First, ethanol is converted into toxic acetaldehyde more quickly than normal. Second, the enzyme responsible for detoxifying acetaldehyde is deficient.
This combination leads to acetaldehyde buildup, causing flushing, warmth, rapid heartbeat, and other symptoms of intoxication. The condition is particularly prevalent in East Asian populations, affecting approximately 46% of Japanese and 56% of Chinese individuals.
Congeners & Fusel Alcohols
Fusel alcohols are long-chain alcohols, and congeners are a broader class of compounds found in extract-rich wines and darker spirits like red wine, bourbon, brandy, and rum.
“Extract-rich” wines contain higher levels of non-volatile compounds—tannins, pigments (anthocyanins), and flavor compounds—dissolved in the liquid. Red wines generally have more extract than white, rosé, or sparkling wines.
These compounds metabolize more slowly than ethanol and promote inflammation, amplifying and prolonging hangover symptoms. This isn’t an allergic response—it’s enhanced toxicity. If this is your issue, you’ll likely tolerate clear spirits (vodka, gin) and white wines better than reds or brown liquors.
Biogenic Amines (Including Histamine)
Biogenic amines—such as histamine, tyramine, and cadaverine—are naturally occurring compounds formed from amino acids during fermentation, particularly malolactic fermentation (MLF).
Poor hygiene, microbial spoilage, accidental fermentation, or overripe fruit can increase their presence. Certain grape varieties (Pinot Noir, Syrah, Sangiovese) and long-aged red wines (Barolo, Barbaresco, Rioja Gran Reserva) tend to be especially high in biogenic amines.
Histamine is the most clinically relevant. In sensitive individuals, it can cause headaches, flushing, nasal congestion, hives, digestive upset, and heart palpitations. While bentonite fining can reduce histamine levels, it cannot eliminate them entirely.
The body normally breaks down histamine using the enzyme diamine oxidase (DAO). Alcohol inhibits DAO release, slowing histamine metabolism. Add histamine-rich foods—cured meats, aged cheeses, tomatoes, chocolate—and you get a perfect storm. Alcohol also increases intestinal permeability, allowing more histamine into the bloodstream and across the blood–brain barrier, triggering headaches.
If histamines are your issue, consider young white wines that haven’t undergone MLF, and avoid histamine-rich food pairings.
Tannins and Flavonoids
Tannins are phenolic compounds found primarily in red wine, responsible for color and structure. High tannin levels can inhibit an enzyme called phenolsulfotransferase (PST), impairing the body’s ability to detoxify certain phenols that reach the brain and trigger migraines.
Tannin sensitivity is often confused with histamine intolerance. A simple test: try a youthful, naturally fermented Gamay with some partial carbonic maceration and a sprinkling of oak aging (low tannins, higher in histamines), then compare it with a young, stainless-steel–aged Langhe Nebbiolo (higher tannins, lower histamines if well-controlled). Avoid traditionally made Barolo or Barbaresco, which tend to be high in both.
If tannins are the issue, white wines are usually the safest choice.
Sulfites
Sulfites have been used in wine since Roman times to preserve freshness and prevent oxidation. Most sulfite sensitivity presents as asthma or rhinitis, triggered by sulfur dioxide produced in the stomach, which stimulates airway irritant receptors and causes bronchoconstriction.
True sulfite allergies are rare. White, sweet, and sparkling wines typically contain the highest levels of added sulfites. If sulfites are your trigger, red wines or low-sulfite natural wines may be better tolerated.
Final Thoughts
Both allergies and intolerances can develop—or worsen—later in life, even if you previously tolerated wine without issue. While this post outlines the most common offenders, it also offers paths forward so you can continue enjoying wine thoughtfully and comfortably.
If you’re experiencing sensitivities, let us know in the comments—you’re far from alone.
Note 1: While there is potential that molds like botrytis cinerea or proteins from insects in the must or even inorganic compounds (ethanol, acetaldehyde, and acetic acid) could pose an issue, the research has not produced any case reports. Therefore, I will not report on those.
Note 2: In case you would like to learn more, I reviewed a few research articles while writing this post:
Gisèle Kanny, Vincent Gerbaux, Agnès Olszewski, Sophie Frémont, Fabienne Empereur, Francine Nabet, Jean-Claude Cabanis, Denise-Anne Moneret-Vautrin, No correlation between wine intolerance and histamine content of wine, Journal of Allergy and Clinical Immunology, Volume 107, Issue 2, 2001, Pages 375-378, ISSN 0091-6749. Some people have cited this study, but I did not find it helpful.
Littlewood JT, Gibb C, Glover V, Sandler M, Davies PT, Rose FC. Red wine as a cause of migraine. Lancet. 1988 Mar 12;1(8585):558-9. doi: 10.1016/s0140-6736(88)91353-0. PMID: 2894493.
Silva M, Gama J, Pinto N, Pivi G, Brancal H, Carvalho L, Loureiro V, Patto MV. Sulfite concentration and the occurrence of headache in young adults: a prospective study. Eur J Clin Nutr. 2019 Sep;73(9):1316-1322. doi: 10.1038/s41430-019-0420-2. Epub 2019 Apr 8. PMID: 30962515.
Vally H, Misso NL. Adverse reactions to the sulphite additives. Gastroenterol Hepatol Bed Bench. 2012 Winter;5(1):16-23. PMID: 24834193; PMCID: PMC4017440.
Wigand P, Blettner M, Saloga J, Decker H. Prevalence of wine intolerance: results of a survey from Mainz, Germany. Dtsch Arztebl Int. 2012 Jun;109(25):437-44. doi: 10.3238/arztebl.2012.0437. Epub 2012 Jun 22. PMID: 22787508; PMCID: PMC3391999.
Wüthrich B. Allergic and intolerance reactions to wine. Allergol Select. 2018 Sep 1;2(1):80-88. doi: 10.5414/ALX01420E. PMID: 31826033; PMCID: PMC6883207.
