Wine Allergies: What Are The Symptoms, Causes And Treatment

American humorist James Thurber once revealed, “I used to wake up at 4 A.M. and start sneezing, sometimes for five hours. I tried to find out what sort of allergy I had but finally came to the conclusion that it must be an allergy to consciousness.”

Luckily, most of the time when we are allergic to something, we can figure out what it is. Maybe it’s something in our environment — cats, dust mites, pollen, cottonwood trees. Or maybe it’s something in our diet — peanuts, pineapples, wheat.

If you've ever experienced an unexpected reaction to a glass of wine, you're not alone. Wine allergies are real and sometimes puzzling issues. As we go through this guide, remember that it's all about making informed choices, especially for those considering reducing or quitting alcohol. Let's break it down.

All About Allergies

In a nutshell, allergies are misguided responses by our immune system to substances perceived as threats. These substances are met with the full force of our body’s defense mechanisms. The “culprits” could be pretty much anything: foods, plants, animal dander, and even certain chemicals.

The immune system responds to allergens just as it does to any “invaders” — in an organized and efficient way by producing Immunoglobulin E (IgE) antibodies to neutralize these supposed threats. This reaction triggers the release of histamine and other chemicals, leading to the allergic symptoms familiar to many.

Histamine causes inflammation in the respiratory and digestive tract and makes the blood vessels in these tissues dilate, leading to swelling. The way this defensive reaction shows up in the body can vary, affecting different systems and causing symptoms that can range from mildly irritating to downright dangerous:

• Skin reactions — including hives, itching, or eczema — are the most common response.
• Respiratory reactions range from sneezing and nasal congestion to asthma.
• Gastrointestinal effects are vomiting or diarrhea.
• In severe cases, a person might encounter anaphylaxis — a rapid, potentially life-threatening response that requires prompt action.

Why Do People Develop Allergies?

That, as they say, is the million dollar question! Nobody knows exactly why, but it’s probably a mixture of genetics and environmental factors.

Can You Be Allergic to Wine?

Yes! Just as any other food, wine can cause an allergic reaction in some people. Officially — according to the European Academy of Allergology and Clinical Immunology (EAACI) and the World Allergy Organization (WAO) — an allergy to wine is defined as a “hypersensitivity” and is distinct from “methanol intoxication” as well as from wine intolerance. In other words, being drunk on wine, being allergic to it, and being intolerant are three separate things.

Wine Allergy Symptoms

Just like any other allergy, a wine allergy involves the immune system. Here's what we might be looking at when it comes to wine allergy symptoms in particular:

• Some people will get mild respiratory symptoms, such as coughing and chest tightness. This could happen after a glass or two — or, depending on the severity, after a few sips!
• In those with asthma or similar conditions, wine can trigger breathing difficulties.
• Others might get more noticeable skin reactions — red, itchy spots or hives that are hard to ignore.
• Some might feel it more in their stomach as vomiting or diarrhea.
• Severe reactions could include throbbing headaches or wheezing — both potentially dangerous symptoms that should be taken seriously.
• As with other allergies, the most severe and potentially life-threatening symptom is anaphylaxis. Symptoms include difficulty breathing, weakness, fainting, and swelling of the mouth and throat area. Anaphylaxis is life threatening and demands medical attention — pronto!

Causes of an Allergic Reaction to Wine

Several ingredients or components in wine could be the culprits: sulfites, grapes, yeast, and proteins. However, if the ethanol itself is the problem, then — as previously mentioned — the issue is an intolerance rather than a true allergy, which involves an IgE-mediated response.

When Sulfite Allergy Is the Cause

When it comes to having an allergic reaction to wine, the most common cause is sulfites — a common preservative used in processed foods and drinks. While some sulfites are naturally occurring, others are added to keep wines fresh and extend their shelf life. Here’s a summary of their role in the winemaking process:

• Sulfites are used to preserve the wine's flavor and color by preventing exposure to oxygen, which can cause it to deteriorate.
• Sulfites also keep unwanted bacteria and yeasts out of the wine, ensuring it doesn't spoil or develop unpleasant flavors.
• By protecting the wine from spoilage and oxidation, sulfites help maintain consistency and quality across batches.

