Do tannins in red wine exacerbate hangover symptoms?

Tannins in Red Wine and Hangover Severity

Tannins in red wine are not the primary cause of hangovers, but they may contribute to hangover symptoms through their astringent properties and interaction with proteins in the body.

Mechanisms of Alcohol Hangover

Alcohol hangovers are complex physiological events with multiple contributing factors:

Primary Causes of Hangovers

• Ethanol itself is the main source of hangover symptoms 1, with congeners playing a secondary role
• Dehydration occurs due to alcohol's diuretic effect, though recent research suggests this is a co-occurring but independent consequence of alcohol consumption 2
• Congeners (minor compounds other than ethanol) present in alcoholic beverages contribute to hangover severity

Role of Tannins and Other Congeners

Tannins are amphiphilic molecules with specific properties that may contribute to hangover symptoms:

• Red wine contains higher levels of congeners compared to clearer alcoholic beverages like vodka 1
• Experimental studies have shown that beverages with higher congener content (like bourbon) result in more severe hangover ratings than beverages with essentially no congeners (like vodka) 1
• Tannins interact strongly with proteins, particularly proline-rich proteins in saliva, which explains their astringent (dry mouth) effect 3
• These protein-binding properties may interfere with normal physiological processes during alcohol metabolism

Why Red Wine Hangovers Can Feel Worse

Red wine hangovers may feel particularly severe due to several factors:

• Tannin-protein interactions: Tannins bind to proteins in saliva and potentially throughout the digestive tract, affecting normal physiological functions 3
• Phenolic compounds: Red wine contains various phenolic compounds that may trigger inflammatory responses in some individuals 4
• Congener content: Red wine contains negligible AGE (Advanced Glycation End-products) content but does contain 0.5-1.8 mg/l of MGO (methylglyoxal) 4, which is a reactive carbonyl compound

Physiological Effects During Hangover

During a hangover, several physiological changes occur:

• Increased cardiac work with normal peripheral resistance
• Diffuse slowing on electroencephalography (affecting brain function)
• Increased levels of antidiuretic hormone 5
• Hormonal alterations and dysregulated cytokine pathways 5

Hangover Prevention and Treatment

Prevention Strategies

• Hydration: While water consumption during or after alcohol consumption has only modest effects in preventing next-day hangover 2, maintaining hydration is still recommended
• Moderation: Limiting alcohol intake is the most effective prevention strategy
• Food consumption: Consuming fatty foods while drinking may reduce tannin absorption, as tannins bind preferentially to lipid droplets in food (the "camembert effect") 3

Treatment Approaches

• Rehydration: Though not a complete solution, it helps address the dehydration component
• Prostaglandin inhibitors (anti-inflammatory medications)
• Vitamin B6 supplementation 5

Clinical Implications

Hangovers have significant societal costs:

• In the United States, related absenteeism and poor job performance cost $148 billion annually 5
• Patients with hangover may pose substantial risk to themselves and others despite having a normal blood alcohol level 5
• Hangover may be an independent risk factor for cardiac death 5

Recommendations for Alcohol Consumption

The American Heart Association recommends:

• No more than 1 drink per day for women
• No more than 2 drinks per day for men 4
• People with hypertension should avoid alcoholic beverages 4

Remember that while moderate alcohol consumption has been associated with some cardiovascular benefits, the ideal situation for health is to not drink at all 4.