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Alcohol and Migraine: Your Guide

Posted on November 29, 2021
Medically reviewed by
Amit M. Shelat, D.O.
Article written by
Sarah Winfrey

Many people diagnosed with migraine work hard to figure out what causes (or triggers) their migraine attacks. For some, making dietary and lifestyle changes plays a critical role in managing symptoms and preventing future attacks. This process often leads a person to question whether drinking alcohol actually causes attacks or simply makes existing migraine symptoms worse.

In this article, we’ll consider research on the potential effects of alcohol on your migraine symptoms and treatment. Ultimately, the decision of whether or not to consume alcoholic drinks is up to you. However, knowing the effects alcohol may have on your body and migraine attacks could help you make up your mind.

Alcohol as a Migraine Trigger

Many people believe that alcohol (particularly red wine) is a major trigger of migraine-related headaches — but the effect may not be quite as strong as most people think.

According to the American Migraine Foundation, internationally, about 10 percent of people with migraine report a frequent link between alcohol and headaches. In some parts of the world, that number drops to as low as 1.4 percent. Other experts disagree with these numbers. One study found that alcohol contributes to migraine attacks in up to one-third of people diagnosed with the condition.

Regardless of the percentage of people affected, it is clear that the effects of alcohol can result in migraine episodes for some people.

Alcohol may have small positive effects on heart health for some people diagnosed with migraine. Generally, if alcohol causes headaches for you, it is not worth this small benefit.

Different Types of Alcohol and Migraine

The type of alcohol consumed may play a role in some people’s migraine attacks. In one U.S. study that quizzed approximately 700 people (some with the condition and others without it), up to 70 percent of diagnosed participants blamed red wine for the migraine headaches they experienced after drinking alcohol. (Experts add that the quality of a wine — not just its type — may also factor in.)

Red wine’s propensity for causing headaches is usually attributed to the sulfates and sulfites it contains. But experts do not link migraine headaches to sulfates and sulfites alone. Other potential contributors in red wines include tannins, flavonoid phenols, histamines, and more.

In still more reports, researchers have found that white wine and other alcoholic drinks can also cause migraine episodes, and perhaps even more frequently than red wine. Compounding matters, many people who report having a migraine attack after an alcoholic drink (or drinks) say an episode is not a given every time they raise a glass. No matter the exact percentage of migraine episodes that occur after drinking — be those red or white wine or other alcoholic beverages — the truth is that any alcohol can cause a migraine.

Amount of Alcohol Consumption and Timing of Migraine

Even a small amount of alcohol can sometimes spur on a migraine attack. One member of MyMigraineTeam shared how many drinks they could have without triggering an episode. “I can usually handle one or two, but that is it,” they wrote.

Researchers suggest that any headache within about 12 hours of drinking alcoholic beverages may be associated with the consumption. Associated migraine headaches can occur immediately after drinking alcohol or a few hours later. In one 2018 study out of the Netherlands, 90 percent of the nearly 2,200 people with migraine in that country who reported attack symptoms after drinking alcohol said they experienced headaches in the 10-hour timeframe after drinking. About 30 percent of those people reported headaches within three hours of drinking.

People with migraine might confuse later-occurring headaches for regular hangover headaches, which are different from the migraine kind. Hangover headaches typically occur when blood alcohol levels go down or reach zero.

Alcohol and Stress

Stress is a common migraine trigger, and drinking alcohol can be a response to stress — and the cause of even more stress. It can become a vicious cycle: a person may drink because they are stressed (whether about migraine or otherwise). Then they become more stressed as a result, potentially worsening their migraine attacks or symptoms, and so on.

Alcohol and Migraine Medication

People with migraine who treat their attacks with certain drugs should avoid drinking alcohol because it may interact poorly or dangerously with their medications. When mixed with alcohol, the common migraine medication Topamax (topiramate) can cause dizziness, problems with memory, sleepiness, and even depression.

People who rely on nonsteroidal anti-inflammatory drugs (NSAIDs) to manage migraine pain should also be careful with alcohol. Drinking alcohol while taking NSAIDs can increase the risk of serious side effects, like gastrointestinal bleeding. The more alcohol consumed, the more the risk of these problems increases.

Anytime a person with migraine starts a new medication, it’s important you ask a doctor, neurologist, or pharmacist how the medication might interact with alcohol. If you aren’t sure whether your medication is compatible with alcohol, it’s best — always — to avoid drinking until you have more information.

Managing Alcohol and Migraine Symptoms

The best way to find out what triggers your migraine is to keep a journal. Track what you eat and drink, how much sleep you get, and other potential triggers (such as stress). Then record when your symptoms worsen. You may find that alcohol triggers your migraine, or you may see that alcohol has no effect on your symptoms. Once you know what effect alcohol has on your body, you can make decisions about whether to drink at all — and, if so, how much to drink and when.

It is also important to have open discussions about your alcohol consumption with your health care team. Your team will be able to alert you of any potential interactions between your migraine medications and alcohol, and they can help ensure you are approaching alcohol consumption safely. Be honest with your doctors about your habits and preferences. Remember, your health care providers want to work with you to make your symptoms as manageable as possible. Their intent is not to judge or shame you.

As you decide how alcohol may fit into your life with migraine, there are many factors to consider, such as the type of alcoholic beverages you drink, your other risk factors, and your neurologist’s recommendations specific to your medical history. Most importantly, monitor how you feel when you drink alcohol and be willing to have open and honest conversations about drinking with your doctor and other important people in your life.

If you really want to drink, you may want to find out if any types of alcohol are unlikely to cause symptoms. You can try sips (or other small amounts) of different types of alcohol to see how your migraine reacts. Keep in mind that you may have to deal with several migraine attacks before you can determine what kind of alcohol causes your symptoms. Given that, this may not be the best approach if you’re unwilling to trade discomfort for a personal “safe” list of beverages.

When Could Drinking Be Problematic?

Some people may feel that they can’t control their drinking, have negative feelings when they don’t drink, or generally feel that their alcohol consumption is negatively impacting their life. These may be signs of alcohol use disorder. If you feel as though you can’t limit how much you drink or if you continue drinking even though it’s hurting you or those around you, it’s time to talk to your doctor.

Whether you decide to continue with your current intake of alcohol, reduce your consumption of it, or eliminate it from your life altogether, it’s important to listen to your body and have open conversations about these topics with your health care team. Your trusted professionals are your best resource for getting medical advice when it comes to limiting the negative effects alcohol has on you, your life, and your migraine.

Find Your Team

If you’ve been diagnosed with migraine and you have questions about drinking alcohol or anything else related to the condition, it can help to talk to others who understand. On MyMigraineTeam, the online social network for people with migraine and their loved ones, more than 73,000 members come together to ask questions, give advice, and share their experiences with others who understand life with migraine.

Does alcohol seem to affect your migraine attacks and symptoms? Do you think you might react to certain alcoholic beverages more than others? Share your thoughts in the comments below, or start a discussion on MyMigraineTeam.

All updates must be accompanied by text or a picture.
Amit M. Shelat, D.O. is a fellow of the American Academy of Neurology and the American College of Physicians. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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