While sulfites are generally harmless to most people, they can cause problems for those with sulfite sensitivity or allergies. For one reason or another, their immune system responds to sulfites by releasing IgE into the bloodstream. The defensive protein then recruits other immune cells — basophils and mast cells — to douse the body with histamine as a protective response against the perceived “invader.”

A doctor or allergy specialist can help diagnose the condition and most likely will advise the patient to stay away from foods or drinks that contain sulfites. In addition to wine, there are a few other foods that are high in sulfites — an amount high enough that anyone with a sulfite allergy is usually told to stay away from:

• Vinegar 
• Bottled lemon and lime juice
• Instant tea
• Molasses
• Sauerkraut
• Grape juice
• Dried fruits

Those especially sensitive to sulfites will also need to stay away from dried potatoes, fruit toppings (including Maraschino cherries), gravies, and wine vinegar. Nevertheless, for those with a sulfite allergy, wine is definitely off the menu.

When Grape Allergy Is the Culprit

Grapes are the true heart of wine, but they can also be the cause of a wine allergy. Research shows that this is a lot more rare, yet case studies show that some people are, indeed, allergic to grapes — usually in combination with other fruits such as cherries or peaches. While some of the case studies reported mild symptoms — sneezing, runny nose, and the like — rare cases of anaphylactic shock caused by grape allergies have occurred.

The variety of grape, as well as individual sensitivity levels, can make a difference as well. Different types of grapes contain varying levels of proteins and allergens, and the winemaking process can also affect these levels. For example, the skin, seeds, and stems of grapes — where most of the allergens are concentrated — may induce a more severe allergic response. The process of making red wine involves using these parts of the grape, so those with grape allergies tend to be more sensitive to red wine. 

Diagnosing a grape allergy involves a few steps:

• Step 1. A doctor will typically start by taking a detailed history of symptoms and dietary habits — how often the patient drinks wine or eats grapes, and whether the reaction to both is similar.
• Step 2. If grapes are narrowed down as the prime suspect, skin prick tests or blood tests may be used to identify specific grape proteins that trigger reactions.
• Step 3. Temporarily cutting out grapes and grape products from the diet can help determine if they are, indeed, to blame for the allergy.

When Yeast Is the Reason

Next on the list of suspects? Yeast. It is a key player in the winemaking process, responsible for the fermentation process that transforms grape sugars into alcohol. Typically, once fermentation is complete, yeasts are removed from the final product. However, traces can remain, and these can be problematic for those who happen to be allergic.

As with grapes, symptoms can range from the more innocent skin or respiratory reactions to gastrointestinal issues or even anaphylaxis. Testing is similar as well — an elimination diet to narrow down the possible culprit, skin prick tests, or specific IgE blood tests to identify yeast as the allergen.

Those with yeast allergies may also have reactions to things like breads, beers, ciders, and fermented products such as soy sauce or kombucha.

When Protein Is the Problem

While we talked about the proteins in grapes and yeast as potential allergens, there are other types of proteins in the mix that could be the cause of the problem. 

Why would there be proteins in our wine in the first place, other than the ones found in grapes and yeast? As it turns out, some proteins — enzymes, to be exact — are introduced during the winemaking process as a way to enhance the wine’s flavor, clarity, and stability. Enzymes are naturally occurring proteins that catalyze chemical reactions. Here’s how they are used to improve various aspects of winemaking:

• Some enzymes help break down unwanted particles, leading to clearer wine.
• Other enzymes can release aromatic compounds, making the wine more flavorful.
• Certain enzymes can help break down complex sugars, aiding the fermentation process.

All of these extra proteins are harmless for most people. However, for those with a yeast allergy, they could be the dealbreaker that makes that particular wine a no-go.

Tannins: The “Red Wine Allergy”

As we’ve noted, red wine tends to cause more allergic reactions to white, and data back this up.

