Why does red wine make me feel sick?

Red wine isn't everyone's cup of tea

Drinking too much alcohol can give anyone a terrible hangover. But some people get sick after just a single glass of red wine, with symptoms ranging from an itchy rash and a wheezing cough to a pounding migraine headache. What makes wine so different? There's no easy answer: A handful of substances in wine, particularly red wine, can wreck havoc on the unlucky people whose bodies can't handle them. Here are the likely culprits behind your red wine woes, depending on your symptoms.

Pounding migraines

For those who experience debilitating migraines following a glass of red wine, the most likely culprits are congeners, says Leslie Bonci, a registered dietitian and sports nutritionist. These substances occur naturally in most types of alcoholic drinks, including red wine, and give the beverages their distinctive flavors. But certain types of congeners found in red wine, including ones called tannins, can make people who are already susceptible to migraines much more likely to get them. Fortunately, it's a pretty easy thing to recognize. But unfortunately, most doctors and nutritionists advise people who regularly experience headaches after drinking red wine to avoid it entirely. "If someone says 'Every time I drink red wine, I get a headache,' then they really should consider switching to white wine altogether," says Bonci. White wine doesn't contain the migraine-inducing congeners that are so prominent in red wine, she says.

Wheezing, coughing, and itching

In other individuals, wine can cause symptoms similar to those seen in food allergies—coughing, wheezing, and itchy skin rashes. A number of different substances found in all wine can cause these 'allergic-like reactions', Bonci says. Sulfites, which winemakers in the United States sometimes use to keep wine from spoiling, are often to blame for wine-induced sniffles. Sulfites are not only found in wine, but also in many types of foods. Parmesan and other aged cheeses are on the list, so sulfite-sensitive folks are no fun at wine and cheese gatherings. "For people who are sensitive to sulfites, they might notice wheezing and coughing, and might even get a stuffy nose," says Bonci.

But if you're getting an itchy rash or experiencing abdominal pain, then another allergen called histamine is the more likely cause. People with histamine allergies may even experience headaches, though probably not as severe as the migraines that can be triggered by cogeners, says Bonci.

Sulfites and histamines are found in all types of wine, red and white. But Bonci says there are some workarounds: "Organic winemakers tend not to add sulfites, so that's an option," she says. And sweet wines tend to have more sulfites in them, so choosing a dry wine is a safer bet.

Digestive issues

"Red wine is kind of the trifecta," Bonci says. Not only does it have histamines and sulfites, but it also has a protein found in grape skin called LTP. This protein gives red wine its color, but it might induce allergic responses in certain people which include flushing, and even diarrhea. While it won't kill you (or cause an anaphylactic response) it's extremely uncomfortable. "Drinking it really doesn't make a lot of sense," she says.

Moderation is key

Bonci says the most important thing to remember about wine intolerances is that the effects are often dose-dependent. This means the more red (or white) wine you drink, the more likely you are to experience some kind of reaction—and the worse it will be. A serving of red wine is about 5 ounces, Bonci says. But most people drink much more than that—a 6 ounce pour is standard at most restaurants, and wine glasses can hold a lot more if you're your own bartender.

In fact, red wine glasses are intentionally much larger than white wine glasses, because you want air circulating through the wine to open up the aroma and open up your pallet. This comes at a cost for those who have wine sensitivities. Some people who would be able to tolerate 5 ounces of red wine might frequently have their sensitivities triggered by a generous glass.

Bonci recommends getting out a measuring cup and pouring out 5 ounces—just to see what that amount of wine looks like—so you can know how much to pour yourself in the future.

At the end of the day, the rich taste of red wine may not be worth the cost of a nauseating headache or an itchy rash. Sometimes your best bet, Bonci says, is to just avoid it altogether.

For the red wine lovers among us, here are 50 great-tasting red wines under $20:

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50 great-tasting red wines under $20
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50 great-tasting red wines under $20

CLINE ZINFANDEL ($14)

Cline Cellars has been making rich and indulgent wines in the family tradition from Sonoma, California, since the 1990s. Its entry-level zinfandel offers plenty of ripe berry and spice flavor. It is smooth enough to enjoy on its own and powerful enough to pair with steak.

