Sept. 15, 2008 -- Cursed, blessed wine. Since ancient times, this drink has been simultaneously touted for its health benefits and blamed for its tortuous side effects.
A single glass with dinner may protect the heart, but it can send others into a wheezing attack with a bad headache, flushed face and runny nose.
"I, too, have experienced the stuffy nose after a glass of wine," said Sloane Miller, a food allergy coach and advocate, who is also president of Allergic Girl Resources Inc. in New York City.
Miller said the symptoms can get worse since she has found that wine frequently compounds her other food allergies. "It seems between the stuffy nose and the skin irritation that there's a reaction," said Miller.
Reports of wine allergy are usually relegated to symptoms after drinking a glass, but this Monday the U.K.'s Telegraph featured a teenager who reportedly falls into sneezing fits anytime she smells it.
"I only have to see a glass of wine and it sends me off which can be incredibly annoying for my friends, but it happens so often they have almost got used to it," Leah Miller told the Telegraph.
Leah's sneezing symptoms may be one-of-a-kind, but plenty of adults occasionally find themselves with pounding headaches and congestion from a glass.
Despite these common reactions to wine, allergists say a true wine allergy is a fluke at best, and a controversial misnomer at worse.
Allergy or Reflex?
"If you ask people if they have an allergic reaction to wine … about 8 percent of the population will say 'yes, alcohol will cause me to have an allergic reaction,'" said Dr. Marc Riedl, section head of Clinical Immunology and Allergy at the University of California in Los Angeles.
That study, which only looked at northern Europeans, might have reported even higher statistics in other parts of the world. A metabolic phenomenon called "alcohol flush reaction" is common among people of East Asian decent, and is commonly called an allergy.
Riedl and other allergists have heard the range of complaints: patients get headaches, they may get flushed, and they even get a runny nose. But they insist not all mucus that runs is an allergy.
"There are a handful of people reported in the medical literature who were allergic to something in the grape," said Dr. Brian Vickery, medical instructor in the department of Pediatric Allergy and Immunology at Duke University in Durham, N.C.
But a lot more goes into a bottle of wine than grapes. Take sulfites, which are commonly blamed for allergies. Vineyards add sulfites to wine to keep it from spoiling into vinegar too quickly.
Despite their notoriety, allergists say the chances of someone responding to sulfites are one in 100. Even when sulfites cause problems, doctors are debating whether it is technically an allergy.
"It's not an allergy, it's a reflex," explained Dr. N. Franklin Adkinson, professor at Johns Hopkins Asthma and Allergy Center in Baltimore, Md. That means wheezing and chest tightness similar to an asthma attack, rather than hives or the possibility of going into anaphylaxis with an allergy.
Especially among asthmatics, sulfites act as irritants to the nose and lungs in a similar way as cigarette smoke and perfume can.
"You're not really allergic to the cologne if you start sneezing," said Dr. Clifford W. Bassett, vice chair of the Public Education Committee at the American Academy of Allergy, Asthma and Immunology and a professor at New York University.
Whether sulfite sensitivity is technically an allergy or not, the statistic that just 1 percent of people actually react to sulfites prompts the question of what happened to the other 7 percent (or more) of the population who report allergic-like reactions to wine.
Bassett said an alternative explanation may be "oral allergy syndrome": a cross reaction between pollen in the air and a chemical in food can magnify any existing allergies. Among the culprits are banana, kiwi, melon and… grapes.
But wine experts have other words of wisdom to share about what lurks in our favorite bottle.
Much More Than Grapes
"Histamines -- that's probably the leading cause of reactions," said Tyler Colman, author of the blog drvino.com and the book, Wine Politics: How Governments, Environmentalists, Mobsters and Critics Influence the Wines We Drink.
Coleman said while most wines contain both sulfites and histamines, sulfites get more notoriety from the Tobacco Tax Trade Bureau's requirement that the presence of sulfites be designated on wine labels.
"A small fraction of the population reacts to sulfites -- that's why there's a government label," said Coleman. "But because it's there, everybody thinks, 'I'm allergic to sulfites.'"
Unlike sulfites, every person has the potential to react to histamines, although some may be more sensitive than others.
Histamines don't actually cause an allergy. Instead, they are the body's annoying byproduct of an allergic reaction, and the chemicals responsible for the sneezing, itching, congested symptoms.
"Histamine is more common in red wine," said Coleman. "But even the levels in red wine aren't all that elevated."
Colman explained histamine is only one of many "amines" in wine, and one of hundreds of other compounds that may come in contact with wine during processing. Lesser-known processing tricks include using egg whites and clay during the filtering process.
Coleman said that whether any of these compounds is responsible for reactions is still unknown.
"The TTTB is considering changing the labeling on wine to make producers list everything they use in the wine making process," said Coleman. "For a lot of producers, the list would have to be longer than it is right now."
"Wines that are produced in large quantities manipulate the wine a lot in the winery," Coleman said.
The histamine, sulfite and general wine allergy confusion has led many people Coleman meets to misdiagnose themselves with specific wine allergies.
"I knew one woman who said 'oh, I think I have an allergy to chardonnay,'" said Coleman. "Meanwhile she was drinking a glass of champagne which, in this case, was comprised mostly of chardonnay grapes."
Coleman said one way to tell if you truly react to sulfites would be to check with a bag of dried apricots.
"Ninety-nine percent of wines do have a drop of sulfur dioxide," said Coleman. "But sulfites appear in a much higher level in dried fruits." React to dried fruits, and you'll be more likely to react to wine. Miller tested positive to the fruit test.
"If I open a package of Dole dried apricots and if I'm standing over a package when I open it, my chest tightens," said Miller.