• A 2005 study in Respiration Medicine reported that out of all the survey respondents who reported having an allergic reaction to alcohol, 83% were referring specifically to red wine.
• A 2012 study in Deutsches Artzteblatt International showed that red wine was more likely to cause an allergic reaction than white wine.

One of the reasons red wine tends to cause more allergic reactions has to do with tannins, which are more prevalent in red wines. ​​Tannins are a type of polyphenol responsible for the astringent quality of wine — that dry, puckering sensation we might feel when drinking certain reds. Their complex nature means they can sometimes interact with proteins in the body, leading to allergic reactions or intolerances.

Alcohol Intolerance

Finally, let’s come back to a point we mentioned earlier — alcohol intolerance. The main culprit here is ethanol, the “pure alcohol” part of any alcoholic beverage. While ethanol is not an allergen in the traditional sense, it can cause adverse reactions in some people — reactions that can look a lot like allergies. Here are some of the most common symptoms:

• Face flushing
• Nausea and vomiting
• Rapid heartbeat
• Headaches or migraines

Unlike allergy symptoms, intolerance symptoms are caused by the process of alcohol metabolism. When alcohol is broken down by the liver, it’s converted into a toxic substance known as acetaldehyde before being broken down further into acetic acid. In some people, a genetic mutation leads to a faulty version of the enzyme that runs this process. As a result, acetaldehyde builds up in the system, causing the unpleasant symptoms. It’s often referred to as an “alcohol flush reaction” or sometimes “Asian flush” due to its prevalence in some East Asian populations.

Treating a Wine Allergy

To get to the bottom of wine allergies, here's what you might do:

1. Try to narrow down the root of the problem. To address the problem, you have to first figure out what’s causing it. To pinpoint what’s behind your allergy symptoms, try these steps:

• Talk to a pro. A visit to an allergist can clarify things and help you create a plan.
• Start a wine and food diary. Keep tabs on what you drink and how you feel afterwards. Also keep an eye on foods that contain yeast and grapes to spot any coinciding patterns that could point you in the right direction.
• Keep a record of your symptoms. Noting down your reactions can help identify patterns.

2. Read the labels and talk to the winemakers. If you manage to narrow down a specific ingredient behind your symptoms — such as sulfites, grapes, or yeast — read the labels carefully.

If you’re trying to avoid sulfites, look for wines labeled as "sulfite-free" or "no added sulfites." However, remember that all wines naturally contain some sulfites, so determine your sensitivity and find ones that work for you. Also, sometimes winemakers will know more than the label can tell you, so it never hurts to ask.

3. Try over-the-counter antihistamines. Over-the-counter antihistamines are a tried-and-true method for easing mild symptoms.

4. Consider allergy shots or other treatments. These approaches are much more serious and come with potential side effects, so they’re not usually the first resort. Still, allergy shots can retrain the immune response by exposing it to the “offensive” ingredient in small doses to stimulate a small response, but not enough to trigger a full-blown reaction (it’s the same principle used in most vaccines). There are also medications available — some experimental at this stage — that aim to retrain the immune system entirely in order to prevent the response altogether.

5. Look for alternatives. It’s always an option to explore other beverages — especially if you’re thinking of cutting back or are in the process of rethinking your relationship with alcohol. If that sounds like you, here are some ideas to try:

• Mocktails. You can never go wrong with a fun mocktail! There are mocktails for every season, including winter varieties with cinnamon and spices, cheerful spring creations, and refreshing heat-beaters for the summer. Plus, most bars have plenty of components for fantastic craft mocktails.
• Kombucha. If grapes are the issue, try kombucha! With names like “Cosmic Cranberry” and “Guava Goddess” (both from Synergy Kombucha), this fermented tea drink has enjoyed a recent revival and comes with many health benefits. (Of course, for those with allergies to yeast or sulfites, this would still be a no-go).
• Teas. There’s a whole world of fascinating teas out there, ranging from refreshing green jasmine or mint varieties to spicy chai.

Summing Up

While allergies can be frustrating to get a grip on, once you figure out what’s causing them, life gets easier. And if that means finding a creative way around certain foods, try to see it as an opportunity to explore!