CRANE LAKE CABERNET SAUVIGNON ($6)

This California line represents one of the best values in domestic wines. The cabernet is round and smooth, with supporting notes of raspberries, blackcurrants, and hints of earth. It is a cheerful wine that suits any occasion, be it casual or fancy

BODEGAS LUZÓN VERDE ($8)

An organic wine from Jumilla, Spain, this all-purpose red has a medium body, flavors of spicy red fruit, and notes of earthy foliage, baking spices, and ripe red berries. Soft enough to be enjoyed without food, it also pairs well with grilled meats and hearty vegetables.

QUPÉ CENTRAL COAST SYRAH ($18)

This is an elegant wine with deeply concentrated flavors of black cherry, red plums, and spice-laden cassis. The Central Coast of California is known for producing wines of considerable heft, and this full-bodied wine is typical of the bold style.

FOXGLOVE CABERNET SAUVIGNON ($15)

Made from grapes sourced from different subregions within California's Central Coast, the entire Foxglove line is quick to sell out, thanks to its reputation for delicious, high-value wines. The cabernet sauvignon is typical of the region, with notes of currants and green bell pepper.

EMILIO MORO FINCA RESALSO ($18)

Emilio Moro is a well-known producer from the Ribera del Duero region of Spain, famous for powerful and luscious red wines that are best paired with hearty meals. This wine is in line with the traditional style, offering big flavors of chocolate, blackberries, and hot and sweet spices, with a long, velvety finish.

MULDERBOSCH CABERNET SAUVIGNON ROSÉ ($13)

From one of the most popular producers from South Africa, this cabernet sauvignon rosé has been a popular bottle since it was first released in 1999. It's a particularly full-flavored rosé with tons of berry and cherry flavors.

COLUMBIA CREST GRAND ESTATES CABERNET SAUVIGNON ($12)

Situated along the Columbia River in Washington state, Columbia Crest produces wines that have won awards from Wine Spectator, among others, and has a deserved reputation for excellence. This is a full red wine with plenty of spice and fruit.

CASTLE ROCK MENDOCINO PINOT NOIR ($12)

From Mendocino, California, this medium-bodied pinot noir is one of Castle Rock's top sellers and widely recognized as a good value in domestic pinot noir. The flavors include bright cherry, hints of violet, and plenty of earthy herbs. Delicious on its own, it would also pair well with duck or turkey.

CASAMATTA ROSSO ($14)

From producer Bibi Graetz, this juicy wine from Tuscany, Italy, is an old standby for inexpensive, high-quality red. Made from 100 percent sangiovese grapes, it has a tart and tangy profile full of red fruit and spice that is begging to be paired with red sauce, from pizza to lasagna to mushroom bolognese.

LINDEMAN'S BIN 40 MERLOT ($7)

Hailing from southeastern Australia, this cheap and cheerful wine is an all-purpose, easy-drinking red. Round and smooth, in true merlot fashion, it features ripe red berry flavors with some herbal notes underneath. Keeping a couple of these on hand for impromptu occasions is always a good idea.

RAVENSWOOD VINTNERS BLEND OLD VINE ZINFANDEL ($11)

Ravenswood is known for its zinfandel, which gets its powerful kick from the old vines from Sonoma, California. In this yearly release, flavors of blueberry, black cherry, chocolate, and spice are all rolled up into a velvety-smooth, full body. Open it on a cozy night by the fire.

MONTINORE ESTATE PINOT NOIR ($16)

Arguably the best value in Oregon's Willamette Valley, this entire line of wines is stellar. The pinot noir is a blend of styles, incorporating the elegance and lighter body associated with traditional European wines as well as the full flavor of cherries, flowers, and earth characteristic of domestic pinot noir.

LOUIS JADOT BEAUJOLAIS-VILLAGES ($12)

A tried-and-true classic, Louis Jadot's Beaujolais-Villages is a standard among wine enthusiasts. The medium-bodied red is full of plum, berry, spice, and earth flavors that combine to make a balanced wine. It is smooth and light enough to stand alone and plenty flavorful enough to go with food.

REGALEALI NERO D'AVOLA ($14) 

From producer Tasca d'Almerita in Sicily, this wine is one of many bottles proving that the Italian island is home to some of the very best wine values worldwide. The bright juicy wine is medium-bodied with considerable cherry and raspberry flavors. A long finish highlights the silky texture.

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TERRAZAS DE LOS ANDES RESERVA MALBEC ($18)

Argentinian malbec has become a darling of the wine world, and this example from Mendoza delivers on every expectation. It's a big, plush wine full of dark fruit flavors with undertones of chocolate and smoky earth. Enjoy it alongside hearty fare in cool weather.

CONO SUR BICICLETA PINOT NOIR ($10)

This all-purpose, medium-bodied red is made with sustainably grown grapes from Chile. The flavors are light and typical of the variety, offering hints of cherries and red berries. It works especially well chilled, in warm weather or with spicy foods.

BOB'S PINOTAGE ($9)

A South African specialty, the pinotage grape makes a hefty red wine that is earthy, spicy, and totally dry. This inexpensive bottle is a good, full-flavored introduction to the variety. Proceeds support HIV/AIDS awareness and research.

KINGSTON ESTATE CABERNET SAUVIGNON ($15)

This Australian wine has undertones of smoky berries, chocolate, and earthy herbs like rosemary. The texture is bold and soft, giving this full-bodied wine a velvety feel. It's meant to pair with roasts and steaks.

DINGAČ PLAVAC MALI ($15)

The plavac mali grape is a Croatian relative of zinfandel, offering many of the same flavors. This medium-bodied wine is perfumed with blueberries, mace, nutmeg, and juicy red fruit. Enjoy it on its own or with food, room temperature or chilled.

MARIUS GRENACHE SYRAH ($10)

This blend of syrah and grenache comes from Michel Chapoutier, a well-known producer of French wines from the Rhône Valley. A silky body unveils flavors of spicy berries, pink peppercorn, and wild mountain herbs. True to its European heritage, this wine is best served with food.

INDABA MOSAIC RED ($12)

Indaba is a consistently inexpensive and good-quality producer of red and white wines from South Africa. In this red blend, Bordeaux grape varieties create a supple, smooth, and rich wine with flavors of cranberry and baking spices.

BANDIT MERLOT ($10)

Packed in environmentally friendly Tetra Pak containers, this crisp and easy-drinking California wine comes in a liter size. That's 25 percent larger than a regular bottle, making the savings even more pronounced. The flavor profile is supple, round, and smooth.

BIG HOUSE RED ($10)

This juicy and powerful California wine gets its name from a nearby prison yard. The flavors are bright and concentrated, with tons of juicy cherry and raspberry flavors, hints of chocolate, and earthy elements that linger on the finish.

CHONO CABERNET SAUVIGNON ($11)

Chilean wine is becoming known for sophisticated flavors and low prices, and Chono cabernet is a good example why. This full-bodied red is laden with flavors of tobacco, cocoa, and black raspberries, with distinct green pepper notes coming through. This is the bottle for a steak dinner.

JELU MALBEC ($12)

Having a good go-to malbec is important, because it has become one of the most popular varieties in the United States. This example from an organic Argentinian producer delivers the full body, dark fruit flavors, and silky tannins that people have come to love in malbec.

BOGLE PETIT SYRAH ($9)

Petit syrah is a variety of grape that makes intense wines with a deep concentration of ripe plums and berry flavors along with considerable spice. This California version does not disappoint, offering all the typical flavors in an inexpensive bottle.

UNDERWOOD PINOT NOIR ($14)

Inexpensive pinot noir can be difficult to find from any country. This Oregon producer prides itself on upholding strict quality standards while creating an affordable, everyday wine. The pinot noir has flavors of cherries and flowers, a medium body, and a silky finish.

VRAC CÔTES DU RHÔNE ($12) 

Wines from the Rhône region in central France are known for being easy drinking and pairing well with a variety of foods. This one is a medium-bodied wine with juicy red fruit flavors, undertones of cinnamon, and a balanced, dry finish.

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CHÂTEAU MARIS OLD SCHOOL ($17)

This red blend from the Minervois region of France is a nice change of pace from many other inexpensive options. The flavors are bold and rich with notes of lilac and violets alongside ripe and spicy fruits. The producer's biodynamic practices add a lot of character.

GNARLY HEAD OLD VINE ZIN ($12)

A classic California producer, Gnarly Head has an entire line of wines made from old vines that provide depth of character and concentration. No matter what the vintage, this zinfandel is a full-bodied wine that leads with spicy blueberries and blackberries and notes of dark roasted coffee.

HEDGES CMS RED ($10)

In production since 1987, this blend from Washington state is a standby for delicious red wine at a good price. It's a structured, balanced wine with black and red fruit flavors, bright acidity, and a smooth, medium body.

LA VIEILLE FERME ROUGE ($8)

This medium-bodied, spicy, and fruity wine is an easy-drinking all-purpose red. Tasty on its own, it also pairs well with many types of food, from burgers to Thai. The blend of grapes from the Rhône region of France creates a smooth texture.

GOULEYANT CAHORS MALBEC ($14)

This medium-bodied wine from producer Georges Vigoureux comes from the homeland of malbec, in southwestern France. It is similar to malbec from Argentina but with a slightly lighter profile and a touch more elegance, rather than boldness. The flavors play between juicy blackberries and baking spices.

SAN FELICE IL GRIGIO CHIANTI CLASSICO ($19)

Chianti is one of those wines that will always be a classic. Whether it's for casual pizza night or homemade eggplant parm, this wine is an inexpensive go-to for Italian fare made with red sauce. The medium-bodied wine balances traditional flavors of cherries, spices, and earthy herbs.

IL FAGGIO MONTEPULCIANO D'ABRUZZO ($11)

From the Italian wine region Abruzzo, this is an easy-drinking wine that suits most any occasion. It's a crowd-pleaser with a medium body, flavors of red fruit, and hints of spice.

RED TRUCK CALIFORNIA RED ($10)

In this blend, five grapes from various regions in California come together to create a well-integrated and drinkable red wine. Flavors of red fruit and baking spices and a velvety finish characterize this anytime wine.

VERAMONTE MERLOT ($10)

The flavors of this soft wine from Chile are characteristic of merlot, offering ripe plum, blackberries, and a smooth, velvety texture. Hand harvesting ensures only high-quality grapes go into the wine.

PORTILLO MALBEC ($9)

Not all malbec from Mendoza, Argentina, is created equal, and the Portillo from Bodegas Salentein has been recognized as one of the top examples. Bold flavors of cocoa, coffee, and tobacco are complemented by juicy dark fruit flavors and a smooth finish.

LIBERTY SCHOOL CABERNET SAUVIGNON ($16)

This straightforward cabernet is spice forward, with elements of black peppercorn, menthol, and cinnamon all wrapped up in fine tannins that are satiny on the palate. This wine from Paso Robles, California, has been given high scores by Wine Spectator for its quality.

GEYSER PEAK CABERNET SAUVIGNON ($14)

Having made appearances on various lists for its quality and value, Geyser Peak sets a benchmark for inexpensive wines that taste good. The cabernet sauvignon is a blend of flavors, mixing blackberry preserves with herbs like rosemary and thyme and a hint of nuttiness on the back end.

WOLFFER ESTATE CLASSIC RED ($18)

This is one of the few New York wines that sells for less than $20 and maintains a high level of quality. A food-friendly red from a leading producer, it's rich with smoky cedar notes that mingle with the intense red fruit and overall smooth and dry palate.

FONTANAFREDDA BRICCOTONDO BARBERA ($12)

Barbera is one of the premier grapes from the Piedmont region of Italy. While most of the wines from this area are quite expensive, this juicy, medium-bodied wine allows drinkers to savor the flavors of the region for less.

D'ARENBERG STUMP JUMP SHIRAZ ($13)

When grown in Australia, the syrah grape is called shiraz and makes a richer, fuller wine than syrah from other areas of the world. This example is full-bodied and full of plush red and black fruit flavors, along with baking spices like cinnamon, nutmeg, and mace.

CANTINA ZACCAGNINI MONTEPULCIANO D'ABRUZZO ($14)

This traditional Italian wine still comes with a straw and twig decoration that people who have been drinking wine for 30 years will remember. With easygoing flavors of red raspberry, baked cherry, and herbal undertones, it's a crowd-pleasing choice for any occasion.

HESS SELECT CABERNET SAUVIGNON ($13)

This sturdy wine from California can be a workhorse during any season. The full body encompasses traditional flavors of red and black currants, blackberries, and hints of green peppers that are classic and balanced.

MEIOMI PINOT NOIR ($14)

A fuller style of pinot noir from California, this wine is for those who love the delicate floral and cherry flavors of pinot but want a rich and bold wine. The silky body continues to develop and unveil flavors of mushroom and earth as the bottle breaths.

NOVECENTO MALBEC ($9)

A classic Argentinian malbec from producer Dante Robino, this red is full-bodied, with smooth flavors of blackberry, black cherries, and juicy plums. Undertones of cocoa powder and hints of cayenne pepper keep the overall profile dry and well-matched for rich meat dishes.

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